The foot contains 26 bones, 33 joints, and more than 100 muscles, tendons and ligaments. A compromised foot structure is a major perpetuating factor in the development of chronic musculoskeletal pain throughout the body.
Having dysfunction just in the big toe can be responsible for plantar fasciitis, Shing splints, knee pain, hip problems and low back pain.
When you look at it from this perspective a lot should go into getting fit for an orthotic, otherwise they can actually cause some of the problems they are purported to fix!
For those of you with orthotics or thinking of getting them here are a few things to consider.
A thorough examination of your lower kinetic chain, including the feet, ankles, knees, hips and low back. This should include
*Range of Motion
*Muscle Strength
*Muscle Recruitment patterns
*Gait Analysis (a video of how you walk)
*Joint function
*Along with balance and proprioception
With the information collected it can be determined if the foot is functional or dysfunctional. If it is determined that an orthotic is needed a NON-weight bearing cast should be taken. Weight bearing casts show you what the problem or compensation is, why would you want to cast someone in their pathology and perpetuate it?
Machines that have you stand on a scanner to map out the foot may seem legit, but patients rarely see the long term benefit when the orthotic is casted in such a way.
Even with the preferred method of casting, the patient should still be given the appropriate exercise prescription. Shoe recommendations may also be discussed as different foot types require certain characteristics.