Problems can be caused throughout the body (including pain in the neck, lower back and hips) by foot and ankle issues that affect your posture (how you stand) and the way you walk.
Persistent soreness in the lower back, hips or knees, can indicate and be caused by problems in the toes and feet or also by inappropriate footwear choices. We are here to help with practical advice (within the constraints of your work/lifestyle).
An orthotic is a device that sits in your shoe to control the functions of the foot whilst walking. It can be made from a cast to specifically fit your foot or we can provide (and apply simple adjustments to) a core range of insoles that have different shapes to address different issues.
The important point is that an insole, if indeed you need one, is individually selected to suit your needs and your foot shape. Different people will have different requirements and your two feet may have different needs. Like glasses, you may find that insoles are recommended for specific activities or only when wearing particular types of footwear. Used inappropriately, they can be a cause of your pain rather than a cure.
Also, don’t assume that just because you have needed insoles in the past, that is necessarily still true as your body and gait will evolve as you get older. The type or strength of insole might need to change over time as you grow, recover from an injury, or in response to changes in your lifestyle and body – this is particularly true for women during pregnancy.
Simply picking a random insole off the shelf in a shop risks making the problem worse or creating other issues. Different orthotics are suitable to different foot types, varying in firmness, depth and location of support as well as in size. We can offer different options to suit your budget whilst giving you the advice and help you need.
All of the conditions described below can result from poor posture, walking style or foot structure. If you are getting these pains then by undertaking a biomechanical assessment we can try to identify the problem and provide you with suitable help to alleviate it.
Please also ask about our leaflet on choosing shoes, as poorly fitting or the wrong shape of shoe can often lead to problems. Our leaflet provides some practical advice on picking footwear that will be better for your feet without sacrificing your individual style.
What will happen at a biomechanics assessment?
Biomechanics is a part of podiatry that analyses the structure and function of the bones in your feet and legs. Primarily it assesses the muscles and joints and how they act when you walk and move.
We will assess your gait (your walking pattern) and posture and determine how best to support you. We generally prefer to fix foot and ankle issues where we can in order to give you natural mobility, rather than relying on artificial support if it isn’t necessary.
- The assessment will last approximately 30 minutes.
- Please bring a pair of shorts/loose clothing so that we can view your lower leg in action.
- You will be assessed sitting, standing and walking
- Please bring a well worn pair of trainers/shoes with you.
- Following your assessment you will be given advice on footwear, stretching and strengthening exercises, and whether you would be expected to benefit from orthotics.
Conditions we can help with orthotics
Heel/Arch Pain – Heel Spur / Plantar Fasciitis
Heel pain occurs when the plantar ligament beneath the foot is constantly pulled and strained due to the foot collapsing into pronation or supination. This causes a condition called plantar fasciitis or heel spurs. Many different foot types that can be affected by this condition and it can aggravate all areas of the foot including the heel, inner or outer arch and even the ball of the foot.
Bunions are caused by excessive weight being forced through the outside of the big toe joint. The pressure can cause the big toe to start to turn inwards causing a lump to form on the outside of the toe. This can become very sore, lead to a burning sensation and look unsightly. Accurate orthotics cannot cure a bunion, but will realign the foot and thus reduce pain and prevent the bunions becoming worse.
Ball of the foot – Metatarsals
Pain and symptoms occurring in this area are usually due to a drop in the metatarsal heads which form the metatarsal arch in the ball of the foot. This can lead to metatarsalgia (a general pain in this area), Morton’s Neuroma, March fractures, corns and calluses.
Shin Pain / Shin Splints
Pain in the shins is usually a result of shin splints. This is caused by poor foot biomechanics resulting in the pulling of the muscle (Tibialis anterior) which runs between the bones in the lower leg. A relatively common sports injury, you may find this is normally aggravated when running and can instantly affect your training or hobbies.
Pain in this area can be caused by a misalignment of the main joint of the foot (subtalar joint). This misalignment can lead to instability of the ankle and can cause pain in either side of the ankle.
Achilles Pain – Achilles Tendonitis
An instability in the main (subtalar) joint in the foot can push the foot into a flatter position (pronation). This in turn forces the calf muscles to work harder to attempt to keep the foot in a neutral position. Since the Achilles tendon attaches onto the calf muscle and heel bone this can result in a constant pull and lead to inflammation of the Achilles (Achilles tendonitis). The Achilles can be slow to heal so this condition can be extremely debilitating.
Knee Pain – Patella-Femoral Syndrome
Pain which is localized to the front or inside of the knee is normally caused by over pronation of the foot (flat feet). The foot can then cause the knee to internally rotate resulting in a misalignment of the knee cap. This leads to irritation of the Patella Tendon known as Patella Tendonitis or Chondromalacia.
Hip Pain – Piriformis Syndrome
Pronation of the foot (flattening of the arch) can have an effect on the knee, causing an internal rotation. This can have an impact on the muscles that support the leg. In some cases this can lead to a pain in the outside of the thigh (Ilio Tibial Band syndrome) and into the hips (Piriformis syndrome).
Lower Back Problems
Lower back pain can often be a result of poor foot function and can occur if a patient has a condition known as Ankle Equines. Ankle Equines can cause a hyper extension of the knees and a forward tilt of the pelvis. Lower back pain can also occur from other biomechanical imbalances of the feet such as pronation and supination.
We also offer Foot and Joint Mobilisation as part of our Biomechanics Assessment and treatment regime.
Joint and soft tissue mobilisation can be used to treat acute and chronic pains, restrictions and instability in the foot and lower limb. Soft tissue mobilisation involves movements to massage and stretch specific soft tissue structures including ligaments, fascia, muscles and their tendons. This can be used to improve strength and function or elasticity in these structures. Following injury, scarring and interlocking of muscle fibres can reduce the gliding motion in a muscle. Working into these structures can improve ranges of motion and help to re-activate a muscle. This can be used alongside acupuncture in achieving similar results.
Joint mobilisation works by gently working a joint close to its end range of functional movement and establishing an eventual improvement in motion. This improvement can be in range or quality of motion. Mobilisation is patient friendly, usually pain free and does not involve adjusting or forcing any joints past comfort. Within the foot, it is best used in mobilising smaller joints with minimal ranges of motion, for example fibula shift, subtalar drift and midfoot rotation. Mostly, these joints do not have a huge range of motion, but restriction in them can cause an overall change in the foot’s function.