Biomechanical Assessment & Orthoses

Pain in the feet and lower limb can be caused by structural or functional problems with their respective bones, joints, ligaments and tendons.  Pain can be localised, such as to the heel, ankle, ball of the foot or between the toes. Problems can arise when walking, standing or pain may just persist, impacting on your sleep, work or activities.

A number of common conditions that lead to foot and ankle pain can be diagnosed then treated by wearing foot orthoses. Orthoses are different from insoles of the type most people can buy from a pharmacy or online retailer. Insoles simply provide cushioning with gel or foam. Some even help with smelly feet!

Orthoses are professional medical devices used to help redistribute pressure away from joints and tissues under stress. Their design and manufacture is based on the patient's specific gait and foot pathology, taking into account the individual's foot posture and shape. For this reason, most orthoses are bespoke or semi bespoke and require a written prescription.

The type of orthoses available are many and varied, with equally varied methods of customisation for individual patients. Different Podiatrists will use different types and methods that are suitable to their business set up and ways of working. 

Some orthoses are prefabricated with specific pathologies in mind and can be supplied off the shelf. Some can be customised with additions and heat molded to the patient's foot. Most are manufactured either from a standard shell or cast of the patient's feet and the requirements of the prescription built into the orthoses directly, making them truly bespoke to the patient.

 Examples of the types of conditions that can benefit from orthoses can be found below.

Put simply, an assessment is series of tests involving the active and passive manipulation of joints, muscles and tendons of the lower limb and foot while standing and sitting, along with measured observations of foot and body posture during gait or walking.  The circulation and sensation of the feet is also examined and a full medical and drug history is taken.

The aim is to identify and isolate the problem or pain, attempt to reproduce it and deduce from the structural or functional problems identified in the assessment, the actual cause. Usually an assessment can identify the problem and the next step is to offer options for treatment including prescription or off the shelf orthoses.

Some problems can not be identified by a biomechanical assessment or relieved by orthoses. In these cases other treatments are available following further testing which may include onward referrals to GP's for medication, imaging or Physiotherapy and in some cases, surgery. 

Providing you have adequate space for a Podiatrist to examine you walking, standing and sitting, in most cases a simple assessment can be carried out at home.  Please refer to our price list for more information. 

Bunions

Neuromas

Fibromas

Plantar Fasciitis

Oesteoarthritis of the joints

Ankle Sprain

Metatarsalgia and Heel Pain

Heel Fissures

Flat Feet

Bursitis

Tendonitis 

The type of orthoses you choose will depend on your budget and the type of condition requiring treatment. 

Conditions involving significant changes in the structure of the foot may require more robust, fully bespoke orthoses with a longer life and able to take increased wear and tear. 

While others may require a simple off the shelf type that only needs to last as long as the inflammation or pain settles. Each of these will lie at opposite ends of the price spectrum with choices in between. Following your assessment, we will always provide you with choices for treatment.

We currently employ a laboratory to manufacture all of our semi and fully bespoke orthoses. Following your assessment a prescription is sent to the laboratory and the orthoses are delivered to our office usually within 2-3 weeks. At which point we will contact you to arrange a fitting appointment at your home.

Simple, off the shelf orthoses can usually be supplied during your appointment or ordered to arrive within 2-3 weeks. Speak to your Podiatrist or refer to our price list for more information.

Occasionally, pain in some soft tissues and joints can persist despite rest, orthoses, and medication. In particular, the painful symptoms of Planatar Fasciitis, Bunions and Neuromas may be stubborn and refuse to respond to other types of treatment. 

Following your assessment, and depending on your medical history and the particular condition, you may be suitable for a corticosteriod injection. Please speak to your Podiatrist and refer to our price list for more information.

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions in the body. Steroids are a man-made version of hormones normally produced by the adrenal glands, two small glands found above the kidneys.

When injected into a joint or soft tissue, steroids reduce redness and swelling (inflammation) in the nearby area. This can help relieve pain and stiffness. In the foot, methylprednisolone with a local anaesthetic provides immediate pain relief that lasts a few hours.  The steroid in the injection normally take a few days to start working.

Most people can have steroid injections. However,  you usually need to wait at least six weeks between injections and it is usually recommended no more than three injections in the same area in the space of 12 months.