HOW SHOULD WE USE FOOT ORTHOTICS?
As Pedorthists, we are in a profession that is assigned the responsibility to assess for and treat clients with orthotics when necessary.
Orthotics have been a treatment approach for lower extremity issues since the 1950’s. From the late 80’s to present, orthotics have grown in popularity to the point where they are now readily available to many due to being an insurable treatment option.
Finding out if orthotics are a good option, why, and for how long they should be used for are the reasons many clients come to SoleFit and other pedorthic clinics. However, not all clinics or practitioners share the same strategies and viewpoints when treating clients, thus there are many different arguments for and against orthotics.
SYMPTOMS AND SOLUTIONS
As a clinic, we have always felt our primary responsibility to a client is to help them understand why they may be experiencing a problem. What are the causes? What is at the root of the problem? To do so equips the client with a better understanding of how to go about addressing the cause.
Pain or discomfort is generally the most prominent symptom we hear. However, we don’t simply treat the symptom—we address the cause.
Think of it this way: If you get chronic headaches or suffer from poor sleep, your instinct might be to take Advil or a sleep aid. However, this would only address the problem in the moment. It would not bring you closer to understanding how to prevent that headache or insomnia. The same thing happens when we look at pain and injury in other areas of the body: We can get stuck on the symptom.
We don’t simply treat the symptom—we address the cause.
The same thing happens when we look at pain and injury in other areas of the body: we can get stuck on the symptom. When someone has back pain, we could immobilize the back by wearing a brace and quickly reduce the pain. But, if we took off the brace without addressing what caused the pain, we often would be back to square one.
Therefore, as pedorthists, we feel our principle responsibility is to identify the cause behind a problem. Understanding the cause is where we can attempt to reverse engineer the problem and determine the solution.
Invariably, if orthotics are a part of this solution, it is likely to address a ‘shortcoming’ in the foot’s function. Several underlying reasons might be at play, such as damage from injury, poor footwear choices, muscular weakness, tissue restriction, or atrophy.
Our exceptionally-designed feet balance our body’s posture and position, so they deserve detailed analyses. This is often the first place we try to support when problems arise. Thus, our footwear can become integral to ‘brace’ the foot in effort to change movement patterns.
In addition, ideally we should always consider improving foot support and structure naturally. This would include improving toe alignment, arch tissue strength, and ankle, knee and/or hip stability and mobility.
We talk at length in our assessments about how potent a change it is to improve joint mechanics via mobility work and stretching, or the long term benefits of building strength or stability where it’s lacking. Improving foot strength alone is a significantly influential option to improve many conditions requiring pedorthic care.
Below we have put together a list of 10 healthy exercises to help create stronger and more natural feet.
10 STEPS TO HEALTHIER FEET
Free your feet from the confines of your modern, fashionable shoes as often as possible. When sitting at work, take OFF your shoes. Cramped feet get tight around all the 33 joints that otherwise would give you a supple, adaptable foot. Shoes should ideally be shaped like our feet: wide and splayed at the toes. Owning at least one pair of properly fit shoes and choosing them most of the time is a great idea. See our video on minimalist casual shoes here. A few brands to consider are Vivobarefoot, Lems, and Leguano.
It's all too common to see toes develop bunions, hammertoes, and calluses from poorly shaped footwear. To uncramp the toes and align them to their natural shape, let them splay and point straight! Our toes are five levers that engage our arch and the entire foot to create a functional foot. Toe socks, corrective spacers and mobility exercises help to restore poor alignment.
Toe spacers like Correct Toes and Wild Toes, can go a long way to improving the alignment of your toes. Even toe separator socks like Injinji can help to make a difference.
Proper posture from the neck down is best achieved with a flat heeled angle. However, modern shoes with elevated heel positions cause many feet to become dysfunctionally dependent on the heel being raised. Slowly adapt your body over time to being barefoot or in flat heeled shoes. Listen to your body and progress slowly for long term benefit.
Like a toddler taking their first steps, we count on feeling the ground with the nerves in our feet to input sensory information to the brain. Our vestibular and proprioceptive systems are stimulated through our bare soles. Just like knitting with oven mitts would hardly tell us what to do with our fingers, overbuilt and stiff shoes shut down the signals our feet use as messengers to everything above. Engage your bare feet or use thin shoes when possible to get as much information as possible to the neuro-muscular system. This yields greater stability, balance, coordination and agility.
Trophic means to feed or nourish and therefore atrophy is the absence of nourishment. Atrophy to muscles or range of motion occurs when we don’t engage our tissues often enough. Sitting requires very little action from muscle or joints due to an absence of load or motion. We tighten up, lose circulation and tissues weaken. This causes degradation of function in our feet and creates problems when we do want to move. Change your seating position and work setup, or try getting down on the floor to sit in different positions for variety throughout the day.
Varied textures in surfaces allow our joints more ‘bandwidth’ to explore movement. Let your feet explore grassy hills, tiny pebbles, warm sand, and other surfaces to prevent overdosing on flat, artificial surfaces.
Humans are designed to move frequently at slow speeds. Due to increased sitting and limited time to exercise, many people only move if they are exercising, which can be too intense when that’s the only movement being performed. Walking is low impact and highly effective at stimulating our circulation while loading weight on our bodies safely. There is no ‘upper limit’ to walking, but rather do ‘as much as you can’. Don’t underrate the power of this activity for strong feet and longevity!
Joints require space to move through the range of motion they operate with, and they need motion to allow fluids to pass through them. It’s how joints stay healthy. To mobilize the foot’s 26 bones and 33 joints, just grab a lacrosse ball or Yoga Tune Up Ball. Place this under your foot, and roll out each foot daily. This will unravel the tightness in your feet and give your feet more ‘freedom’ to move. Just 1-2 minutes of rolling through the arches and around the toes can do wonders when done regularly!
Our feet are dynamic springs that can store an exceptional amount of energy in ligaments, muscles and fascia. When these tissues are restricted or atrophied, they lose the ability to act as springs. Try loading the feet by doing balance drills, changing pressures, light hopping, or walking on your toes. This helps engage the tissues in your feet and improves your feets’ ability to function. Exercises like ‘short foot’ and ‘foot tripod’ will help you stabilize your feet via the arches and toes .
On a car, the rubber meets the road with its tires but the wheels don’t steer themselves! The driver controls the direction of the car with the steering wheel. Similarly, our feet respond to steering from the hips and core. Control from the hips is vitally important, but so many individuals have poor movement and restrictions or strength . Once the control from our hips is lost, our feet compensate just like a car being pulled to the side by bad steering. Working out the hips with joint range of motion work or daily yoga is a monumental step towards strong and functional feet!
AN OUNCE OF PREVENTION, A POUND OF A CURE
Sometimes the easiest solution is the most attractive one, and often it is the best first step. Orthotics, bracing and taping can help achieve that quick fix. However, we don’t want to ignore the deficiencies that caused the problem in the first place. Regularly making time for the above suggestions can help in the long term to create a fix that will stand the test of time.