SPACE CLINICS & EDINBURGH PODIATRY CLINIC
EPC and 'Space Clinics' are currently undertaking a study into 'How excessive pronation affects the upper kinetic chain', and with very clear results, we are finding that our means to treat this is very successful indeed. As part of this research we are designing a foot measurement tool. We plan to present our findings of this research at 'The Second World Congress into sports injury prevention', in Oslo, Summer 2008.
PODIATRY
This is the study of feet and gait.
It addresses all Chiropody issues in addition to Nail Surgery (a longterm solution to in-growing toe nails) and Biomechanics: how you walk/run/perform your sport.
It is suitable for all ages and everyone can benefit from it.
BIOMECHNICS AND GAIT ANALYSIS
The term biomechanics is used in a variety of ways. Most simply, biomechanics can be translated as ‘The evaluation of movement technique’ (e.g. walking, running, skiing, sporting biomechanics) and it’s a term often used in clinical circles.
It is becoming increasingly obvious that correct biomechanics plays a key role in both performance and in injury prevention.
Correct biomechanics provides efficient movement and is likely to reduce injury risk. Abnormal biomechanics should always be considered as a potential cause of non-traumatic walking/sporting injuries.
BIOMECHANICS OF WALKING
The foot functions in two ways:
A rigid lever This is when the foot functions in a ‘locked’ position to enable ‘push off’.
A mobile adaptor The foot also acts as a shock absorber to adapt to the impact at ground contact. Pronation.
If the foot is unable to shock absorb, then the impact is felt further up the kinetic chain, e.g. as ankle pain, knee, IT band, hip or back pain.
If the foot remains in the flat shock absorbing position for too long, (excessive pronation) it does not allow the correct position for 'push off'. The foot may then compensate by turning outwards or inwards, in turn engaging the wrong (smaller) muscle groups e.g. peroneals, IT band, piriformis, or ileopsaos, to enable the foot to 'push off'. This translates as; foot and ankle instability, medial knee instability and pain, and increased hip rotation and pelvic instability (lower back ache). Often there is gluteal dysfunction.
It is the means with which one compensates, that attributes to the aches and injuries experienced.
Quite simply – with excessive pronation, there’s a deviation from the optimal position of the bones and the muscles. Joints and ligaments are aggravated, big muscles are underused, and small muscles are overused, leading to early fatigue and often injuries.
This is why it’s imperative to locate the cause, which in turn will stop the effect.
During walking, the support of the body is being transferred from one foot to the other.
If one foot is unable to function to its optimum, then the other will compensate for it.
This is the point at which the correct shoe or corrective orthotic (prescriptive insoles which can be made to fit into all shoe/sports shoe types) can help the foot to achieve its optimal position, which in turn keeps the knee and pelvis and all the supporting muscles correctly aligned.
On walking the impact of this is felt. On running and during sports, due to single leg weight bearing and increased impact, this is amplified.
Structural abnormalities of the foot, ankle joint, lower leg bones and hip joint may contribute to abnormal biomechanics.
These are complex, but can easily be recognised by an experienced Podiatrist.
It is not essential to understand these fully in a non clinical setting, however understanding the area of the foot requiring support will help you to find the correct shoe for your foot type.
CORRECTION OF BIOMECHANICS
Asymmetries detected by a Podiatry Biomechanical Assessment may require correction. These abnormalities can include muscle tightness, weakness or poor co-ordination, joint stiffness and increased neutral tension.
Muscle tightness is corrected with appropriate stretching. Specific muscle weakness or poor co-ordination requires strengthening and retraining. Joint stiffness may be treated with active or passive joint mobilisation, while increased neural tension should be treated with appropriate neural stretching and correction of possible causes.
Two important methods of correction of lower limb biomechanics are the use of appropriate footwear and/or orthoses (prescriptive insoles), and the correction of poor pelvic biomechanics.
Orthoses
Orthoses are placed in the shoe to correct abnormal lower extremity mechanics and alignment. They precisely, but subtly control excessive subtalar (ankle) and midtarsal (mid-foot) movements that may occur, to compensate for structural abnormalities.
They do not change structural abnormalities and should not be considered the only means of treatment of excessive movement, rather they help place the foot in a position from which it can function optimally (bones and muscles), allowing the ankle, knee and pelvic position to follow in their optimal position.
It is important also to consider the influence of excessive muscle tightness and weakness, the influence of shoes and the influence of surfaces.
Correct foot function is not achieved with orthoses alone and ideal control is achieved by using the appropriate orthotic with the appropriate footwear.
Many athletes do not tolerate large degrees of control from orthoses and often a small degree of control is very helpful. To this end a neutral or mild stability trainer on the most part will suffice in addition to orthotic control.
Adaptation to one’s own mechanics should never be underestimated.
Footwear
The correct (sports) shoe is paramount.
It is advisable to consult a specialist sports footwear shop – where staff have direct knowledge of both sports and foot types relative to footwear, when choosing your running shoes. We recommend 'Run and Become', 66 Dalry Road, Edinburgh.
One last thought to consider: McLaren wouldn’t settle for any old tyres, same applies to your structure and (sports) shoes – choose well!
“Happy walking”!
Regards
Toni Blacklock BSC POD. MCHS SRCH RGN
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