Posture & Back Pain

The London Orthotic Consultancy (LOC) was the first clinic in the UK to specialise in the treatment and prevention of poor posture and back pain using bespoke Proprioceptive Insoles.

LOC’s specialist clinicians will take a detailed history of the patient’s current symptoms and past medical history before undertaking a thorough investigation to uncover the root cause of an individual’s symptoms. The assessment will identify the patient’s posture type and areas of high muscular tension.

The resulting prescription is unique to every individual and the insoles will stimulate your body to correct postural misalignment; you should notice an immediate improvement as the insoles are being fitted for the first time.

 

Back Pain

Back pain is very common, and, according to the National Pain Audit, the costs of back pain alone account for 20% of the UK’s total health expenditure. It is the greatest cause of time off work in the UK. It is difficult to diagnose the exact cause of an individual’s back pain. However, a contributing factor is poor posture because it means the body is less resistant to the strains we put on our body during our lifetime.

Poor posture can result in the following:

  • postural back pain;
  • abnormal muscle tension;
  • muscle imbalance;
  • joint mal-alignment;
  • general muscular aches and pains.

If back pain persists, or if you suffer from chronic back pain, it is worth investigating whether your symptoms are caused by poor posture. At the initial consultation, your body will be scanned to identify areas of spinal and pelvic mal-alignment and abnormal muscle tension. The London Orthotic Consultancy was the first clinic in the UK to use the DIERS 3D Back Scanner.

The London Orthotic Consultancy’s treatment for back pain caused by poor posture is Proprioception Therapy.

Back Pain Diagnosis

The DIERS Formetric 11 Plus scanner is the world leader in optical 3D measurement systems for the back and spine. The London Orthotic Consultancy (LOC) was the first clinic in the UK to use one.

The scanner provides a fast, contactless and radiation-free measurement of the back surface and spine. It will identify any problem areas of:

  • pelvic torsion and mal-alignment;
  • spinal rotation and curvature;
  • abnormal muscle tension.

It is used in our clinic to diagnose postural problems and analyse the effectiveness of neuromuscular proprioception therapy for poor posture and related back pain. It provides repeatable objective measurements.

FAQS:

An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.

They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.

If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.

If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.

We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.

An AFO is an Ankle Foot Orthosis which as the name would suggest encompasses the ankle and foot. The objective is to control the position and movement of the ankle. AFOs are used to support weak limbs; they can also be used to immobilise the ankle and lower leg to correct foot drop. When set up correctly they can also have a great influence on the knee and hip joints. They are the most commonly used Orthoses.

The length of time that one needs to wear an AFO very much depends on the condition being treated. If it is a long-term condition like cerebral palsy or post-polio syndrome it is likely to be years as the condition cannot be cured. Your orthotist will advise you.

A patient’s comfort in their AFO is vital for compliance with the prescribed wearing regime.

So there are a number of steps the orthotist should take to ensure a comfortable fit: the patient’s heel should fit fully into the heel cup without excess space, the contours of the plantar surface of the AFO should match the patient’s foot, for children there needs to be up to half an inch growth room in the toe shelf length. At LOC we use our Gait Laboratories at our Kingston and Manchester clinics to fine-tune our bespoke orthotics.

A GRAFO is used to control instabilities in the lower limb by maintaining proper alignment of limbs and controlling their motion. It reaches around to the front of the knee extending down to the ankle. It works by altering a patient’s limb presentation to displace load and impact as well as offering further control to the knee.

The cost of an AFO is dependent on the type of AFO that has been prescribed and the material that it has been made with. Carbon fibre will be more expensive than metal or plastic for example. LOC’s bespoke AFOs cost can be found on our Orthotic Prices page.

The ability to drive while wearing an AFO is dependent on the condition being treated and the orthosis that has been prescribed. If wearing a hinged AFO, for example, you will be able to drive, but if wearing a knee brace, you won’t. Your orthotist will advise you.

The most flexible type of AFO is a Dynamic Ankle Foot Orthosis (DAFO).  It is thin and provides flexible support to the foot and ankle.

Both normal AFOs and DAFOs improve static balance (eg: while standing). Research among MS sufferers suggests that DAFOs aided balance while walking more than AFOs.

The simple answer is: yes they can. However one has to be sensible and look for wide-fitting trousers/jeans preferably of light and thin material.

Typically an AFO is stiff and rigid whereas a DAFO is thin, flexible and wraps around the patient’s entire foot. A DAFO provides support but also allows some range of normal movement.

A Supra Malleolar Orthosis SMO gets its name from the part of the body it encompasses. Thus an SMO supports the leg just above the ankle bone or malleoli. It allows dorsiflexion and plantar flexion(toes up and toes down) but eliminates mediolateral movement.

It typically takes a few weeks but is slightly dependent on the chosen materials and current availability.

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