bones reds

Feet And Orthoses

The foot to me is like a "loose bag of				(overpronation) available to the foot
bones." Tied together by the soft
				as it coils to the ground (called
tissues, each bone moves on one or more of				pronation). Most prescription
the planes of motion and
				orthoses do this. In fact many non
moves as much as necessary in order to				prescription supports do it too.
reduce incoming shock
				However, the closer the orthoses is to
An orthosis to my way of thinking is				limiting the precise amount of
designed to "assist" the foot and
				motion and yet, lets the foot move naturally
minimize this motion. It does this by				and balanced across the
aligning the foot to the ground
				floor, the more comfortable it will be to
and tightening up the laxity of the foot				wear, and above all else
motion making it more
				produce results.Foot orthoses unfortunately
efficient in its course of action(s).				do not work like eye glasses. You do not

What the SDO does so well, is allow each				get an instant resolution. Some people do
bone to move through its				respond amazingly quickly,

natural planes of motion in a fluid manner				although this is the minority. Some people
(NO PUN INTENDED). It does				are more complex for

not alter these motions and does not				whatever reason and they may take anywhere
restrict them abruptly. It simply				up to six months to begin

guides the structure through its course of				to respond favorably. The majority of people
action, yet limits the				feel a 40-60% minimum

laxity. This is what makes the SDO so easy,				average improvement in their symptoms within
accurate and comfortable to				8 weeks, (this is not the

wear.				same as being cured). As time continues it
				is possible to feel like
A traditional support (rigid or semi-rigid)
on the other hand (in my				progress has stopped or that the pain is
				coming back. As you wear the
opinion) holds the foot to a casted position
which is rigid to the				orthoses you begin to absorb the
				prescription so you may start to feel
planes of motion. Granted, if the foot
structure feels comfortable to				the residual inflammation and tension
				temporarily. If your orthoses are
this position and way of walking, and it
works in its concept of				comfortable and you are able to wear them
				most of the time they are
healing, then that is the bottom line. To
me, just because the foot is				working. The healing of biomechanical
				inflammation takes time.
custom casted to a biomechanical position,
does not mean it fits the way				It can take 1-2 years for an orthoses to
				generate its maximum effective
that foot works (that's why I hear so many
patients say it is very				range of healing. As your foot flexibility
				increases, the optimal
uncomfortable even if it helps). Especially
during an injury where the				position of alignment will change (due to
				increase in health from
muscles are under tension and spasm and
therefore tight and restricted				reduction in tension and inflammation). Then
				regardless of your
to the correct biomechanical position. This
is why in my experience				symptoms you need to get another
				prescription in order to keep your
working with traditional orthotics for 15
years, I found so many				feet and body working to their best
				efficiency. If your orthoses work
failures. And I could do very little to
adjust that device to make it				correctly you can expect 2-3 changes in your
				lifetime. Most of these
that much more acceptable to the patient.
				changes should occur in the first to the
The SDO can be adjusted to anyone (as long				second year. The next change
as that individual is willing
				should be very gradual over the next 4-6
to work with you and understands that just				years. After that changes may
because the orthotic fits
				or may not occur. If they do it will take a
does not mean that resolution is going to be				long time.So to clarify the last question,
quick), because the				"Is there an orthoses so ideal as to

intrinsic muscles of the foot determine that				prevent foot problems?" Depends on what
the fit in that position				problems we are looking to

is acceptable to them. We also know that if				prevent. If we are looking to prevent
an orthotic does work, we				injuries from inadequate

will need to adjust the alignment position				training, excessive distances, increasing
in 1-2 years to compensate				mileage too quickly,

for that shift in fit vs biomechanical				anatomical or functional abnormalities,
position.				accidental sprains or strains ,

Does The Ideal Foot Orthotic Exist?				uneven surfaces, and aging, probably not.
				But if there are biomechanical

				reasons for something to eventually happen
The ideal foot orthotic: "Is there such a				e.g. structural (like a
thing?" Perhaps not. Can one
				bunion or heel spur), then it is possible to
orthoses meet the needs of all people? Of				at least slow down the
course not. Is there an
				process and possibly prevent this from
orthoses so ideal that can prevent or slow				occurring enough to not let it
down foot problems? Possibly
				be a problem in your lifetime.Copyright 2006
so, but this needs clarification.The purpose				Dennis Kiper, all rights reserved.
of a foot orthoses is to
				Dennis N. Kiper, D.P.M., specializes in
limit the total range of motion				Podiatric Sports Medicine.

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Feet And Orthoses