Orthotics for your problem feet: yes or no?

Truths that existed for decades now seem taboo. Take carbs, for example: A few years ago, many sports gurus recommended carb-loading for peak performance; now carbohydrates seem to be disappearing and a high-fat, high-protein diet is all the rage. Three balanced meals were supposed to be the best option to achieve constant energy levels and stay healthy; now intermittent fasting, or two meals a day, is often touted as the ideal “diet.”

A few decades ago, on-demand feeding of babies was the norm; we are now told that many babies have a strict three-hour routine. Similarly, the footwear industry, as well as orthotics, a medical field which focuses on “specialized footwear and other devices like braces and calipers” seems to hesitate, and waver, about what kind and how much support will prevent injury.

the oldest known shoe It was a sandal dating from between 7000 and 8000 BC. South African Olympic star Zola Budd shocked the world in 1986 when she ran the 3,000m barefoot Olympics. Since then, designs have morphed massively and today, one can buy a shoe that corrects just about any biochemical problem: flat feet, high arches, plantar fasciitis, leg cramps and pronation, the list goes on… And if you still haven’t are satisfied, there are orthotics or insoles that can be customized to suit the needs.

barefoot shoes

Despite these developments, there is a lot of pushback from those who say that barefoot shoes, with virtually no support, are the way to go to prevent injuries. minimalist shoes that mimic the sensation of being barefoot, strengthen muscles, bones, tendons and ligaments; the feet are able to readapt and compensate for imperfections. Minimalist shoes or walking barefoot also help with balance and stability and ensure that the strike is natural.

padded shoes, on the other hand, change the tread. Instead of landing on the toes, one lands on the heels. This increases pressure on the legs and calves.

Natascha Heine, an energetic 80-year-old who calls herself a “nature’s child,” says she has walked barefoot since childhood. She believes that our bodies are charged with electricity and to get rid of it we have to ground ourselves. The shoes prevent that connection from taking place. Heine walks barefoot in a park for at least an hour a day and says grounding and unloading her body is what keeps her healthy.

Bruce Talbot, a 38-year-old production manager, is an avid ultramarathon runner who has completed several Comrades marathons. He believes in keeping things as natural as possible and prefers to run in minimalist shoes with zero drop and no arch support. He allows you to have a faster and shorter forefoot strike and strides. This, he believes, has kept him injury free.

The experience of this writer and that of his friends in a walking group has been quite different. I must confess that we are on the wrong side of sixty, and our feet are probably not as flexible as those of younger people. A few years ago, I started getting a sharp pain in the bottom of my foot when I woke up. It was worse with my first few steps and gradually got better throughout the day. A podiatrist diagnosed plantar fasciitis and referred me to a physical therapist. He gave me a series of exercises to build my strength, with ice packs and massages on my foot that gave me some relief. After six weeks with no signs of healing, the podiatrist suggested braces. Although I only wear them in my walking shoes, I have never looked back.

expert view

Andrew van Rensburg He is a physiotherapist and international triathlon coach. He says that in most cases, orthoses are oversubscribed. Foot problems are often the result of structural problems caused by muscular problems and can be fixed with the right exercises, adding that over 80% of his patients have recovered without braces.

Before considering them, he says, you need to establish what caused the problem. He follows a top-down approach to strengthening and believes patients should get braces, not see them as a first choice. Even in cases where they are prescribed, they do not necessarily have to be permanent. Van Rensburg is a hundred-miler and says he runs in trail shoes that feel almost flat, even though they have a 4mm rise.

Chiropodist grant monaghan He says that it is essential to correctly identify the cause of the problem and agrees that it is necessary to look at the functioning of the rest of the body when making an assessment. In many cases, custom-made orthotics designed specifically for a patient will correct foot problems.

Exercises require discipline.

In his experience, very few patients are disciplined enough to do the prescribed exercises on a regular basis, so they return frequently. He says that although orthoses can, in some cases, cause the feet to lose some muscle tone, correctly made prescribed orthoses do not immobilize, but guide them to a more efficient way of functioning and better posture.

Certain designs can improve problems that cannot be fixed and results are not achieved overnight. If there is an improvement, it is often temporary, as training often ceases as symptoms subside. If a patient is experiencing excruciating pain, a remedy that addresses the pain quickly is often preferred.

Orthoses have also made a great difference in patients with diabetes. Many suffer from arthritic feet or diabetic neuropathy which causes tingling and pain in the feet. In most cases, custom-made orthotics can help prevent this and keep it from getting worse.

Professor Mmampapatla Ramokgopa, head of the Department of Orthopedics at the University of the Witwatersrand, believes orthoses play an important role as a conservative treatment for some birth defects, developmental, degenerative and traumatic problems. In many cases, they can help avoid surgery by supporting and modifying deformities in children. They also help influence scoliosis in children until they reach maturity and prevent regression after surgery.

In adults, orthotics are often the best solution to treat bunions and rebalance the foot to help biomechanical deficiencies. He agrees that they allow muscles to become loose if used permanently, but thinks they might be the best option for preventing pain.

In summary

It is important to get a thorough evaluation, weigh possible treatment options, and decide what is best for a particular individual. MD/ML

In case you missed it, read also For the best running shoe, choose comfort over marketing promises.

For the best running shoe, choose comfort over marketing promises.

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