Bio Mechanical/Sports Injuries
Biomechanics is the study of the body movements and of the forces acting on the musculoskeletal frame work. We apply our biomechanical knowledge to the feet when there appears to be an imbalance causing problems.
Not all podiatrists deal in biomechanics as it is a complex and challenging area of podiatry. If you suspect that your condition may be due to a biomechanical problem, it is advisable when booking to mention this to the receptionist. This way we can make sure that that the best possible care and treatment is given to the patient.
Biomechanical problems can occur at any age, in the athletic type and also in the partially immobile. It is not possible to go into a great deal of detail here as this would end up being a novel! However, the below are common problems we see every day in the clinic.
At our Laindon practice we are able to offer video gait analysis and pressure plate assessments in our MSK workshop.
Heel Pain (Plantar Fasciitis) / Flat feet / High arched feet / Ankle Pain / Lower Leg Pain / Knee Pain / Hip Pain / Lower Back Pain / Sports Injuries
Heel Pain (Plantar Fasciitis or Heel Spur)
This is a condition that is becoming more and more common. The patient presents with a tender pain under the ball of the heel near the mid line of the body. Usually worse straight after rest. The pain lasts a few minutes and then returns later after activity. The pain can eventually progress towards the toes if left untreated. Here at the tender area of the heel, many of the structures under the foot attach into a bony prominence called the medial calcaneal tuberosity. Any condition causing the foot to stretch underneath such as increased body weight, leg length discrepancies (possibly caused through knee or hip surgery), sudden increase in exercise or ‘dropped arches’, can give rise to this condition.
It is essential that a good history is taken to ascertain the cause. Treatment will then be a combination of ice or heat therapies, stretching exercises, supports in shoes (orthotics) and sometimes anti-inflammatories. Treatment must be sort quickly if this condition is suspected. It is not easily treated and we often see patients in the chronic state.
If left untreated, steroid injections may be the suggested treatment. This can be carried out in the clinic quite easily and often gives immediate relief. However, the cause must be rectified otherwise the condition will reoccur.
The correct height of the arch has not been defined but it is important that the feet function as a good shock absorber with the ability to propel the person forwards without causing pain. Often a collapsed arch is incorrectly described as a flat foot, but technically is actually a pronated foot where it is rolling inwards. This can often be easily corrected with orthotics, (arch supports), exercises and good advice.
High Arched Feet
This foot type is usually inherited and can be a very unstable foot type. A true abnormally high arch is the condition known as pes cavus. Should this foot type give rise to pain we will try to stabilize the foot with insoles.
Ankle / Lower Leg / Knee / Hip / Lower Back Pain
All these conditions can arise from a bio-mechanical imbalance of the lower limbs, either occurring naturally over a long period of time, related to different activities or because of surgery. Natural causes may include arthritis or circulatory issues whilst surgery can cause leg length differences and compensation problems in muscles. There are just too many variables to mention here.
A good examination and history taking are key to ascertaining the cause.
These conditions vary from minor sprains to fractures. Too many to go into great detail here. Often the problem is of a bio-mechanical imbalance that has been discussed previously in this chapter or due to a change in exercise activity. Once again, it is essential to inform us at the time of booking that the condition is sport related.
A short list of more common conditions include stress fractures (causing pain in the metatarsals), neuromas (and trapped nerves), tight Achilles tendon, shin splints and all previously mentioned conditions on this site. Often treatment involves footwear advise, orthotics / insoles and/or exercises. We are fortunate enough to have physiotherapists on sight should we feel the need for referral.
ORTHOTICS AND INSOLES
It is worth mentioning here that we are able to manufacture our own orthotics and insoles thus keeping the cost to an absolute minimum. Theses devices may be custom made or bought off the shelf and personally adapted. It is not necessary to spend a fortune to correct these problems or wait a long time for the orthotics to be made.