Anyone who suffers from heel pain, often referred to as plantar fasciitis (plan-tar fa-shee-eye-tis), knows that it can be a chronic problem that affects their lifestyle and activity.
By far the most common condition see at Northumberland Physiotherapy and Foot Health Centres, plantar fasciitis is an inflammation of a fibrous band of tissue that runs along the bottom of the foot, called the plantar fascia (fa-sha). One of its purposes is to maintain the arch of the foot, and it works during all impact activities, like walking or running. One method of treatment that may be very effective for plantar fasciitis is orthotic therapy.
Orthotics are footwear for your footwear that help correct structural problems in your feet. However, from shoe stores to shopping mall kiosks and other entrepreneurs, it seems everyone is selling "orthotics" these days. Even some helath practitioners who are not foot specialists are providing orthotics as a sideline.
Methods like foam boxes, ink pad prints, and seemingly "advanced" technology like 2-dimensional weight bearing electronic computer scanners may seem impressive. However, what the unsuspecting public may be purcashing is an overpriced arch support, or worse, a custom insert that is shaped to a faulty foot.
Ideally, prescription custom orthotics are precisely "cast" using a very specialized technique. The practitioner should be adjusting the foot into a special position called "sub-talar joint neutral" while it is suspended in the air, and then either creates a plaster mold or creates a 3-dimensional non-weight bearing scan. Adjustments to the cast are then prescribed using precise calculations to help correct any deficiencies in the foot structure. The other methods of casting, take a mold of your foot while you are standing on it. But why would you want a device that was created for your foot while it was in the position that was causing your pain in the first place?
So, why must the average foot pain sufferer face so much confusion? One challenge is that orthtotics therapy is not regulated in Canada. Essentially, anyone can set up shop to provide a device they call an "orthotic". As the only government regulated health practitioners in the province trained and licensed exclusively in foot medicine, members of the College of Chiropodists of Ontario (chiropodists/podiatrists) are bound by specific rules, including using the "sub-talar neutral" method for foot orthotic molds.
Another issue is training. Chiropodist and podiatrists receive several years of lower limb biomechanics, in addition to their undergraduate degree, as part of the foot medicine program. Some people providing orthotics receive a little as one day of training, or worse, none at all. They often lack expertise in other foot health treatments that might be needed instead of, or alongside, orthotic therapy. Chiropodists and podiatrists must also receive continuing education throughout their career to maintain their license. Much of this includes further biomechanical tranining.
All of this should not frighten the average person away from orthotic therapy. High quality, properly cast and properly prescribed orthotics can be extremely effective in treating heel pain and numerous other foot problems. Seeing a chiropodist for a foot problem is assurance that you are being assessed and treated by a government regulated health practitioner whose only focus is foot medicine, and who has the expertise to provide the widest range of treatment options, including whether orthotic therapy is best for you.
Posted via email from Northumberland Physiotherapy and Foot Care Centre's posterous
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