Biomechanics

The human foot is a very complicated piece of engineering. A quarter of all the bones in our body are in our feet. Our feet have to deal with enormous pressure whilst providing flexibility and resilience. The different parts of the feet have to work together to provide the body with support, balance and mobility to allow us to walk and run without injuring ourselves.  Podiatric biomechanics looks at how all the compartments of the feet relate to each other and to the legs hips and spine. In summary, biomechanics looks at how our feet function when we stand and move and if the way they are functioning leads to pain in the feet, knees, hips or back.

Orthotics

Orthotics (insoles or arch supports) are devices used to control abnormal foot function. When the foot is not functioning correctly, painful areas result. An orthotics device can relieve that pain by offering support to the ligaments and the bone structures of the feet. Basically, they are padded insoles, shaped to achieve the correct posture and gait.

When appropriately prescribed, orthotics can decrease pain, not only in the foot, but in other parts of the body such as the knee, hip and lower back. They can also increase stability in an unstable joint, prevent a deformed foot from developing additional problems, and improve overall quality of life.

Who can benefit from biomechanical therapy?

Many common complaints can be related to biomechanical dysfunction so almost anyone who suffers persistent pain in the feet, lower limbs and back would benefit from orthotics. However it is not a miracle cure and it cannot promise complete pain relief in every patient. Typical examples of patients who respond well to orthotics therapy are:

• People whose occupations involve long periods of standing or walking
• Athletes especially long distance runners.
• Children with growing pains and development problems in their lower limbs.

How do Orthotics work?

Your feet are the foundations of your posture and your gait (the way you walk). Just as a car whose wheels are not aligned correctly will have problems with tyres wearing unevenly and be difficult to steer, your feet, if not functioning correctly, will cause excess pressure on soft tissue muscles and joints causing them not to function correctly - resulting in pain. Think of the orthotics gently altering the way you walk and providing cushioning for overloaded areas reducing the strain on soft tissues, muscles and joints and therefore reducing pain.

Orthotics and Footwear

Orthotics need to be worn the majority of the time to be effective, therefore footwear needs to be able to accommodate them. A compromise can be made with some orthotics which can be prescribed in a slim fit version but for maximum benefit, a good functional foot shaped shoe with plenty of depth will be required to accommodate a functional orthotic. We believe in patients making an informed choice; for some patients such a shoe would not fit in with their lifestyle and therefore orthotics would be an inappropriate choice of treatment. Please discuss this aspect of treatment with the podiatrist before you chose to purchase any orthotics.

Do I need Orthotics?

Choosing to wear orthotics we feel is a bit like choosing to wear glasses. If you had very minor eye problems, perhaps occasionally you couldn’t read very small print, you probably would not bother to wear glasses, but solve the problem in other ways e.g. ringing directory enquires for a number you couldn’t read in a telephone directory. We have many patients who choose to come into the practice for general callous and corn reduction in order to maintain comfortable feet.

If you eyes were a little worse perhaps you couldn’t read restaurant menus, you may decide a pair of off the shelf reading glasses would be sufficient to help you in those situations, we can also provide off the shelf orthotics which will support the foot and for many people improve foot function to the point where they can live pain free. This practice does not sell off the shelf orthotics to children.

However if your eyesight meant that you were struggling with everyday tasks or your work or leisure activities involved a lot of close work, you would probably go to your optician and have a custom made pair of glasses specifically made for your eye problems. These would not only improve your sight but help prevent damage in later life. Custom made orthotics work in the same way. The podiatrist will prescribe orthotics specifically for your foot problems.

How much do Orthotics cost?

The majority of “off the shelf” orthotics are priced between £25.00 and £30.00

Custom made orthotics require a full biomechanical examination £80.00 plus the cost of the orthotics this includes up to two follow up appointments and any minor modifications required. These range from £50 to £125 dependent on the results of the examination. The cost of the orthotics would be explained to you at the examination.  Further pairs of the same orthotics can be purchased without the need for a biomechanical examination. We keep records for a minimum of seven years however they are archived after two years which may delay finding your prescription. Orthotics would be charged for at the retail price on the day of re-order or an equivalent offered if no longer available.

Most health insurances such as Welsh Hospitals or H.S.A will pay for biomechanics/orthotics but you should check with your particular policy before commencing treatment. Custom made orthotics are available on the N.H.S. In the Pontypridd area you would need to be referred by your G.P. to the Community Podiatry Service. In the Cardiff area you can self refer but would need to get an application form from your local clinic.