Foot Orthotics

Foot Orthotics help stabilise and correct poor foot posture. LOC specialises in the manufacture of precision, custom-made insoles. Foot pain is often misdiagnosed because of the complexity of the foot itself. The foot and ankle combined contain 26 bones – one quarter of the bones in the human body – with over 100 muscles, tendons and ligaments working in conjunction. These parts work together to support, balance and make the body mobile. A malfunction in any one part can create problems elsewhere in the body, such as the back, hip or knee.

Very often the pain can be globalised over the foot, therefore it can be difficult to pin down exactly what the problem is and that’s where we come in. We look at the areas of the foot closely during a biomechanical assessment and take the time to find a more specific diagnosis. If we diagnose a biomechanical foot problem, insoles represent a non-invasive approach to treatment.

At our Kingston clinic, we offer an express orthotic insole service which takes two hours from initial assessment to manufacture and fitting. We open late on Monday, Tuesday and Thursday evenings until 19:00 to accommodate people who would like their express service outside working hours.

Biomechanical Problems

The feet often suffer from increases in pressure on foot structures and the surrounding soft tissues, creating localised pain in the foot and ankle, as well as problems in the lower limbs, knees, hips and back.

Correction of poor foot biomechanics can improve and prevent many types of symptoms.  Flat feet are arguably one of the most common conditions regularly treated through foot orthotics techniques.

 

The Solution

The aim of a foot orthosis is to correct dysfunctional biomechanics and therefore:

  • reduce pain;
  • provide support;
  • prevent or halt the development of foot deformity;
  • provide better positioning;
  • relieve pressure on a certain area of the foot;
  • improve the overall biomechanical function of the foot;
  • improve pelvic alignment;
  • reduce lower limb torsion and knee stress. 

This allows joints to be aligned correctly and promotes efficient transmission of biomechanical forces.

At LOC, we believe in a holistic approach to any biomechanical problem. We understand that the underlying problem may not always be located around the area of the body where symptoms develop. In some cases, the problem may lie in a number of areas, such as poor posture, pelvic malalignment, leg length discrepancies, tight or poorly-toned muscles. We can use foot orthotics to improve posture and accommodate for any limb length discrepancy; they can be designed to fit in many types and styles of slim fitting shoes. However, if your specific foot problem makes footwear fitting difficult, we can advise upon the different types of footwear that are available and even make bespoke footwear to your individual requirements.

For cases where bespoke insoles are not considered to be the correct treatment option, we would look at alternatives, such as proprioceptive insoles. Poor posture can have a knock-on effect on vulnerable parts of the body, particularly the back. LOC can provide a complete posture assessment and can fit Proprioceptive Insoles to correct poor posture.

 

CONDITIONS TREATED:

The posterior tibialis tendon attaches the calf muscle to the bones on the inside of the foot. Its main function is to hold up the arch and support the foot when walking. It is therefore one of the most important tendons in the leg and any dysfunction will cause problems. If the tibialis becomes inflamed or torn the tendon may not be able to provide stability and support for the arch of the foot resulting in flat feet.

Symptoms

The most common location of pain is along the course of the tendon itself which travels along the back and inside of the foot and ankle. There may be swelling in addition. The pain is likely to be more severe with activities such as running.
In reaction to the collapse of the foot the heel bone may shift and this can put pressure on the outside ankle bone leading to pain in this new location.

Causes

An acute injury such as a fall can tear the posterior tibial tendon. The tendon can also tear due to overuse. High impact sports like tennis, basketball or soccer may cause tears due to repetitive stress.

Treatment

Initial treatment may require rest and immobilisation. To help the tendon to rest and for any swelling to go down a cast or walking boot may be prescribed for 6-8 weeks.

Following this period of rest bespoke insoles are the most common non-surgical treatment for those who present with moderate or severe changes to the shape of the foot.

In addition an ankle brace can be used to support the joints of the back of the foot and reduce tension in the tendon itself.

Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the kneecap. It is sometimes referred to as Runner’s Knee and is the most common running injury. However non-runners can suffer from it, particularly office workers who spend a lot of time sitting at a desk.

Symptoms

The most common symptom of Patellofemoral pain syndrome is a dull, aching pain in the front of the knee. The pain usually increases gradually. It can be associated with activities that repeatedly bend the knee such as climbing stairs or running. Or at the other end of the scale it may be noticeable after sitting for a long period of time with your knee bent like when on an aeroplane. Occasionally sufferers report popping or cracking sounds in their knee when climbing stairs or when standing up after a long period of sitting.

Causes

In many cases patellofemoral pain syndrome is caused by overuse, any activity that puts repeated stress on the knee, or it may be triggered by an increase in physical activity. There may also be mechanical factors at work – abnormal tracking of the kneecap in the trochlear groove – which causes the patella to be pushed out to one side of the groove.

This will irritate the soft tissues surrounding the patella.

There may also be problems with the alignment of the limbs between the hips and the ankles or muscular imbalances especially in the quadriceps muscles at the front of the thigh.

Treatment

If there is a biomechanical dysfunction, a detailed assessment of the lower limb mechanics should be carried out to determine whether bespoke insoles will help to provide optimum alignment and function, reducing stress at the patellofemoral joint. 

Metatarsalgia is the name given to pain in the front part of your foot under the heads of your metatarsal bones – the ball of the foot. It is not a specific disease itself rather a symptom of other problems with the foot. It is most common in middle aged females.

Symptoms

Quite simply the primary symptom is pain usually made worse when standing, walking or running. It usually comes on gradually rather than suddenly. Some have described the pain as akin to walking bare foot on pebbles.

Causes

Metatarsalgia can be caused by a number of different conditions:

  • Overuse – runners may put extra stress on the metatarsal bones
  • Having a stiff ankle or Achilles tendon – can affect the way that pressure is distributed around the foot leading to extra stress on the metatarsal heads
  • Morton’s neuroma – a fibrous growth of the nerves that run between the metatarsal bones which can cause pain in the metatarsal region.
  • Claw foot (pes cavus) – a very high arch foot which does not flatten when you plant your foot. Most people with pes cavus also have a neurological condition such as cerebral palsy, spina bifida or polio. Extra stress is placed on the ball of the foot.
  • Shortened 1st Metatarsal- this can cause more weight to be distributed on the 2nd metatarsal head.
  • Hammer Toe or claw toe deformity – again extra stress is put on the ball of the foot
  • Diabetes – can cause damage to the nerves in the feet

Treatment

Bespoke insoles for shoes/trainers will help to relieve pain in the foot by reducing the pressure placed on the metatarsal heads, will improve foot function and protect the ball of the foot.

Charcot’s foot or Charcot disease takes its name from Jean-Martin Charcot (1825-1893) who was the first to define and describe the degeneration of the joints caused by the condition .Charcot Foot is a progressive, degenerative condition that affects the joints in the foot. The bones in the foot can be weakened enough to fracture with the joints collapsing.

Causes

Charcot Foot develops as a result of neuropathy (nerve damage), which decreases sensation and the ability to feel temperature or pain – a significant risk factor for those with diabetes.

Symptoms

The symptoms of Charcot Foot may include:

  • Apparent generation of heat, the affected foot will feel warm to the touch
  • Redness of the foot
  • Swelling of the foot
  • Pain or soreness

Treatment

Early diagnosis is vital. If the condition is caught in time non-surgical intervention can help bones to heal and prevent future problems. In the early stages a cast or boot can be prescribed. At LOC we prescribe Aircast boots with bespoke insoles to reduce pressure at the plantar surface of the foot and promote healing. This treatment will reduce swelling and protect the bones. Healing can take 3 months or more.

After this initial healing period, a customised boot or diabetic shoe may be recommended. These shoes are designed to decrease the risk of developing ulcers and to prevent recurrence of the condition.

Aircast

Plantar Fasciitis (known also as Policeman’s Heel) occurs when the plantar fascia ligament along the bottom of the foot develops tears in the tissue. It is the most common heel pain condition. Around 1 in 10 people will develop the condition at some time in their life.

Symptoms

Most sufferers complain of a burning, stabbing or aching pain in the heel of the foot. It seems to be particularly acute when getting up and putting pressure on the ligament. Due to heel stiffness climbing stairs can also be difficult.

Causes

The plantar fascia ligament absorbs significant weight and pressure and an ‘excess’ of physical activity or exercise may overload the ligament. Active men and women between the ages of 40 and 70 are most at risk of developing Plantar Fasciitis. Long distance runners are particularly prone.

Arthritis is another common cause as certain types of arthritis can lead to inflammation to develop in the tendons. This is most common in elderly patients. Diabetes is also a factor that can contribute to foot damage.

An individual’s gait may also be a causative factor, as flat feet, high arches and pronation all may cause the fascia ligament to tear and become inflamed. A tight Achilles tendon can affect one’s ability to flex the ankle making it more likely that the plantar will be damaged.

Treatment

Bespoke Foot Orthotics or insoles help to reduce pain and promote healing by offloading the plantar fascia as the patient walks.

Bespoke insoles may be prescribed to address any underlying bio-mechanical dysfunction such as over pronation which may be the root cause of the Plantar Fasciitis.

Night splints may also be worn; these work by keeping the fascia stretched to promote healing.

Hammer toes are a painful deformity of the three middle toes where the toes are always bent.

There are two types – flexible and rigid.

If the toe can still be moved at the joint, it’s termed a flexible hammer toe. If the tendons in the toe become rigid, the joint will be moved out of alignment and the toe will not be able to move, thus it’s known as a rigid hammer toe.

Symptoms

Visually a toe that looks like it is stuck in an upside-down ‘V’ position is probably a hammer toe. Other symptoms include:

  • Pain at the top of the bent toe when putting on footwear
  • Difficulty in moving the toe joint with associated pain when doing so
  • The toe joint itself swelling
  • Corns forming on top of the toe joint

Causes

There are a variety of causes. Hammer Toes have been linked to:

  • Footwear that’s too tight in the toe box which means that the toes cannot lie flat
  • An injury like stubbing or breaking a toe can trigger the condition
  • Imbalance of the toe muscles
  • Second toe longer than big toe
  • Some medical conditions like arthritis and diabetes can be contributory factors

Treatment

If your toe is still flexible bespoke insoles will reduce pain and keep the condition from getting any worse. In addition, bespoke footwear can be made to accommodate hammer toes ensuring some measure of comfort when walking or standing.

Sesamoiditis is a painful foot condition caused by the inflammation of the sesamoid bones which are a pair of tiny bones.

Their function is to act as a fulcrum to hold the tendons away from the joint in the big toe.

Symptoms

The most common symptom is pain experienced when walking and strongest when the body weight transfers onto the toes. Pain is felt at the base of the big toe.

Causes

Osteoarthritis of the sesamoid bones is the most likely cause in older patients. Osteoporosis is another factor as it weakens the bones. In younger adults the condition is most likely to have been caused by a traumatic event to the sesamoid bones or repeated stress over time. High heels can place an increased stress on the forefoot and activities like athletics and dancing can trigger the condition.

Treatment

Bespoke insoles are prescribed to offload the sesamoid bones allowing them to heal quickly and completely.

Orthotic Insoles are a good preventative measure to take if your age or activity puts you at risk and they should be used to prevent any recurrence of an existing condition, ensuring that the bones and muscles in the foot are properly aligned and the feet cushioned.

A bunion, medically known as Hallux Valgus, is a deformity of the big toe. A painful, bony lump develops on the joint at the base of the big toe. More than 15% of women in the UK suffer from bunions.

Symptoms

The primary symptom of a bunion is when the big toe starts pointing to the other toes on the same foot. Other symptoms include:

  • Pain and swelling over the big toe joint
  • A bony lump on the outside edge of the foot
  • Changes to the shape of the foot which make it difficult to find footwear that fits
  • When the big toe overlaps with the second toe, hard and callused skin will develop in the affected area

Causes

Although it is popular to blame footwear for the condition, it is more likely that bunions are caused by a defective bio-mechanical structure of the foot; they are therefore a genetic condition. However it is true that poorly fitting footwear will aggravate the problem.

Treatment

Provided the cause of the bunion is due to an underlying bio-mechanical reason bespoke insoles are a relevant and appropriate treatment.

Heel Spurs are tiny protruding calcium deposits that can develop near the base of the heel bone; this is a process that takes many months to develop. The heel spur itself does not cause the pain, it is the soft tissue surrounding it that becomes inflamed.

Symptoms

Heel spurs often have no symptoms but can be associated with both chronic and intermittent pain. The pain is often described as like a pin being stuck into the bottom of your foot when you first stand up in the morning. The pain then becomes a dull ache.

Causes

Risk factors for heel spurs include:

  • Walking gait abnormalities which place excessive stress on the heel bone
  • Shoes/trainers that do not provide enough arch support
  • Excess weight and obesity
  • Running or jogging frequently on hard surfaces(road running generally)

Treatment

Bespoke insoles can be prescribed to rectify any gait abnormalities which result in bio-mechanical misfunction.

Shin Splints is the general term to describe exercise-induced pain or tenderness along the inside of the lower limb but can also be felt centrally along the front of the shin. They are very common amounting to over 10% of injuries associated with running. The most common cause of shin splints is medial tibial stress syndrome (MTSS).

MTSS is a result of frequent or intense periods of exercise when a person’s body is not necessarily used to it. Long-distance running and sports involving a lot of stopping and starting increase the risk of getting MTSS.

Although shin splints is primarily an overuse injury it is often related to an individual’s foot mechanics and the subsequent effect on muscles in the lower leg during stance phase.

A detailed biomechanical assessment is therefore key to the successful treatment of shin splints. Bespoke insoles are appropriate if there is a mechanical deficit, excessive pronation can cause medial shin pain while excessive supination can cause lateral shin pain.

INSOLES AND FOOTWEAR

Bespoke Insoles

At our Kingston clinic, we offer an express orthotic insole service which takes 2hrs from initial assessment to manufacture and fitting. We offer this express service late on Monday, Tuesday and Thursday evenings until 19:00. If time is of the essence, call us to book your slot.

Widget - Footwear

We are highly experienced in making complex plaster casts, scanning and taking foot measurements for shoes and boots. In addition, as part of a continuous drive to use the latest technology to improve our service, we can take a 3D scan of your foot.  

Insole FAQS

You may have seen our video with Alan explaining the fundamentals of insoles and their benefit for both adult and paediatric conditions. For more understanding, common questions about custom/bespoke insoles, how they work and how they are made, visit this page.

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