1 Foot 2 Foot

What is biomechanics?

Podiatric biomechanics is a specialism concerned with foot function and locomotion. It encompasses foot development, and aims to preserve and/or restore the function of the foot and its associated structures.

The foot is an intricate and mechanically complex structure made up of 26 major bones, associated joints and soft tissue structures. The efficiency with which the foot functions when walking depends on the way in which these bones and joints move in relation to each other. Efficient and pain-free function also depends heavily on the foot"s angle to the leg and to the ground. If things do not work well in any of these areas, painful problems may result.

Biomechanics refers to the analysis of the foot and leg function and the diagnosis of any functional problems or abnormalities.

What problems can occur?

Aching feet and painful lower limb problems don"t have to be endured. The cause of such problems is often due to the misalignment of the joints and resulting soft tissue stresses in the leg or foot. This can lead to common problems, such as:

• Aching and over-tired feet
• Ankle sprains and weaknesses
• Over pronation (collapsing of arch)
• Sports related overuse injuries
• Bunions
• Corns and callouses
• Painful toe nails

But, the pain caused by these misalignments is not always restricted to the feet. Because our feet take the strain of our daily activities, every step impacts directly upwards through the body. This means that stress and pain may be experienced in the joint of the following areas:

• Feet
• Hips
• Neck
• Knees
• Back

All of these parts of the body are connected to the feet via the skeleton. Effects may show as pain, instability, restricted movement or, in some cases, just fatigue.

How does the foot function?

The foot is an impressive architectural and functional design, able to act as both a flexible supportive base and a rigid lever. It is expected to work efficiently under excessive loads and demands, often in extreme conditions imposed on it by footwear and the environment in which it has to work. However, this complex structure"s function depends heavily on having its correct functional angles and joint movements maintained.

In walking or running, the foot needs to be flexible enough to absorb the shock of hitting the ground. It also has to be firm enough not to collapse as the body's weight moves over it with each and every step. It is no surprise that sometimes when things start to go wrong with the foot function, pain or disability results. In most cases, it is not until heavy or unusual demands are made on the feet by work, sport, injury, or simply by the passage of time, that potential weaknesses are revealed.

What is a biomechanical examination?

A biomechanical examination involves taking a series of measurements of the feet and legs with the patient standing and lying down and may include checking joint movements and assessing muscle strength and flexibility. It will often include watching the patient walk to assess the way in which the foot works. The examination will enable the podiatrist to identify and treat functional foot faults.

As modern technology advances, so does the variety of new equipment available to podiatrists to gather information from a biomechanical examination. Nevertheless, the most important factor in any examination will remain the podiatrist's professional skill in interpreting the information gathered, and using it to prescribe the specialist treatment that will most benefit the patient.

When attending for a biomechanical assessment, please bring a pair of shorts, and footwear which you have worn over the last 6 months (if in doubt bring 2 pairs). Allow approximately 45 minutes.

Appropriate treatment?

Once a diagnosis has been reached your podiatrist will discuss the proposed course of treatment, giving options where appropriate. It is possible that a program of exercises and advice on footwear may be all that is necessary. You may need a small clinical insert (insole) in your footwear to alter your walking pattern. This would be fitted during your initial visit using either chiropody felt or Poron, a closed cell foam. Where longer-term correction is required you may be prescribed orthotics (corrective insoles). A plaster, or similar cast, impression may be necessary for the manufacture of your orthotic. Your podiatrist will discus the proposed course of action prior to commencing treatment.

What is orthotic therapy?

The most common treatment for biomechanical problems is the use of special shoe insert known as orthoses, or more commonly, orthotics. Orthotics reposition the foot structure to achieve optimum skeletal balance, thereby reducing the stress and pain on the joints that are causing the discomfort. They do this by controlling joint movement, and by altering some angles to prevent excessive motion.

Many orthotics look like arch supports, but they are not intended to support the arch. Orthotics are angled individually to control the heal and forefoot, and to prevent excessive motion. The natural arch in the foot will in most cases become more apparent while the orthotics are worn. There are many differnt types of orthotics. The type that is used depends on the activity in which the patient is involved, the shoes they want to wear, and the underlying foot problem.

Orthotics ... How long will I have to wear them?

There is really no answer to this question. Orthotics do not cure your foot problem. They work on the same principle of glasses.... An optician may prescribe glasses for you, but they will not cure your vision problems. Instead, orthotics simply modify the function of your foot as you continue to wear them. In essence you will need to wear the orthotics as long as you want to avoid discomfort, as by biomechanical definition you will be predisposed to the particular problem.