| The foot to me is like a "loose bag of bones." | | | | prescription |
| Tied together by the soft | | | | orthoses do this. In fact many non prescription |
| tissues, each bone moves on one or more of | | | | supports do it too. |
| the planes of motion and | | | | However, the closer the orthoses is to limiting |
| moves as much as necessary in order to reduce | | | | the precise amount of |
| incoming shock | | | | motion and yet, lets the foot move naturally and |
| An orthosis to my way of thinking is designed to | | | | balanced across the |
| "assist" the foot and | | | | floor, the more comfortable it will be to wear, |
| minimize this motion. It does this by aligning the | | | | and above all else |
| foot to the ground | | | | produce results.Foot orthoses unfortunately do |
| and tightening up the laxity of the foot motion | | | | not work like eye glasses. You do not |
| making it more | | | | get an instant resolution. Some people do |
| efficient in its course of action(s). | | | | respond amazingly quickly, |
| What the SDO does so well, is allow each bone | | | | although this is the minority. Some people are |
| to move through its | | | | more complex for |
| natural planes of motion in a fluid manner (NO | | | | whatever reason and they may take anywhere |
| PUN INTENDED). It does | | | | up to six months to begin |
| not alter these motions and does not restrict | | | | to respond favorably. The majority of people |
| them abruptly. It simply | | | | feel a 40-60% minimum |
| guides the structure through its course of action, | | | | average improvement in their symptoms within |
| yet limits the | | | | 8 weeks, (this is not the |
| laxity. This is what makes the SDO so easy, | | | | same as being cured). As time continues it is |
| accurate and comfortable to | | | | possible to feel like |
| wear. | | | | progress has stopped or that the pain is coming |
| A traditional support (rigid or semi-rigid) on the | | | | back. As you wear the |
| other hand (in my | | | | orthoses you begin to absorb the prescription so |
| opinion) holds the foot to a casted position which | | | | you may start to feel |
| is rigid to the | | | | the residual inflammation and tension temporarily. |
| planes of motion. Granted, if the foot structure | | | | If your orthoses are |
| feels comfortable to | | | | comfortable and you are able to wear them |
| this position and way of walking, and it works in | | | | most of the time they are |
| its concept of | | | | working. The healing of biomechanical |
| healing, then that is the bottom line. To me, just | | | | inflammation takes time. |
| because the foot is | | | | It can take 1-2 years for an orthoses to |
| custom casted to a biomechanical position, does | | | | generate its maximum effective |
| not mean it fits the way | | | | range of healing. As your foot flexibility increases, |
| that foot works (that's why I hear so many | | | | the optimal |
| patients say it is very | | | | position of alignment will change (due to increase |
| uncomfortable even if it helps). Especially during | | | | in health from |
| an injury where the | | | | reduction in tension and inflammation). Then |
| muscles are under tension and spasm and | | | | regardless of your |
| therefore tight and restricted | | | | symptoms you need to get another prescription |
| to the correct biomechanical position. This is why | | | | in order to keep your |
| in my experience | | | | feet and body working to their best efficiency. If |
| working with traditional orthotics for 15 years, I | | | | your orthoses work |
| found so many | | | | correctly you can expect 2-3 changes in your |
| failures. And I could do very little to adjust that | | | | lifetime. Most of these |
| device to make it | | | | changes should occur in the first to the second |
| that much more acceptable to the patient. | | | | year. The next change |
| The SDO can be adjusted to anyone (as long as | | | | should be very gradual over the next 4-6 years. |
| that individual is willing | | | | After that changes may |
| to work with you and understands that just | | | | or may not occur. If they do it will take a long |
| because the orthotic fits | | | | time.So to clarify the last question, "Is there an |
| does not mean that resolution is going to be | | | | orthoses so ideal as to |
| quick), because the | | | | prevent foot problems?" Depends on what |
| intrinsic muscles of the foot determine that the | | | | problems we are looking to |
| fit in that position | | | | prevent. If we are looking to prevent injuries |
| is acceptable to them. We also know that if an | | | | from inadequate |
| orthotic does work, we | | | | training, excessive distances, increasing mileage |
| will need to adjust the alignment position in 1-2 | | | | too quickly, |
| years to compensate | | | | anatomical or functional abnormalities, accidental |
| for that shift in fit vs biomechanical position. | | | | sprains or strains , |
| Does The Ideal Foot Orthotic Exist? | | | | uneven surfaces, and aging, probably not. But if |
| | | | there are biomechanical |
| The ideal foot orthotic: "Is there such a thing?" | | | | reasons for something to eventually happen e.g. |
| Perhaps not. Can one | | | | structural (like a |
| orthoses meet the needs of all people? Of | | | | bunion or heel spur), then it is possible to at least |
| course not. Is there an | | | | slow down the |
| orthoses so ideal that can prevent or slow down | | | | process and possibly prevent this from occurring |
| foot problems? Possibly | | | | enough to not let it |
| so, but this needs clarification.The purpose of a | | | | be a problem in your lifetime.Copyright 2006 |
| foot orthoses is to | | | | Dennis Kiper, all rights reserved. |
| limit the total range of motion (overpronation) | | | | Dennis N. Kiper, D.P.M., specializes in Podiatric |
| available to the foot | | | | Sports Medicine. |
| as it coils to the ground (called pronation). Most | | | | |