Everyone’s foot type is unique. Each person’s own two feet are similar, but not completely symmetric. Just as the majority of the population has some degree of vision impairment – ranging from subtle difficulty with reading to complete blindness – varying degrees of imperfections exists in most feet. Vision impairment is not simply ‘accepted’, rather it is corrected via glasses, contacts, or surgical intervention to ensure a high degree of function and improve quality of life. A small percentage of the population has an ideal foot structure without any abnormality. It is much more common for people to have feet that deviate from an ideal foot structure. Some people may go throughout their life without foot pain and thus no concern is raised. Dr. Peterson and Dr. Keeler see patients everyday with foot or ankle pain. Often the root source of the pain stems from the patient’s biomechanical, the way the foot functions, deviations from the ideal foot type.
The foot is a complex system of bones, ligaments, joints, muscles, tendons, nerves and blood vessels. Normal ambulation (walking) is founded on biomechanics – the way the foot is supposed to function at different points in the gait cycle. Initially, when the lead foot strikes the ground at heel strike the foot is in a flexible state. This is from a process known as pronation which allows the foot to be a mobile adapter to the terrain that is about to be encountered. As body weight begins to pass over the foot, supination occurs which makes the foot a rigid lever for weight bearing and propulsion. This process allows the foot structure to support the influence of multiple times one’s own body weight, which is increased or decreased based on activity.
It is very common for one’s standing/resting foot structure to be in varying degrees of pronation. The more pronated a foot is, the more flat or outward appearance of the heel occurs. This mobile foot structure position causes a more rapid development of arthritis -as there are dozens of joints in the foot – along with bunions, hammertoes, heel pain such as plantar fasciitis, or tendon disorders. As the foot structure continues to function deviating away from the ideal normal or rectus position, compensation can occur leading to the above mentioned foot issues.
You should never go barefoot/stocking feet until the end of the day when you are no longer performing weight bearing tasks. Gravity does not care that you walked into your house. Your foot structure is just as susceptible to the influence of force inside as it is outside. People do not walk into their house and remove their glasses. If they did, they would not get the benefits that the corrective lenses provide. The same is true for supporting your foot structure. All too often, people remain active in the household without proper foot support. Maintaining good structural foot support via proper shoe gear and even better yet with custom orthotics, helps to ensure that you will avoid many of the common foot pains that Dr. Peterson and Dr. Keeler see in their office. Also, there is a protective benefit. This ensures that you will not step on a piece of glass you might have missed when cleaning, break a toe on a corner of furniture, drop a knife on your foot, or step on a toothpick/needle in the carpet. We see these problems every day and they are all preventable by simple shoe use.
Custom prescription orthotics are unique to your foot structure. At Family Foot Clinic, we perform a neutral suspension plaster casting technique. The doctors will measure the angles of your feet and perform a mold of each foot while it is maintained in it’s ideal neutral position. There are endless options and ways that the prescription orthotic can be modified. This helps to ensure resolution or better yet prevention of foot pain from biomechanical issues as discussed above. In addition, modifications can be made to the top cover to help with offloading prominent structures on the bottom of the foot that often result in pain or callus formation.
Prescription orthotics are not only for those with pronated/flat feet. Some people have an increased arch and/or inward turning heels which also cause similar issues as discussed above. The prescription orthotics can help to support the increased arch as no stock device will have this ability. Heel and forefoot control ensures less stress placed on tendons and joints. This foot structure also often requires additional padding to the forefoot and hindfoot as it is not as supple and these people get increased pressure to these sites.
Dr. Peterson and Dr. Keeler have a very high degree of success with education and conservative treatment measures which help to keep patient’s out of the operating room. The lab that manufactures the prescription orthotics works with the Drs. and will perform modifications until the orthotic is tried and true and frequently at no additional cost. This is not something that can be done with non-prescriptive arch supports. A simple internet search will reveal comparison between custom prescription orthotics and off the shelf arch supports. Unless the orthotic has been molded to your own foot, it is not meant specifically for your foot. In early July, look for our article detailing an in depth analysis into the difference between real custom prescription orthotics and pre-fabricated arch supports.
Jason Keeler, DPM Family Foot Clinic