Orthotics: Are they for you?

Elevate podiatrist Russell Stokes gives the lowdown

People wear orthotics to correct injuries, alleviate joint stress and to relieve overall pain

If you have painful feet, suffer heel pain or knee pain , or have experienced the discomfort of stress fractures, shin splints or neuromas (nerve impingements) in one or both your feet, you may find orthotics greatly relieve the pain and discomfort you’re feeling.

Elevate’s resident podiatrist, Russell Stokes, sees a lot of runners and physically fit people in his practice – nevertheless, mainly because of congenital preconditions, insufficient strength or general ‘wear and tear’ after years of running and exercise, some of his patients wear orthotics to correct injuries, alleviate joint stress and/or to relieve overall pain.
According to Stokes, ligament laxity (or loose ligaments, in lay language), pronation (or fallen arches) and supination (or underpronation) are all common problems that affect a person’s gait – and can ultimately lead to injury, pain and musculoskeletal problems.

Supination, Stokes explains, is when a person’s foot fails to roll inward sufficiently after landing. This places extra stress on the foot and can result in iliotibial band syndrome of the knee, Achilles tendinitis, or plantar fasciitis, the most common cause of heel pain.

“Runners with high arches and tight Achilles tendons tend to be supinators,” says Stokes, himself a runner. “The supination creates a chain reaction of biomechanical events, with external rotation of the leg, decreased pelvic tilt, and a straighter than normal spine,” he explains.[1]
Stokes says in cases like these, orthotics can often greatly reduce discomfort and pain. “Everyone is built differently,” says Stokes. “However, many of my patients have found that orthotics help enormously.”
Current evidence-based theories, says Stokes, suggest that the presence of orthotics produce adjustments in the muscular response of the locomotor system[2].

Quite simply, when the foot strikes the ground a force is transmitted through the shoe into the lower extremity. This produces a neural signal that is transmitted to the spinal cord and then up to the brain for processing.

From there a signal is sent back down to the muscles of the body, including those in the foot and leg, as to how they should respond to this force in order to optimize the mechanics of movement.

Orthotics adjust the muscular response

The use of orthotics produces adjustments in this muscular response, explains Stokes. The first is that orthotics help to stabilise the joints; the second is they minimise soft tissue vibrations that occur as a result of the force when a foot hits the ground.

Orthotics, quite simply, function by altering the incoming input signal and ‘tune’ the muscles for the task at hand. Properly fitted, they can reduce muscle activity; add comfort; and increase athletic performance.

Stokes says orthotics also help athletes to run better, faster, longer. “Scientific studies suggest that between 70% and 80% of athletes respond positively to orthotics as a treatment for a variety of injuries.”[3]
When it comes to recommending the best running or cross-training shoes, Stokes believes light shoes with orthotics custom-fitted to a person’s gait are preferable to heavy running or walking shoes with in-built “padding”.

Does this mean that orthotics suit everyone?

Absolutely not, says Stokes. “As an athlete, you should seek out a practitioner who is properly trained in sports injury management to properly assess your biomechanics in order to help you determine your need for an orthotic and how it should made.
“You should also have everything explained to you so that you can be confident in the treatment plan. By doing so, you can ensure proper fit, comfort, and possible enhancement in your performance at your next event.”

BREAKOUT:
ORTHOTICS: WHAT TO EXPECT
Assessment: Takes roughly 45 minutes, and 10 working days for custom-fitted orthotics
Material: Carbon fibre that is light and flexible where needed
Price range: $90 to $450
Health care rebate: Yes
Longevity: 2 to 5 years
Maintenance: See your practitioner every two years to check on your orthotics’ efficacy
Recommended shoe brands to accommodate orthotics: Lightweight without too many stability features built into the shoe

[1]http://www.runnersworld.com/running-shoes/supination-explained
[2]http://www.sportsperformancecentres.com/articles/interest/Orthotics_and_Performance_Enhancement.pdf
[3]http://www.footankle.com/Orthotic-Research.htm

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