Repetitive strain injuries are very common. Just like the term repetitive implies, it is something that happens gradually and when you repeat a movement or action multiple times. It can cause pain in various muscles, nerves and tendons.

If we take for example of elbow pain, which can be caused by common daily activities such as typing, gripping or carrying objects and playing a racket sport. There are many muscles that allow you to use your hands and wrists also attach to your elbows. The pain can be described as an ache, burning, shooting, tingling, or cramping of the muscles.

​Often there is inflammation and pain in the early stages of the injuries. If left untreated, muscle tightness, trigger points and scar tissue will set in. Rest, ice, stretches and exercise will also be an important part of the healing process. Your therapist can help guide you through the whole process and give you tips to help you avoid re-injury.

I have had so many patients over the years not understand what an orthotic truly does and how custom foot orthotics can help them. This week we’ll dive into the common misconceptions and in future blogs we’ll touch on other aspects of orthotics including some further misconceptions to share with you in part 2 of our post. 

What is a custom foot orthotic?
“A custom orthotic is a device designed to align the foot and ankle into the most anatomically efficient position. They look like insoles, but are biomechanical medical appliances that are custom made to correct your specific foot imbalance. Custom orthotics work on your feet much like glasses work on your eyes - they reduce stress and strain on your body by bringing your feet back into proper alignment. The plastic body of the custom orthotic helps to re-align the foot by redirecting and reducing certain motion that takes place during the gait cycle. Custom orthotics fit into your shoes as comfortably as an insole - and they have the advantage of having been made from precise imprints of your feet.”  (from TOG patient FAQ’s, 2019)

​Some of the most common misconceptions that I have heard regarding orthotics include some of following that I have listed below. 

“ My feet don’t hurt so everything is fine.” 

• Unfortunately, I have many patients with really terrible biomechanics in their feet, due to a combination of genetics, age, previous injuries, weight etc., that really need to correction of custom foot orthotics.  Your feet may not hurt, but often something else up the chain, we refer to it as the kinetic chain, from the ground up, as you walk ,will suffer due to the biomechanical changes in your feet.
•   I have many patients with horrible knee pain, but didn’t realize that their feet were contributing to their knee pain. They have really flat feet that rolled in excessively and they toed out a tremendous amount. This was affecting the wear and alignment of their knees and resulting in wear and tear on the cartilage in the joints of their knees. 

“It just happened”, “my arch collapsed overnight”, or "I woke up one morning and this bone was closer to the ground!"

• Changes happen gradually and over time, but some times until there are symptoms patients are not aware of the gradual changes that took place with their feet.

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Patients have called orthotics “arch supports”, as though we are trying to force their arch or foot into an abnormal position.

• This is not the case, Orthotics are not trying to artificially give you an arch but give your foot and its associated muscles the proper feedback to help with pressure distribution, motion and timing to correct your particular imbalances. 

“I have high arches so my feet are fine”. 

• Unfortunately this is not the case.  I too have high arches and the result is a very rigid high arched foot that is very poor at shock absorbing.  Most people with rigid feet spend too long on the outside of their foot during part of their gait cycle.  As a consequence of this foot type, it takes so long to get over onto you big toe so that you can toe off properly that it happens rapidly and quickly resulting in an adverse affect on the tissue on the bottom of your foot as well as other tissues and bones of your feet. 
•  I developed, like many others with my foot type, plantar fasciitis (an inflammatory condition affecting the tissue on the bottom of your foot running from your heel to your toes)! This type of foot that develops plantar fasciitis is one of the more difficult foot types to treat.  It requires proper custom foot orthotics, home exercises, footwear modification and sometime even a night splint! 

This week I challenge you to think more about your feet and how you walk!
Have a great week, Dr. P.