Custom-made foot orthotics are becoming very popular these days. Generic over the counter shoe inserts are available at every drug store and pharmacy and it's hard to go a day without watching a television infomercial claiming instant relief through the mail. Custom-made foot orthotics can be purchased from podiatrists, orthopedic doctors, physical therapists, and chiropractors. These inserts, when made correctly, can help with a wide variety of foot issues including plantar fasciitis, heel spurs, metatarsalgia, and neuromas. The correct foot support can help patients who deal with chronic ankle sprains, hammer toes, bunions, and corns. But most people do not realize that foot orthotics can be extremely effective in treating issues above the foot ankle including shin splints, knee pain, hip pain, and yes, even chronic low back pain. Chiropractors especially, stand behind the concept that correcting the alignment and biomechanics of the foot can directly relieve stress and pain from the above skeleton.
In order to fully understand the relationship between the feet and the rest of the body you must first understand the role of the foot and its place in the human skeleton. Each foot is equipped with 3 arches that help it work properly. The arches consist of 2 arches that run long wise down the feet which are called the medial and lateral longitudinal arches and one transverse arch that travels across the ball of the foot. The arches have many purposes but for the sake of this article the most important task is to aid in weight bearing by offering shock absorption for the weight of the body. The arches help to balance the body when standing and walking. The arches have an elastic property which allows the foot to flatten out after foot strike and return to its original shape when weight is taken off.
Because of the fact that we are biped and unfortunately spend most of our waking day on our feet, the feet are the foundation of our body. And over time these arches can begin to flatten and lose its elasticity. Now if this happened symmetrically to both feet it would not be as much of an issue but for one reason or another feet tend to flatten more on one side than the other. This leaves us standing crooked. If the foundation of the body is not properly aligned and supported then the integrity of the structures above are in jeopardy. Good thing for us, our bodies have an innate intelligence that will tighten muscles, rotate joints, and curve our spines in order to level us out. And it is this undetected process that leads to knee pain, hip pain, low back pain, and in some case even scoliosis. To better understand this concept the analogy of a skyscraper can be useful. If we were to gradually raise up the foundation of the Sears Tower on one side of the building it would affect the structure as a whole. Initially the structures would begin to lean to the opposite side but eventually the beams and supports would curve back to hold it from falling over. This would put compressive forces on the concave side of the supports and stretching forces on the convex side. If we were some how able to raise the foundation enough on one side we would start to see teething and destruction through the lower part of the building and eventually the building would collapse.
The biomechanics of this process in the foot is referred to as pronation which is a fancy term for the flattening of the foot. As the arches fall over the years it causes the foot to flatten. This flattening can cause plantar fasciitis, heel spurs, neuromas, and ankle injuries. When the foot flattens it sets off a kinetic chain through the leg and the low back. First as the foot flattens it causes the tibia in the lower leg to rotate. This rotation can lead to shin splints, stress fractures of the tibia, and puts rotational stress on the knee which can cause ligament tears, arthritis, and generalized knee pain. The next step up the kinetic chain is the drop in the hip and an inferior tilt to the sacrum on side of foot pronation. This can cause hip arthritis, bursitis, and tendinitis and most common of all, low back pain. The sacrum is the base of the spell so when it leans to one side it causes the spine to lean just as in the skyscraper analogy. This puts stress and pressure on the spinal and can lead to disc injuries, spinal arthritis, sciatica, and generalized low back pain. In severe chronic cases it can even lead to a curving of the spine called scoliosis. We can have all these issues because of improper alignment of the feet.
Here is where custom-made foot orthotics comes to the rescue. Using a casting or molding system your doctor can make an orthotic insert that properly supports your feet in an even and balanced position that relieves stress off the ankles, knees, hips, and low back. Over the counter insert can provide some support and some cushioning but just remember, these same inserts are used for people of all different shapes, sizes, ages, and injuries. Your health care professional is trained to know what type of orthotic is needed for your specific case and condition.