- Dr. Danny Myrtos
Orthotics and Foot Pain
Foot pain is very common with up to 42% of adults complaining of foot or ankle issues. Usually, foot pain originates from joints, muscles, tendons, ligaments or nerves in the foot. Many common conditions can can lead to foot pain including:
Tendinopathy (Achilles, flexor hallucis longus, posterior tibialis, peroneals)
Foot deformities such as pes planus (flatfoot)/pes cavus
Gout, turf toe, sesamoiditis
Posterior tarsal tunnel syndrome or posterior ankle impingement
Sinus tarsi syndrome
How do you know the cause of your foot pain?
To determine the underlying cause of your foot pain, a detailed history should be taken to assess the severity, location and mechanism of injury, be it prior trauma or inciting activity. The physical exam should include a comprehensive standing and gait assessment. This will determine any deformity of knees, hips, ankle/feet, and over pronation/supination. Additional orthopaedic testing will then be performed to further narrow down the cause of your foot pain. A complete assessment should also include analysis of your footwear for breakdown and wear patterns. Occasionally, we would require imaging studies to further identify the cause of your foot pain. This may include x-rays, ultrasound, MRI or CT.
What can you do about your foot pain?
Depending on the cause of your foot/ankle pain there are many options available to you including:
Orthotics with arch support and shoe modification
Activity modification, including ice, elevation and rest
Physical therapy including range of motion, proprioceptive training, stretching and strengthening exercises
Ankle braces, splints or boot
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics and corticosteroid injection
Rarely, surgical intervention may be required including: arthroscopy, injections, fasciotomy, osteotomy
Custom-made orthotics - Are they for you?
When required and properly constructed, custom-made orthotics will reduce your pain and help you walk with more support and greater comfort. A medical history review will assess your symptoms and also take into account your lifestyle and footwear. A hands-on examination of the entire lower extremity will be performed assessing the alignment, strength, range of motion and soft tissues of her foot and ankle. A thorough biomechanical gait assessment will then be performed to identify any abnormalities when walking. At this point, a determination will be made if orthotics are the right option for you. At our clinic, the devices are custom made from a digital scan of your foam cast, an assessment of your biomechanical patterns, as well as a full medical examination. The orthotics are then custom crafted utilizing a proprietary blend of nylon, fibreglass, naugahyde and other plastics. Information that is both dynamic and weight bearing is utilized. The casts are 3-dimensionally laser scanned and modified according to the prescribing doctor’s specifications. Each pair of orthotics are uniquely determined and customized by the algorithms in the production centre software. After dispensing, your provider should evaluate how you walk while wearing orthotics and follow up with you to ensure that they are addressing your issue while providing some education on how to break them in, the lifespan of your orthotics and how they should fit.