Common biomechanical complaints

Everyone gets pain now and again: a stiff back, an aching knee, a sore foot, etc., perhaps brought on by a serious bout of gardening or a long walk.  As often as not, it clears up in a few days and you think no more about it.  If it persists, however, you might want to find out exactly what the problem is and how it might be treated.  Problems such as these are classified as biomechanical complaints and can often be reduced or, in many cases, completely resolved with the use of an orthotic.

The mention of an orthotic to many people conjures up images of the built-up shoes worn by schoolchildren forty years ago.  The modern orthotic is a slim insole which, as the name suggests, slips inside your usual shoes.  They feel strange initially, but that is because they are designed to change your walking gait in order to correct a problem.  It is heat-moulded to your precise foot measurement, effectively being custom-made for your own feet.

 If you have one or more of the conditions outlined below, I can give you a biomechanical analysis and, if appropriate, prescribe the correct orthotic or alternative solutions.  If you decide an orthotic is the right approach for you, then I can also supply and fit them.

	Shin pain (tibial stress syndrome) Shin pain, referred to as “shin splints”, is a common term for pain occurring in the front and/or inside section of the shin bone (tibia). Anterior (front) shin splints is often experienced by new runners or walkers when pain occurs in the muscles at the front of the shin during exercise. Posterior shin splints (inside shin pain) is a more chronic condition occurring along the inside edge of the shin bone (tibia) and generally occurs with more active sports. Both conditions are related to excess stretching (traction) of muscles & tendons along the shin (tibia and fibula) bones. Orthotics reduce excess stretching (traction) of the front and back leg muscles (commonly called Anterior Tibialis and Posterior Tibialis muscles).
	Lower back pain (lumbar pain) Rolling over of the feet - excess pronation - causes the lower leg to rotate internally. As a result, the pelvis is forced to tilt forward, which can cause an increased curvature of the lower back (see illustration). This is referred to as ‘poor body posture’. Especially after standing upright for longer periods, the curvature in the back will cause tightness and stiffness of the lower back muscles. By controlling ‘excess pronation’ of the feet, orthotics help improve body posture. Because the feet are now properly aligned, internal rotation of the legs and forward pelvic tilt are greatly reduced, thereby easing low back pain.
	Outside knee and hip pain A common condition in athletes caused by abnormal friction and rubbing of the Ilio-tibial band muscle over the knee and hip joints. This condition commonly exhibits a gradual but rather severe pain on the outside knee joint and less commonly on the outside hip section. Sometimes, simply walking up or down stairs may aggravate this condition. The pain usually subsides immediately upon rest but re-occurs with activity. Orthotics control the internal rotation of the shin bone (tibia) and furthermore the rotation on the knee and hip joint via the in-built rearfoot varus wedge, thereby reducing stretching (tractional) and frictional forces on the Ilio-tibial band muscle. Stretching of the Ilio-tibial band muscle is advised.
	Heel pain (plantar fasciitis) Heel pain is usually caused by rolling over of the foot (excess pronation). As the foot pronates, the arch collapses and the muscles (plantar fascia) and supporting structure are forced to stretch and elongate. This puts traction and strain on the ligaments running from the heel to the toes. In turn, the heel bone ‘responds’ by developing a bony growth right in the centre of the heel - the ‘heel spur’. Orthotic shoe inserts align the foot and control body posture. By supporting the arches and realigning the lower limb to its natural angle, orthotics reduce the traction and strain on the plantar fascia.
	Tired, aching legs Tired/aching legs are commonly caused by strain and traction on the calf muscles at the back of the legs. This occurs when the feet roll over and the legs rotate internally. In turn, this places stress on the leg muscles. Orthotics control this ‘excess pronation’, decreasing internal rotation of the leg and traction on the calf muscles.
	Achilles Pain (Achilles tendonitis) Achilles tendonitis commonly occurs from shearing and stretching (tractional) forces placed on the Achilles tendon at the back of the heel, causing the heel bone to tilt excessively and placing extra strain on the tendon. Inflammation of the tendon is a common result along with tightening of the calf muscles. Orthotics align the heel bone and significantly reduce the shearing and stretching forces on the Achilles tendon, providing relief from Achilles pain.
	Knee pain (patello-femoral syndrome) Excess pronation - or rolling over of the foot - causes the lower leg (the tibia & fibia) to rotate internally. In turn, this will put excessive forces on the knee cap and over time it will weaken the muscles and ligaments in the knee joint. Often, a ‘grinding’ sensation is experienced in the knee, combined with a sharp pain. By supporting the arches and re-aligning the lower limb, orthotics stop the leg from rotating internally.