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Custom Foot Orthotics & Shoes

Custom Foot Orthotics & Shoes

Understanding Foot Pain

Heel & Arch Pain

Often referred to as plantar fasciitis or heel spur syndrome, it is one of the most common and easily treated foot problems.

Healthmedica Custom Orthotics will provide tremendous relief of pain.

Symptoms

Some people describe the pain as sharp, others describe it as dull. Often most painful with the first step, after a period of rest, especially in the morning. Pressure on the heel and arch reproduce the pain.

Cause

There are many different medical conditions that can cause heel and arch pain. The most common cause is plantar fasciitis, an inflammation of the plantar fascia, a dense fibrous band that runs from your heel to the ball of your foot. This is the result of improper foot function while walking or standing. This condition may appear suddenly, due to an injury, or present gradually over time.

Ideal Walking

As we walk (gait) our feet ideally move in different directions, supination and pronation. Our arches rise up and lock into place (supination), when we are preparing to step off a firm platform, our foot. When we land our arches unlock and start to lower (pronation), allowing us to absorb shock. Ideally our foot should go through both these motions in normal walking. Unfortunately not everyone is built perfectly and often our arches unlock excessively or fail to lock properly. This is sometimes referred to as a “flat foot” or “fallen arches” or “collapsed arches.” This flexible or pronated foot results in a foot that elongates and stretches the dense fibrous band or plantar fascia on the bottom our foot, resulting in pain.

Painful Calluses

Calluses, found on the sole of the feet, are a buildup of the dead outside layer of your skin (epidermis). They are similar to “corns,” which occur on toes. Although they can be anywhere on the sole, they most often occur under the “balls” of your feet. Healthmedica Custom Orthotics will provide tremendous relief of pain associated with calluses.

Symptoms

People describe the pain associated will calluses several different ways. It may be described as a burning or aching. Occasionally it is described as a sharp, pin point pain, such as “standing on a pebble.” Often people will believe they have stepped on something when in fact it is a buildup of the dead skin on the sole.

Cause

Calluses are the result of abnormal forces or friction on the skin. This increased pressure, leading to callus formation and pain, is due to abnormal foot function during walking and running. The type of callus and symptoms depends on the type of abnormal function. This explains why different calluses can have different symptoms, even on the same person. Other things such as poor circulation, poor nutrition and normal changes to the skin associated with age can aggravate this condition and magnify the pain. No matter what the type of pain, it is an abnormal walk that causes this pain and the reason that walking closer to your ideal with Healthmedica Orthotics will help. We guarantee it!

Ideal Walking

As we walk (gait) our feet ideally move in different directions, supination and pronation. Our arches rise up and lock into place (supination), when we are preparing to step off a firm platform, our foot. When we land our arches unlock and start to lower (pronation), allowing us to absorb shock. Ideally our foot should go through both these motions in normal walking. Unfortunately not everyone is built perfectly and often our arches unlock excessively or fail to lock properly. This is sometimes referred to as a “flat foot” or “fallen arches” or “collapsed arches.” This flexible or pronated foot results in an unstable foot, one that has difficulty keeping all the joints in proper alignment and will result in abnormal forces and pressure on the skin, resulting in callus formation.

Diabetic Foot Problems

Almost all people with diabetes will have foot problems during their lifetime. In the United States the # 1 reason for diabetics to be hospitalized is a foot problem. The # 1 reason for amputation in the United States is diabetic foot problems. Healthmedica Custom Orthotics will provide tremendous relief of pain associated with diabetes, as well as protect the foot.

Symptoms

Individuals with diabetes may present with the same foot problems as anyone else, but they often have a number of special ones. Diabetics can develop neuropathy, which results in many problems. At first their feet may be hypersensitive (an increase in sensation), where even the slightest pressure is painful. Later hyposensivitiy (a decrease or lack of sensation) may develop. Although this numbness may not be painful, it is a very dangerous situation for the diabetic individual. Even the slightest foot injury or callus formation can be disastrous.

Cause

Due to neurological and circulatory foot complications of diabetes, the skin does not respond well to the increased stress associated with callus formation, often forming a skin ulcer. These ulcers can progress to serious limb and even life threatening situations. Calluses are the result of abnormal forces or friction on the skin. This increased pressure, leading to callus formation and pain is due to abnormal foot function during walking and running. The type of callus and symptoms depends on the type of abnormal function. This explains why different calluses can have different symptoms, even on the same person. Neuropathy may magnify symptoms related to walking that normally could be tolerated. No matter what the type of pain, it is the abnormal walk that causes this pain and the reason that walking closer to your ideal with Healthmedica Custom Orthotics will help.

Ankle Pain

The ankle is a very complex joint and receives tremendous pressure as you walk. It is actually composed of three bones, the tibia, fibula and talus. There are many muscles and ligaments that are involved in motion of this joint. Ankle pain can be one of the most debilitating and long lasting pains a person can experience.

Symptoms

There are a number of different ways this pain will present, depending on the exact cause. The pain can be on either the inside or the outside of the ankle. It can be a sudden sharp pain, although it usually is a constant dull ache, related to activity. The pain will generally increase in severity over time.

Cause

This condition may appear suddenly, due to an injury, or present gradually over time. If the foot moves improperly there will be incorrect motion at the ankle joint and resultant pain of the ligaments and tendons surrounding the ankle. Having your foot and ankle move properly will alleviate the stresses placed on your ankle. Healthmedica Custom Orthotics will provide tremendous relief of ankle pain.

Ideal Walking

As we walk (gait) our feet ideally move in different directions, supination and pronation. Our arches rise up and lock into place (supination), when we are preparing to step off a firm platform, our foot. When we land our arches unlock and start to lower (pronation), allowing us to absorb shock. Ideally our foot should go through both these motions in normal walking. Unfortunately not everyone is built perfectly and often our arches unlock excessively or fail to lock properly. This is sometimes referred to as a “flat foot” or “fallen arches” or “collapsed arches.” This flexible or pronated foot results in the foot stretching the tendon and ligaments on the inside of the ankle and impingement (pinching) of the ligaments on the outside of the ankle. There will also be abnormal motion inside of the joint, resulting in “wear and tear” of the cartilage.

Knee & Low Back Pain

It is estimated that one out of every two Americans will suffer from back pain in their lifetime. The cost to society in medical care and lost productivity is in the billions of dollars every year. Studies have shown that for a large percentage of individuals there is no benefit to undergoing surgery. Knee pain will affect almost one in three Americans during their lifetime and it will also cost society billions of dollars every year. The good news is that Healthmedica Custom Orthotics will provide tremendous relief of knee and low back pain.

Symptoms

Back pain can present itself many different ways. For some it will be an intense ache in the lower back itself. For others it may be a sharper radiating pain extending down into the buttock. Knee pain can usually be isolated to a specific spot or structure, either inside or outside the knee. Initially, the pain may be unusually sharp and often becomes more generalized over time. Any activity such as walking or standing can aggravate both knee and low back pain.

Cause

There are many causes of knee and low back pain. Some complex, others simple. Some of the more common causes are arthritis, trauma, muscle weakness and faulty "mechanics" when walking. No matter what the reason for the onset of this problem an improper walk often aggravates it. When we are seated our foot moves freely in the air and has no effect on the body. But, when standing and the foot goes through excessive improper motion, the leg and ultimately the whole body is forced to follow. Our whole body pivots around a fixed point, the foot when we walk. Healthmedica Custom Orthotics will restore normal motion of your foot and ultimately your body.

Ideal Walking

As we walk (gait) our feet ideally move in different directions, supination and pronation. Our arches rise up and lock into place (supination), when we are preparing to step off a firm platform, our foot. When we land our arches unlock and start to lower (pronation), allowing us to absorb shock. Ideally our foot should go through both these motions in normal walking. Unfortunately not everyone is built perfectly and often our arches unlock excessively or fail to lock properly. This is sometimes referred to as a "flat foot" or "fallen arches" or "collapsed arches." When the foot collapses or rolls in excessively, the leg, which is attached at the ankle, has no choice but to rotate internally. This excessive rotation of the limb results in abnormal pressures on the knee and low back. Also, the body absorbs shock as the foot pronates and if it cannot pronate because it is already pronated, then the shock will be transferred into the legs, knees and back. Think of our feet like the shock absorbers on a car. The shocks absorb shock by shortening. But, if the shock absorber has completely shortened, then it cannot absorb any more shock. In other words, if our foot is fully collapsed, then it can not absorb any more shock and we feel the stresses of walking in our bodies.

Bunions & Hammertoes

If you agree with any of the statements below, please ask us how we can help you feel better, from the ground up.

  • My feet are sore on a regular basis.
  • I spend a good portion of my day standing or walking on hard surfaces.
  • I play a sport regularly (tennis, golf, basketball, etc.)
  • Standing, walking or running gives me joint pain (ankles, knees, hip, or back)
  • I am over 40 years old.
  • I have visible foot problems (bunions, fallen arches, corns, etc.)
  • One of my legs is shorter than the other.
  • I have knock-knees or bow-legs.
  • My shoes wear out quickly or unevenly.
  • My feet: "toe out" when I walk.
  • My parents had foot related symptoms.

Test Your Need For Orthotics

A bunion is a large bony protuberance on the side of the foot by the great toe. Bunions are usually associated with the great toe moving over and pushing on the second toe. Hammertoes are toes that are contracted or bent in such a way that they literally stick up.

Symptoms

These are "progressive" problems, in other words they get worse over time. At first they may be a minor annoyance, but after a while they can make the wearing of any shoe painful, if not impossible. Initially the pain is on the outside of the foot or toe and is usually described as an aching, but over time they will become painful in the joints and hurt both in and out of shoes. Unfortunately only surgery can change the shape of the foot and toes, but Healthmedica Custom Orthotics can provide significant relief of the aching in the joints affected by this condition.

Cause

While there are several different medical conditions that can cause these "deformities," by far the most common cause is an improper walk that results in a muscular imbalance. Over time, this imbalance will result in joints and toes changing position, resulting in these deformities. It is for this reason that Healthmedica Custom Orthotics can slow down and even stop the progression of these problems, by restoring the foot to its ideal function during walking.

Ideal Walking

As we walk (gait) our feet ideally move in different directions, supination and pronation. Our arches rise up and lock into place (supination), when we are preparing to step off a firm platform, our foot. When we land our arches unlock and start to lower (pronation), allowing us to absorb shock. Ideally our foot should go through both these motions in normal walking. Unfortunately not everyone is built perfectly and often our arches unlock excessively or fail to lock properly. This is sometimes referred to as a "flat foot" or "fallen arches" or "collapsed arches." This flexible or pronated foot results in an unstable foot, one that has difficulty keeping all the joints in proper alignment. Also, there are a tremendous number of muscles in the foot and leg that are no longer in balance, resulting in improper pulling on the toes.

Anatomy & Mechanics

Basic Foot Anatomy

The foot is made up of 26 bones, which are divided into three sections called the rearfoot, midfoot and forefoot. The talus and calcaneus (heel bone) are the bones that make up the rearfoot. The talus is the highest bone in the foot and it is also part of the ankle. The calcaneus is the largest bone in the foot. It sits below the talus. The navicular, cuboid and the three cuneiforms are the bones that make up the midfoot. The five metatarsals and nine phalanges are the bones that make up the forefoot..

There are three arches in the foot. There is an inner (medial) arch, an outer (lateral) arch and an arch in the forefoot called the transverse arch. Ligaments are like strong ropes that connect bones and provide stability to joints. In the foot there are numerous ligaments that support the arches and stabilize the bones. These ligaments are located on the top (dorsal), bottom (plantar) medial and lateral aspects of the foot.

The plantar fascia is a key structure that helps support the medial and lateral arches of the foot. The plantar fascia is a strong connective tissue that runs along the bottom of the foot connecting the heel to the base of the toes. When weight is put on the foot the plantar fascia helps to "lock" the bones of the foot and stabilizes these arches.

Many of the muscles that move the foot originate from the lower leg. These muscles attach via tendons to various bones in the foot. The muscles that move the foot upwards (dorsiflex the foot) originate on the front of the lower leg. The muscles that move the foot outwards (evert the foot) originate on the lateral aspect of the lower leg. The muscles that move the foot inwards (invert the foot) originate deep on the back of the lower leg. The muscles that move the foot downwards (plantarflex the foot) and propel the body forward originate from the knee and the back of the lower leg. The muscles that play the largest role in propulsion are the calf muscles (gastrocnemius and soleus muscles). These muscles join to form the Achilles tendon that attaches onto the calcaneus. In addition to the long muscles, there are also numerous short muscles in the foot. These muscles also play a role in stabilizing the arches of the foot and in moving the toes.

Finally, there are numerous fat pads located on the bottom of the foot. These fat pads act as "cushions" or "shock absorbers". The largest fat pad in the foot is located in the heel directly below the calcaneus. There are other "cushions" or "shock absorbers" in the foot called bursae. A bursa (pl. bursae) is a small fluid filled sac that also decreases the friction between two tissues and protects bony structures. There are many different bursae around the foot. One that is commonly injured is the bursa at the back of the calcaneus called the superficial calcaneal bursa. Normally, a bursa has very little fluid in it but if it becomes irritated it can fill with fluid.

Basic Ankle Anatomy

This section is a review of basic ankle anatomy. It covers the bones, ligaments, muscles and other structures that make up the ankle. For more information on how the ankle works please read the section on basic foot and ankle biomechanics.

The ankle is made up of three bones, which are connected by muscles ligaments and tendons. The tibia is the large bone located on the inner (medial) aspect of the shin. The fibula is the smaller bone located on the outer (lateral) aspect of the shin. The ends of the tibia and fibula are joined together by a strong ligament to form a socket called the ankle "mortis". The talus is the highest bone of the foot. It has a "dome" which fits inside the ankle mortis to form the ankle joint. The ankle links the foot to the lower leg. The bony structure on the lateral aspect of the ankle is called the lateral malleolus. It is formed by the end of the fibula. The bony structure on the medial part of the ankle is called the medial malleolus. It is formed by the end of the tibia. The medial and lateral malleoli are the bony attachment sites for the ankle ligaments.

Articular cartilage is a smooth shiny material that covers the ends of the bones in the ankle. There is articular cartilage anywhere that two bony surfaces come into contact with each other. In the ankle, articular cartilage covers the end of the tibia, the dome of the talus and a small part of the fibula. Articular cartilage allows the ankle bones to move easily as the ankle bends up (dorsiflexes), and bends down (plantarflexes).

Ligaments are like strong ropes that help connect bones and provide stability to joints. In the ankle there are three ligaments on the lateral aspect of the ankle and one broad ligament on the medial aspect of the ankle. It is most common for people to injure the ligaments on the lateral aspect of the ankle.

Tendons connect muscles to bone. Many of the muscles that move the foot originate from the lower leg. The tendons of these muscles cross the ankle and attach to various bones in the foot. The muscles that move the foot upwards (dorsiflex the foot) originate on the front of the lower leg. The muscles that move the foot outwards (evert the foot) originate on the lateral aspect of the lower leg. The muscles that move the foot inwards (invert the foot) originate deep on the back of the lower leg. The muscles that move the foot downwards (plantarflex the foot) and propel the body forward originate from the knee and the back of the lower leg. The muscles that play the largest role in propulsion are the calf muscles (gastrocnemius and soleus muscles). These muscles join to form the Achilles tendon that attaches onto the heel bone (calcaneus).

Finally, a bursa (pl. bursae) is a small fluid filled sac that decreases the friction between two tissues and protects bony structures. There are many different bursae around the ankle. The two that are commonly injured are the bursae that protect the medial and lateral malleoli. Normally, a bursa has very little fluid in it but if it becomes irritated it can fill with fluid.

Basic Foot & Ankle Biomechanics

Biomechanics is the term used to describe movement of the body. This section is a review of basic foot and ankle biomechanics. In order to understand the biomechanics of the foot and ankle it is important to understand their anatomy. Please read the sections on basic foot anatomy and basic ankle anatomy before reading this section.

The ankle is a modified hinge joint. It plays a key role in transferring the forces from the foot to the leg. The ankle joint is made up of three bones, which are connected by ligaments, muscles and tendons. A strong ligament joins the ends of the tibia and fibula to form the ankle "mortis". The "dome" of the talus (the highest bone of the foot) fits inside the ankle mortis to form the ankle joint. The ankle allows movement in only one plane. It allows the foot to move upwards (dorsiflexion) and downwards (plantar flexion).

The foot is made up of 26 bones. There are numerous joints between these bones that allow the foot to be both a rigid lever and a shock absorber. The largest joint in the foot is the subtalar joint. Inward movement of the foot (inversion), and outward movement of the foot (eversion) occur primarily at the subtalar joint.

The normal end ranges of motion for the foot and ankle vary between individuals and between children and adults. The following are approximate end ranges of motion for adults:

  • Dorsiflexion – 20 degrees
  • Plantar flexion – 60 degrees
  • Eversion – 15 degrees
  • Inversion – 35 degrees

The gait cycle (walk cycle) describes what happens to the foot and ankle from the point of initial contact of one foot with the ground to the point at which the same foot contacts the ground again. The gait cycle is divided into the swing phase and the stance phase. During the swing phase the foot is not in contact with the ground. As the name implies it is the phase of the gait cycle in which the foot swings forward to take another step. During the stance phase the foot is in contact with the ground. The stance phase of the gait cycle can also be divided into three stages. The first stage is called heel strike, the second stage is called mid-stance, and heel lift is the final stage. The biomechanics of the foot are best explained by describing what happens to the foot during the stance phase of the gait cycle.

During heel strike of the stance phase the foot begins to pronate. Pronation of the foot is the term that describes the rolling motion of the foot inwards and flattening of the inner (medial) arch of the foot. Pronation allows the foot to adapt to uneven terrain and absorb the impact of the foot striking the ground. It is during this phase that the foot begins to act like a shock absorber.

During midstance the entire foot is in contact with the ground and the weight of the body is directly over the foot. It is during this phase that the foot is maximally pronated. The foot acts as a shock absorber during the early part of this phase. As the body weight shifts forward the foot begins to return to a neutral position in preparation for heel lift.

Heel lift occurs at the end of the stance phase. Supination of the foot is the term used to describe the rolling motion of the foot outwards and the rising of the inner (medial) arch of the foot. During heel lift, the foot supinates to act as a rigid lever. The plantar fascia is a strong connective tissue that runs along the bottom of the foot connecting the heel to the base of the toes. The bones, muscles and the plantar fascia act together to form this rigid lever.

Abnormal amounts of pronation or supination can cause a variety of foot and leg problems. Abnormal pronation (overpronation) occurs as a result of the foot pronating when it should be neutral or supinating. Abnormal supination occurs when the foot is too rigid. These abnormal biomechanics can create lower back, hip, knee, ankle and/or foot problems.

The Gaitscan System

Lack of proper care, ill-fitting shoes and general foot neglect are responsible for the majority of foot problems.

It’s important to understand your feet have direct impact on the rest of your body and support you with each step. A small abnormality in foot function can have a large impact on joints higher up in the body, causing pain and discomfort.

When you are running, the pressure on your feet can be three or four times your body weight. Even walking can produce more pressure than the sum of your body weight. The American Podiatric Medical Association says that the average person takes 8,000 to 10,000 steps a day. That adds up to about 115,000 miles in a lifetime or more than four times the circumference of the globe. That is a lot of walking with ill-fitting shoes or painful feet!! In some cases foot ailments can be an early signal of more serious medical problems like arthritis or diabetes. Women have four times as many foot problems as men because they have a long history of wearing high heels and/or pointy toe shoes.

Remember if you are experiencing pain or discomfort in your ankles, knees or hip joints… the direct cause may be the function of your feet or ill-fitting shoes.

Our GaitScan™ System is a revolutionary diagnostic tool for assessing the biomechanics of your gait, particularly how your feet align with the ground when you walk. GaitScan™ has an industry high 4096 sensors and scans at an industry high 300Hz (scans per second). These measurements provide us with a sophisticated explanation of foot mechanics and assists them with orthotic and/or shoe solutions. Your biomechanical assessment will include static and dynamic weight bearing alignment in the lower extremity, inspection of shoe wear patterns and callus formation on your feet and muscle testing for length, strength and balance.

How does GaitScan™ work?

  • Scan your foot
  • As you walk across the plate, thousand of tiny sensors capture the distribution of pressure throughout the sole of your over time.
  • Map your foot pressure
  • From your step, the computer then display on its screen, 2-D and 3-D visual representations of the pressures under your feet.
  • Prints Reports
  • This information is also summarized in an analysis report that can be printed out for you to see. The report findings will help to evaluate your foot function and determine if the symptoms you are experiencing are related to faulty foot mechanics.
  • Determines need for Orthotic Therapy
  • This information will provide us significant information to determine your need for orthotic therapy, and will aid the lab in manufacturing prescription orthotics to support your feet.

Foot clinic – Guarantee

We at Healthmedica are so sure that we can improve your life, we will unconditionally guarantee your orthotics in writing! If for any reason within 90 days from receipt of your orthotics you are unhappy with them, we will do whatever is necessary to make you happy. We will remake them at no charge to be sure you are completely satisfied with them.

Not only do we give you 90 days to try them out, but we also guarantee all Healthmedica Orthotics against breakage for one year.

Not many places offer a guarantee like this because they can’t! No one matches our quality and prices!

You owe it to your feet. After all, they have to last a lifetime.

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