Patients often present with back, hip and/or knee problems. The entire lower body must be assessed to determine the sources of misalignment or dysfunction when determining care for these complaints. The foot is the supporting pillar upon which the rest of the body balances. If there is a deformity of the foot, it can cause the joints all the way up the body chain to become aligned improperly. This can cause pain and imbalance in the hips and lower back and even the neck and jaw.
In the past, many of our patients presenting with back complaints got 80% better with the therapies we used. I wondered, why not 90% or 100% of them? I realized I was missing a component-the foot. If the feet were flat or otherwise improperly aligned, the whole chain above the feet was going to rotate. The knees might angle in, the hips might rotate in and the lower back would try to compensate. The forces at the foot would start to compensate as well.
The foot may need additional support to transfer weight from the heel at heel strike to the great toe for push-off. Without the dynamic forces available by the strong arch, this cannot happen without compensatory adjustments by the body. Therefore, we assess the patient in standing, while they walk (gait cycle) and we assess range of motion and soft tissue limitations. We cast the person to determine the best position for the foot. We send the information to the lab. I advise the lab to make the best orthotic for the patient based on that person’s foot position, their pain complaints, their walking style and what they do for work and fun. In addition, when the orthotic is fitted to the patient, we make sure all of the assessment criteria are matched. We educate the patient about the wearing time and suggest proper foot wear.