How do I Know if Custom Foot Orthotics Could Help?

Quite often while I’m walking to my office from Union Station I notice horrible ankle/foot mechanics of fellow commuters walking in front of me. In fact yesterday I was cringing as I watched the man in front of me walking. His left ankle was bucking inwards so severely you could see major wearing of the inside heel of his shoe (it is actually normal to have a little more wear on the outside of the heel – not the inside). I had an overwhelming urge to stop him and find out if he knew how badly his biomechanics were. I chickened out at the last second for fear of offending or scaring him. Unfortunately this scenario happens far too commonly. The sad truth is – most of these people with poor ankle/foot mechanics are totally unaware of the toll this is taking on their body.

Effects of Poor Biomechanics

Most often, as the example cited above, the poor ankle/foot biomechanics result in overpronation. Less common is the opposite movement of oversupination (rolling outwards – usually present with a high arched individual). Typically overpronation occurs because of low or collapsed arches. The arches may get lower as you age due to gravity, tissue stretch, loss of muscle, injuries such as ankle sprains, and other factors. Because of the lack of arch support, your feet may buckle inwards when you walk. Other then causing stress on the ankle and foot – this can change the mechanics of your entire ‘kinetic chain’. Think of the kids song: ‘the knee bone is connected to the … leg bone’. What I’m referring to is that changes in your feet and ankle can greatly affect other areas of your body. For instance – the buckling inward of the feet can put more stress on the inside of the knee joint, cause muscle imbalances in the thighs/hips and even contribute to back pain. Common conditions may include:

• Foot Pain (plantar fasciitis, heel spur, bunion)
• Shin Splints
• Achilles Tendonosis
• Low Back/Hip/SI Joint pain
• Iliotibial Band (ITB) Syndrome/Patellofemoral Pain (runner’s knee)

Exercise Could Make it Worse

If you already have poor mechanics walking – imagine how much more stress your putting on the body if you were doing an activity such as running which can increase forces by many times your body weight.

What to Do?

See a Podiatrist, Chiropodist, or Chiropractor and have your gait (how you walk) assessed. There are different methods to examine gait. I do a combination of a visual scan, a couple quick orthopedic tests, and a computerized GaitScan. This assessment takes around 20-30mins. A few stretching and strengthening exercises are usually recommended along with advice on which shoes might be a best fit for your foot.

Shoe Inserts

If you are deemed to have faulty ankle/foot mechanics then a custom foot orthotic may be suggested. This is an insert made specifically for your foot that you can put into your shoes to provide the support you are lacking. There are many types of orthotics depending on what shoes you want them in. There are Running, Sport, Casual, Dress, Workboot,  Golf,  and many other styles. Most patients with health benefits will have the cost of the orthotics covered by their plan.

Other Options

Other than the custom foot orthotics which are the best in my opinion are ‘off the shelf’ inserts. These can be found at drugstores with an obvious drawback – they aren’t customized to your foot shape. You can also purchase shoes that provide some correction. For instance – if you are an overpronating runner – you could buy a ‘motion control’ shoe.

What About Barefoot Running?

A current trend is ‘barefoot running’ or purchasing shoes with minimal to no support (such as 5 toe style shoes). I believe  choosing to run barefoot is likely aright assuming your not running on concrete or other hard surfaces and you have good ankle/foot mechanics. Those with poor ankle/foot mechanics should avoid these options. If you insist on barefoot running some studies indicate it is best if you land on your toes/forefoot to help reduce the forces as opposed to landing on your heel like most do when donning running shoes.

So if you think you may have foot/ankle issues or flat feet please get checked or you may be creeped out when I approach you on the street and make a comment about how you walk! 🙂