Treatment: Foot Orthotics
About 3 out of 4 people will suffer foot pain at some time in their lives. Problems with your feet, as well as sore legs and knees and even back pain, are often caused by your leg alignment and the way you run, walk and stand.
Foot Orthotics is a medical solution to correct and support the foot’s bio-mechanical weaknesses. Common foot and leg problems treated include heel pain, shin splints, knee pain and Achilles Tendon Injuries.
Core Concepts uses the medical range of the Formthotics System.
The Formthotics System
The human foot is uniquely different, in structure and function, from the feet of other animals including the primates. It provided a basis for stable and efficient bipedal gait and thus freed the hands for the manipulation of the environment with tools. It could be argued that the genetic mutations that produced the structure of the human foot began our evolution to become Homo Sapiens, the dominant species on this planet.
We have become so successful at manipulating our environment that we have replaced the natural walking surfaces on which we evolved and lived for millennia with hard, flat, level ones that our feet must pronate and flatten to adapt to.
The identification of flat feet as a physical abnormality became recognized in the 19th and 20th centuries and, in 1907, Dr. Whitman recommended the fabrication of contoured steel arch supports for its correction. These Whitman Plates were based on the notion that the anatomy of the feet that had served us so well in the past was somehow defective and needed static support. This assumption is still widely held today.
In the 1960’s American Podiatrist Dr. Merton Root and colleagues adapted the principles of biomechanics to the prescription and fabrication of devices that could improve the mechanical efficiency of foot and leg function in gait. His theoretical model, published in two volumes entitled Clinical Biomechanics, appeared to be so scientifically derived and presented that it became widely accepted and presented as a scientifically valid method, the Podiatric Model. Despite abundant evidence to the contrary many Podiatrists still believe that this model is valid and evidence based. Numerous studies of the efficacy and method of action of Foot Orthoses have been published in the last ten years and they almost unanimously conclude that, although Foot Orthoses are effective in treating many musculoskeletal conditions, the Podiatric model is not scientifically valid. Some authors have suggested that a new model should be developed to better explain the efficacy of Foot Orthoses. The Podiatric model describes a number of structural deformities of the feet and legs, which result in malalignment and mechanically inefficient gait when standing, walking or running on flat level surfaces. It proposes a method of taking a plaster cast of the foot (in a position called the Neutral Subtalar Position) and measurements of the deviation of the rearfoot and forefoot from a theoretically “normal” alignment. This plaster replica of the foot and the measurements are then used in the fabrication of corrective device made from hard materials. It is presumed that these Balanced Orthoses will improve the biomechanical function of the foot and leg during gait.
A new model is proposed, which includes the biomechanical concepts of the Podiatric model but expands on them in the light of theoretical and scientific information that was not available when Dr. Root developed his model.
This new model, called the Formthotics System™, is based on a different paradigm, in that the walking surfaces and footwear of our modern civilization result in dysfunction of the foot and leg. The following table describes some of the differences between the two models.
|The Podiatric Model||The Formthotics System Model|
|Abnormal Anatomy||Abnormal Environment|
|Normal foot and leg||Individual Foot and Leg|
|Structural Deformities||Dysfunction of Normal Structures|
|Correction of Deformities||Improvement of function|
|Prescriptive Model||Diagnostic-Therapeutic Model|
|Device Determines results||Response determines results.|
|Biomechanical||Neuro-motor and biomechanical|
|Lab Device||Clinical Device|
|Balanced Orthotic theory||Total Contact Theory with posts|
|Joint Restriction||Joint Mobilization|
|Motion Control||Motor Pattern Alteration|
|Hard Materials||Softer materials|
|Therapist Centered||Patient Centered|