Foot Conditions

 

INTRODUCTION TO ORTHOTICS

An orthotic is best described as an appliance or device, which can control, help, or correct biomechanical or structural abnormalities of the foot and lower limb. Left untreated, these often lead to sore feet, shin pain and lower back pain. Orthotics are used extensively for correcting abnormal posture and related problems, such as high arch and bunions, and there are quite a few different types of orthotic devices available. The three basic types of orthotics are : Rigid, Semi Rigid and flexible.

Rigid Orthotics

Rigid orthotics are made from a variety of plastics or fibreglass. They can range in thickness depending on the prescription. 

Semi rigid Orthotics

Semi rigid orthotics are also made from a variety plastics or fibreglass but these are generally thinner and more flexible than rigid orthotics.

Flexible Orthotics

Flexible orthotics are designed and manufactured using many different types of materials. As the name 'flexible orthotics' suggests, they generally provide more cushioning than rigid or semi rigid orthotics and can be very useful in the sports industry for their shock absorbing capabilities.

The type of orthotic device needed depends on the problem or pain occurring and where the problem exists. For example, symptoms of shin pain, bunions, a high arch, or general sore feet would all be treated differently.

Orthotics are used extensively and have extremely good rates of success when used for improving biomechanical abnormalities, enhancing posture, joint position and performance, reducing pain and prevention and speedy recovery from sports injuries. Orthotics are effective means of both treatment and prevention.  As described earlier, orthotics are used for the correction of biomechanical and structural abnormalities of the foot and lower limb.  Orthotics can correct a range of biomechanical problems that often hinder your daily routines. The following is a basic overview of some of the conditions that orthotics can be used for.

Conditions;

Pronation
A complex triplane motion that consists of abduction, eversion and dorsiflexion of the whole or part of the foot.  This causes the whole or part of the foot (flat foot) to collapse towards the ground in static stance or in gait.

Supination
A complex triplane motion consisting of adduction, inversion and planter flexion of the whole or part of the foot.  This causes the whole or part of the foot to weight bear on the lateral side of the foot giving the impression in some cases of a high arch.

Both the above conditions can lead to many lower limb problems including shin pain and sore feet, and can be assisted or corrected by orthotics.

Treatment

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BUNIONS

A bunion is a deformity of the metatarsophalangeal (MTP) joint of the big toe in which the metatarsal bone shifts inward, away from the rest of the foot and the big toe shifts outward, towards the other toes. This results in a "crooked" big toe. As a result, the tissues around the MTP joint can become irritated and painful

Treatment

The treatment of bunions should be based upon the amount of pain because the degree of deformity. The most important ways to treat and prevent bunions are:

if the above measures are not successful, surgery may be required.

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HALLUX RIGIDUS

This condition causes the big toe joint (Hallux Joint) to feel stiff and hard to bend.  It can cause pain on movement of the toe or with standing or pressure.  It is often caused by osteoarthritis or from injury to the joint itself.

Treatment

if the above measures are not successful, surgery may be required.

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METATARSALGIA

Literally meaning 'pain in the toes', it is a broad description of any pain felt in the metatarsals. The pain can be dull or sharp, constant or intermittent. Often it can feel like you are walking on pebbles or glass - there can be tingling or pins and needles and in many cases calluses under the ball of your feet. Some people describe the pain in their sore feet as something like a burning under the ball or whole sole of their feet.

Causes

This condition is commonly found in

  • High impact sports
  • Ballet dancers
  • Field sports and running due to the constant impact on the forepart of the foot
  • High heels
  • Incorrect fitting shoes
  • Pointed toe shoe
  • Collapsing of the metatarsal arch

Treatment

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METATARSAL STRESS FRACTURES

A stress fracture is generally an overuse injury. It occurs when muscles become fatigued or overloaded and can not absorb the stress, shock or repeated impact. Fatigued muscles transfer that stress to the nearby bone and the result is a small crack or fracture, in the bone. One of the most common stress fractures is shin splints, which cause varying degrees of shin pain.

Symptoms: The pain from a metatarsal stress fracture is usually felt on the top of the foot, over the affected area. The pain can be dull or sharp, constant or intermittent. Pain can persist even while resting. There may be tenderness and swelling over the stress fracture.

Treatment

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MORTON'S NEUROMA

(Interdigital neuroma)

Morton's neuroma is an enlarged nerve that usually occurs in the third interdigital space, which is between the third and fourth toes. (Morton’s Neuroma can occur anywhere in between the digits but is most common in between the 3rd and 4th toes)

Symtoms

  • Pain or numbness in the space between their third and fourth toes
  • A painful lump can sometimes be felt between the third and fourth metatarsal bones
  • Properly fitted shoes
  • Pebble feeling in shoes

Treatment

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SESAMOIDITIS

The sesamoids are two bone-like structures that are found under the Hallux joint. When irritated they can cause irritation and/or inflammation of the tendons and tissues surrounding the Sesamoid bones of the foot. It is generally an overuse injury from excessive activities such as jumping, running or prolonged standing.

Symptoms

  • Pain under the head of the first metatarsal bone
  • Tenderness and sometimes swelling can also be present in this area
  • Pain when walking or bending the joint

Treatment

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PLANTAR FASCIITIS

Heel pain (Heel Spurs, Plantar fasciitis)
Is the irritation or inflammation of the plantar muscle anywhere along the muscle body from either the attachment site to the calcaneus or the insertion points at the toes.

Generally pain can be felt under the heel itself or into the arch, sometimes the pain is described as being worse in the morning or after rest but can be consistent during the day.  Heel pain is caused by inflammation of the soft tissue that attaches to the bottom of the heel, and is often linked to abnormal function of the lower limb or foot. This can be either a structural or muscular weakness or imbalance.  It is also caused by consistent impact to the heel area in such fields of sport such as netball, basketball or any other high impact sport.

Causes

  • It is a condition caused by excessive wear to the plantar fascia of the foot
  • Incorrect biomechanics of the foot i.e. Pronation or supination
  • Tight calf muscles or Achilles Tendons

Symptoms

  • Gradual onset of dull, intermittent heel or arch pain
  • A sharp continuous pain through the arch or in the heel area
  • The pain is most often noticed on rising in the morning or after periods of rest during the day
  • Pain that increases with activity or during the day

Treatment

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SEVER'S DISEASE (CALCANEAL APOPHYSITIS)

Sever's disease (calcaneal apophysitis) is the term used to describe inflammation and/or irritation of the calcaneal apophysis. This condition often occurs before or during the growth spurt in boys and girls, or shortly after they begin a new activity. Sever's disease is common in running and jumping sports.

Treatment

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ACHILLES TENDONITIS

This refers to the inflammation or irritation of the Achilles tendon at its site of insertion to the calcaneus. It can occur anywhere from the top of the calcaneus to mid way up the calf.

Symptoms

  • Swelling
  • Tender to touch
  • Pain with movement such as stretching

Causes

  • Tight calf muscles and Achilles tendon
  • Overpronation (feet rolled in)
  • Supination (feet rolled out); a high arch in the feet.
  • Poor footwear
  • Activities such as jumping, running, or even walking can cause undue stress on the Achilles tendon.

Treatment

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TIBIALIS POSTERIOR TENDINITIS

Tibialis posterior tendinitis is the term used to describe irritation or inflammation of the tibialis posterior tendon.

Symptoms

  • Dull, intermittent pain behind the medial malleolus or in the inside arch of the foot.
  • Reduction in activity
  • Tenderness and swelling is often found along the course of the tibialis posterior tendon.

Causes

  • Physical activity such as running, lunging or jumping.
  • Overuse
  • Prolonged standing
  • Footwear
  • Pronation
  • Tight calves or Achilles tendons
  • Injury or trauma to the area

Treatment

*   Ice, Compression, Elevation

** Please consult your medical practitioner

 

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