Biomechanics and Foot Orthosis

An orthotic is a device used to support, align, prevent or correct deformities or improve the function of movable parts of the body. When internal structures fail, orthosis can modify external forces and anatomic structures to allow the body to function in a “normal” manner. They can be designed to control over- pronation and restore natural foot function. Over-pronation is the dropping of the arches and rolling inwards of the feet and ankles. Orthotics help alleviate many biomechanical problems by ensuring that weight is more evenly distributed over the foot thereby relieving pressure points from the foot.  They help relieve tension and support the arch. They can act as shock-absorber. They provide longitudinal and metatarsal support and correct posture and body biomechanics. They prevent foot strain and injury, providing walking comfort. These devices are placed inside the shoes with the purpose of restoring our natural foot function. This is necessary when the natural biomechanical balance of our lower body has been disrupted by many deformities such as over-pronation. Abnormal foot function caused by over-pronation can lead to serious foot problems like heel pain, heel spur, plantar fasciitis, metatarsalgia – even knee pain and lower back pain in some instances.

Children and orthosis:

Children under the age of 5 are normally flat footed because their foot bones are not completely formed. Between ages 5-7, children’s arches usually are formed. It is important to know that arch height is not actually the main concern in young children. However, determining whether a child suffers from excessive pronation is important. Over-pronation causes the child to develop abnormal gait pattern. At a young age, the child may not have pain, but, later in life, he or she may develop heel pain, knee pain, general foot and ankle pain. Almost all children will experience growing pain, but this condition is more severe in children with over-pronation. Studies have shown that childhood obesity leads to flatter feet, which in turn creates a long-term effect producing poor foot structure in adults. It is important to know that most people that over-pronate have flat feet. Symptomatic children with gait abnormalities must be treated. The goal of the treatment is to hold the foot in a more anatomical and or corrected position and alleviate symptoms. This is accomplished conservatively by providing adequate footwear, stretching where appropriate and inserting foot orthosis into their shoes. The most important feature of foot orthotic to positively affect lower joint moments is contouring the orthotic device to the shape of the child’s foot. At this point, the question becomes the treatment option for asymptomatic individuals. Children with excessive-pronation, hypermobile flatfoot that is not deteriorating and has extrinsic factors that may contribute to symptoms and deformity should be treated. These groups include: obese children, extreme hypermobility of the joints, and individuals with systemic or genetic abnormalities such as Downs’ Syndrome. It is always important to seek professional advice than assume that the child will outgrow the problem. Assuming that the problem will disappear with time is an insufficient medical decision. By re-aligning a child’s abnormal feet early in life, many biomechanical complaints can be prevented, therefore allowing the feet to develop more naturally.

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