May Articles 2014

What Are Ankle/Foot Orthotics?

Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.

Biomechanics in Podiatry

Biomechanics and its related study deal with forces that act against the body and effect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot itself, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.

Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet and limit the mobility everyone takes for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area, all effecting the way you move around on a daily basis.

The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root claimed that changing or controlling the forces between the ankle and the foot, corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of thermoplastic foot orthotics to this day.

As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can not only take readings, but also map out what treatment will do to the affected areas.

These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics is able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot, so speaking with your podiatrist if you have any of these problems is highly recommended.

Getting Back into Sports after Foot and Ankle Injuries

One of the most common injuries that athletes suffer from is a sprained ankle, a very painful and frustrating problem. A sprained ankle usually causes one to avoid participating in sports, and once someone has sprained their ankle, they are very likely to sprain it again.

To get back into sports after a sprained ankle, one should follow the RICE method, which is consistently recommended by physical therapists and sports medicine doctors. The RICE method involves rest, ice, compression, and elevation. If one follows the RICE method soon after experiencing a sprained ankle, he or she will likely get back to the playing fields in no time. In addition to using the RICE method, an athlete should wear an ankle brace after experiencing a sprained ankle to help alleviate the pain and keep the ankle safe until it heels. A brace will also help to stabilize the ankle, and prevent serious injuries in the future. Many times, people suffer from sprained ankles due to weak ligaments near the ankle; because an ankle brace keeps the ligaments in the foot from moving too much, it will help someone avoid this injury.

Fractures in the foot and ankle are another common type of injury athletes suffer. Stress fractures typically occur in the bones of the forefoot. An athlete will usually experience stress fractures if he or she partakes in a sudden increase in athletic training. A stress fracture can be either stable or displaced. A stable stress fracture involves no shift in bone alignment, while a displaced stress fracture involves bone ends that no longer line up.

After an athlete has a stress fracture in the foot, he or she will immediately need to see a doctor. Rest is usually the key to treat this problem. One will have to refrain from any strenuous activities or the sports that caused the injury. A doctor or specialist may be able to pinpoint the specific part of an athlete's training that caused the stress fracture. If this is possible, then an athlete will not have to worry about refraining from his or her sport in the future; he or she will simply have to stop training in such a way that an ankle or foot injury results.

The key for any athlete is to care about the treatment process for an ankle or foot injury. Athletes need to rest and take time before hitting the fields. The more an athlete invests in the treatment and recovery process, the more likely he or she will be able to return back to normal athletic performance.

Effect of High-Heels on the Feet

Women have been wearing various kinds of high-heels for hundreds of years, mostly for aesthetic reasons. Shoes with heels make their wearer appear to be taller and to have longer and thinner legs, and change the wearer’s gait and posture. High-heels’ association with femininity have kept them popular over the years, but there are definite health problems caused by wearing high-heels too frequently.

High heels also limit the motion of the ankle joints as well when they are worn. The ankle is a very important joint in the body when it comes to walking. These joints have a great deal of weight put on them because of their location. This is why it is so important to keep them as healthy as possible. The main tendon in the ankle is the Achilles tendon. Studies have shown that wearing high heels often causes the calf muscle and Achilles tendon to shorten, and stiffens the Achilles tendon as well, which can cause problems when shoes without heels are worn.

By forcing the toes into a small toe box, and putting a great deal of pressure on the ball of the foot, high-heels can cause or worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis. 

Wearing high-heels regularly, especially very high ones, can have long term negative effects on many other parts of the body, as well as the feet. One of the most important joints in the entire body, the knees, can be affected by wearing high heels. Wearing high heels causes the knees to stay bent at all times. It also causes them to bend slightly inward as well. Many doctors believe that constantly walking like this is the reason that women are so much more likely to suffer from osteoarthritis later in life. High-heels also cause increased stress on the knees by limiting the natural motion of the foot during walking.

The back may also be negatively affected by high heels because this shoe style causes the back to go out of alignment. This affects the spine’s ability to absorb shock, and can cause continued pain in the back if high heels are worn constantly. High-heels also compress the vertebrae of the lower back, and can cause overuse of the muscles in the lower back.

This is not to say that high heels should never be worn. They will not cause serious problems if they are worn only occasionally. However, they should not be worn every day in order to avoid long term physical health problems to the feet, knees, ankles and back.

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