| 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. |