Foot Relief

Arthritis (Click for Picture)

A deterioration or wearing down of the joint material. The picture (above) is an arthritic foot. Mild or debilitating arthritis can set in when feet joints are stressed, misbalanced or unsupported. Joints flare up, swell, wear down their protective coatings and become arthritic. When the body is off center, arthritis can spread to upper body joints (like a house on a tilted foundation).

Our particular orthotics help restore function of the foot and body, alleviating painful progression of arthritic joint conditions.

If any of your joints are stiff, hurting or in pain sometimes or all the time, you may have arthritis. Orthotics can help spread your weight evenly across your feet and transfer the weight off your arthritic joints. It's worth a try before walking or regular functioning is difficult or impossible.

Back Pain
Back pain affects more than 50 million Americans each year, and the diagnosis of the exact cause of back pain can be very frustrating, expensive, and inconclusive.

Recent studies have shown that over half of all back pain patients responded well when treated with custom-made orthotics. If you are suffering from back pain and cannot get relief, custom-made orthotics may help you.

In the largest study on back pain, it was discovered that over 50% of all patients had one of the following problems which were not identified by the treating doctor: leg shortages, poor posture, or muscle strains and imbalances. Once the problem was properly identified and treated with custom-made orthotics, 75% of the patients showed marked improvement. Hundreds of dollars were spent on sophisticated tests when instead, with just a few simple diagnostic steps, the treating doctor could have made the diagnosis; the simplest answers are frequently overlooked!
All three of these problems place abnormal pressure and stress on the spine, causing inflammation and pain. Custom-made orthotics reduce the abnormal pressures on the spine, and act as shock absorbers, reducing the jarring of the spine as we walk. These two actions were found to relieve back pain. Why did this happen?

1. Leg shortages: The body compensates for this by leaning towards the short leg, trying to extend it and make the short leg longer. This constant leaning puts a great deal of pressure on the spine. Eventually the spine becomes so inflammed from this pressure that pain results. By using a custom-made orthotic with a lift built into it for the short leg, the legs are then made the same length. This stops the body's need for compensation, which alleviates the abnormal pressure on the spine. No pressure... no pain!

2. Poor posture: By standing and walking improperly, due to slouching or abnormal ways of holding ourselves erect, we place tremendous abnormal forces on our spine. This causes inflammation of the bones that make up the spine, and this eventually causes pain. After many years of standing and walking with this posture, we cannot change it just by thinking about it. Custom-made orthotics, designed with specific lifts and support, will reduce the abnormal forces on our spine caused by poor posture. No abnormal forces... no pain!

3. Muscle strains and imbalances: Attached on either side of our spine are muscles of equal strength which keep the spine straight. If the muscles on one side of the spine become stronger than the muscles on the other side, there is a muscle imbalance. This causes the muscles on the weaker side to try and pull harder on the spine in order to keep it straight. These overworked muscles eventually become strained, inflamed, and painful. Custom-made orthotics with proper support for the foot and leg on the weaker muscle side will help to rebalance the back muscles. When the muscles in the spine are balanced, there is no inflammation —— no pain!

TREATMENT: In the study on back pain, using custom-made orthotics rather than just shoe lifts or pads was more effective for the following reasons:
a. Shoe lifts and pads wear out quickly and loose their original shape. As the heel and sole of the shoe wear down, so does any correction that the lifts or pads might have provided. The comfortable, yet durable materials that our custom-made orthotics are constructed with will last for years without wearing down or loosing their shape. Custom-made orthotics will also reduce abnormal shoe wear, so that your shoes will last longer.

Bunions
Usually started by problems with the length of the metatarsals (middle toe longer than the big toe), arches collapsing, unbalanced feet, or imbalance in the body due to favoring one leg over the other. Our orthotics can help by re-balancing the foot and its arches (especially across the metatarsal regions). The orthotic can help reduce stress across the joints (stopping joints and bones from rubbing against each other allowing swelling and the bunion growth between the toes to reduce.

Without using orthotics, podiatrists can recommend surgery (bunionectomy) if the bunion is large and painful. It is not uncommon, however, that bunions can return within 3-5 years again after surgery! Give your feet a rest! Use our type orthotics and see if your bunions reduce!

Calluses
Excessive weight on the ball of the foot is usually to blame for calluses. Similar to working in a garden and hands get callouses from the tools, the same can happen on the feet. As soon as the tools are not used, the callouses on hands tend to go away. The same can go on with the feet when areas of pressure or fallen arches are supported. The constant rubbing against the bottom of the shoe can cause the skin to harden up and become thicker.

With the regular use of orthotics, pressure on the ball of the foot can be alleviated. This means the callused area should go away; essentially reabsorbing the thickening skin back into the body.

Corns
The corn can be seen on the top of the second toe. It is a hardened circle shape where the skin is thick like a small ball. Orthotics can eliminate this condition because once the hammer toe is straightened out, there will be less rubbing against the top of the shoe.

The corn may also be forming where joints are not functioning properly inside the toe, however mostly the corn is due to rubbing on an external basis. Using wider shoes can help, but orthotics offer a more permanent solution to a problem which may never seem to go away otherwise.

Description: Corns are areas of hard, dead skin which form on toes as a response to abnormal shoe pressure. Corns can become inflammed and painful, if the shoe pressure continues. But a corns is just a symptom of some underlying toe pathology, such as:
1. Hammertoes: Toes which are bent so that the part closest to the foot is directed upwards, while the remainder of the toe is bent down, so that you walk on the tip of the toe. Corns may form on the top of the toe where the shoe rubs against it. Or they can form on the tip of the toe, because you do not apply weight to the entire toe when walking, but just to the tip. Click here to learn more about hammertoes.
2. Bone Spurs: A benign bone mass (extra bone) usually occurring between the toes. The bone spur places increased pressure on the overlying skin of the toe and the adjacent toe. The resulting pressure causes a build-up of hard, dead skin (a corn), which becomes painful when shoes are worn as the toes rub against one another.

Charcot Foot
Description: Charcot Foot is a pattern of bone and joint destruction that can lead to severe foot deformities. This disease begins with peripheral neuropathy (decreased feeling in the feet), most commonly seen in diabetics. People with decreased nerve sensation may injure their feet, producing small fractures in the bones; and because they have decreased feeling, they may have minimal or no pain, and they continue walking on the foot. This causes the bones to heal unevenly, causing the foot to become deformed.

Symptoms & Treatments: The acute, or early symptoms of Charcot Foot are: small fractures of the bones of the foot, swelling over these areas, and later the entire foot may become swollen and inflammed. There is little, if any pain during this stage. Treatment during this stage is imperative, and includes: complete rest of the foot by using a non-weightbearing cast, crutches, and bed rest. If treatment is not initiated, this disease progresses to its chronic stage. During this stage the following symptoms may be present: a foot which is deformed, and noticebly different then the other foot; a collapsed arch; bones which abnormally protrude against the skin, possibly causing the skin to breakdown and ulcerate; swelling and inflammation of the foot; and there may be no pain present, or in some patients the pain is intense, due to the amount of bone and joint destruction present. Treatment during this stage involves non-weightbearing casts until the swelling subsides, physical therapy, and custom-made shoes and orthotics.

Prevention of Charcot Foot:
Anyone who has peripheral neuropathy, especially diabetics, should be treated with custom-made orthotics to help guard the feet against injuries; to support the bones and joints of the feet, thus preventing deformities from occurring; and to protect the bottom of the feet from friction, calluses, and ulcers of the skin.

Examine your feet dailyincluding the tops, bottoms, and between your toes. Look for inflammed areas, cuts, peeling and breaks in the skin, rashes, and swelling. Press on your nail to see if they are painful or ingrown. Touch your feet and make sure the temperature is the same in both, and that they are not cooler then the rest of your body. Test to see that you have good feeling in the bottom of both feet, by gently moving your finger from heel to toes. If any of the above is abnormal, see a podiatrist immeditely.

Wear properly fitted shoes, with uppers made of soft materials, the toe box (the area where the toes lie in the shoe) should be deep and wide to reduce pressure on the toes, and the heels should be no higher than 3/4 inch. Seamless socks and shoes cause less problems then those with seams. Always wear shoes and socks; they protect the feet from injury. Do not walk barefoot.

The Diabetic Foot
Diabetes is a disease that affects every part of the body, even when the diabetes is under control. Diabetics, because of the nature of their disease, have fewer defenses against everyday wear and tear, especially where the feet are concerned. Increased blood sugar affects the feet in the following ways:

The sugar affects the nerves of the feet, causing peripheral neuropathy. Peripheral neuropathy is a disease which can produce anything from strange feelings in the feet (burning, tingling, numbness, etc.), to a complete loss of feeling in the feet. The lack of proper feeling makes the diabetic more likely to injure their feet without knowing it. This makes the diabetic more suseptible to infections; fractures which are not felt, and do not heal properly; and severe bone and joint disease which changes the contour of the foot. See Charcot Foot for more information.

Sugar also affects the smaller blood vessels in the feet causing peripheral vascular disease (P.V.D.). P.V.D. decreases the amount of blood, nutrients, and oxygen that are brought to the skin, fat, muscles, joints, and bones of the feet. This causes: tissues to be absorbed, an inability to properly heal everything from small cuts to broken bones, and just plain fatigue and weakness of the feet.

Absoprtion of the natural protective fatty pad on the bottom of the feet. This is due to P.V.D. and/or the natural aging process. When the fat pad becomes thinned or completely absorbed, it cannot protect the skin properly from normal bone pressure. This puts tremendous stress on the skin which underlies these bones, and can cause inflammation, calluses, and eventually skin ulcers which may become infected. These problems may become worse without the diabetic knowing it, if peripheral neuropathy is present.

To sum up, the diabetic foot is "at risk," even when the blood sugar is controlled. In my practice, I have found that Diabetic Custom-Made Orthotics will greatly reduce the risk of foot disease. These special orthotics act as a replacement for the thinning fat pad on the bottom of the feet, thus protecting the skin from excessive bone pressure. These orthotics will also gently support the arch and all the bones and joints of the feet. Our orthotics are made of durable, comfortable, space-age materials. They are lightweight, and will fit in all flat shoes. Custom-made orthotics are the diabetic's "ounce of prevention" that may eliminate a "pound of cure" later on.
Other risk relievers:

Gel Insoles: Designed for the diabetic who wants to prevent foot problems. In my practice I use these innersoles because they help to protect the thinning fat pad on the bottom of the foot, thus protecting painful pressure points and calluses. They also help to relieve foot fatigue. This is a long-lasting innersole, made of lightweight but durable materials, that will fit in any shoe and can be moved from one pair of shoes to another. These do not duplicate the protection that custom-made orthotics provide, but they are a help. Call us at 800-717-5505 for the Gel Insoles they are only $39.95 plus tax and $5 shipping and handling.

Examine your feet daily includung the tops, bottoms, and between your toes. Look for inflammed areas, cuts, peeling and breaks in the skin, rashes, and swelling. Press on your nail to see if they are painful or ingrown. Touch your feet and make sure the temperature is the same in both, and that they are not cooler then the rest of your body. Test to see that you have good feeling in the bottom of both feet, by gently moving your finger from heel to toes. If any of the above is abnormal, see a podiatrist immeditely.

Wear properly fitted shoes, with uppers made of soft materials. The toe box (the area where the toes lie in the shoe) should be deep and wide to reduce pressure on the toes, and the heels should be no higher than 3/4 inch. Seamless socks and shoes cause less problems then those with seams. Always wear shoes and socks; they protect the feet from injury. Do not walk barefoot!

Wash your feet daily, with warm water (not hot). Dry well, especially between the toes. Cut your nails straight across, do not dig in the corners (if the skin around the nail is red, swollen, moist, or painful, you may have an infection, see a podiatrist immediately. At bed time, massage a moisturizing cream into your feet to prevent dry skin and cracks. Do not use chemical corn and callus removers; they usually contain an acid, which can burn sensitive diabetic skin. And finally, see your family doctor regularly to help keep your diabetes under control.

Stages Of Collapse (Flat Feet)
The Pictures here are indications of weak weight bearing structural positions of the feet. The stages of collapse can happen in the above progressions. The first stages, (1-2) appears to show the transverse arch collapsing along the metatarsal bones. The next appears to show the collapse of the longitudinal arches along the inside and outside (3-4). In either or both, heel rotation can sometimes occur, which can creating unstable positioning throughout the foot and upper body. With orthotics, problems of flattening or collapsing of the arches for most people can possibly be reversed.

Orthotics can help by supporting all the arches in the foot which helps lift the arch into a more normal foot. This support can allow for more circulation, reduce swelling as well as possibly help muscles grow stronger and function better.

The normal arch functions as a shock absorber for our entire body. Each time we step down, we place up to 5 times our body weight on the foot, depending on whether we are walking, running, or jumping. If there was no shock absorber in the foot, the force of each step would eventually fracture or dislocate the bones of the foot, leg, and lower back. When the arch is flat (a flat foot), it is "sick" and cannot function properly. If left untreated, this will lead to a completely collapsed foot which cannot function as a shock absorber at all; and, this in turn will cause constant pain in the foot, and eventually the knee, hip, and lower back.

Causes: The normal arch is made up of bones and joints which are held tightly together in a precise relationship. In order for the arch to flatten out, the ligaments and tendons which hold the bones and joints together must be more flexible than normal. This abnormal flexibility may be a result of: the genes we inherit from our parents, the weakening of muscles and ligaments caused by advancing age, neuromuscular diseases, or injury. Injuries may include one severe trauma, or years of standing for long periods of time in the wrong types of shoes (those with high heels or those with poor support). This flexibility of the bones, joints, and soft tissues is what causes the foot problems which are related to flat arches or feet. The following conditions are the most common foot problems seen in flat feet:

1. PRONATION is the most common and damaging medical problem that may occur as a result of flat arches. Pronation is a turning outward of the foot at the ankle, so that one has a tendency to walk on the inner border of the foot. You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run straight down the leg, but when it lies on the heel, it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone. Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. If left untreated, pronation may be the cause of heel spurs, plantar fasciitis, frequent ankle sprains, shin splints, weak and painful arches, and eventually knee, hip, and lower back pain.

2. STRUCTURAL DEFECTS are foot problems that may occur because the bones and joints of the foot are not held together with the normal amount of tension. This allows the bones and joints to move into abnormal positions causing: bunions, hammertoes, neuromas, calluses, and corns. If these problems are left untreated, they become progressively more painful and debilitating.

Treatment: In the child and adolescent, treatment must be directed to supporting the individual bones and joints which make up the arch, and to aid the arch in its job as a shock absorber during the individual's growing years. This support of the individual components of the arch will prevent the arch from flattening out further as growth continues, allowing a normal arch to be formed. Aiding the development of a normal arch is accomplished through Custom Orthotics

Fungus (Athletes Foot)
Symptoms: Itching, cracking, peeling skin. Try our:
Tri-Pod Labs
Anti Fungal Herbal Cream

This product is really good on getting rid of fungus. Fill out our Order Form, email or call 1-800-717-5505 for details.

Tea tree oil is also another product which can solve fungus quickly. Please call us for details.

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Foot Odor
Foot Odor is usually the result of a buildup of bacteria. Bacteria excrete while they eat. The odor you smell is that excretion. If your feet sweat or are moist during the day, bacteria can begin to thrive more and more.

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Toe Nail Fungus
Nail fungus is a little more tricky than it may seem. When caught early enough, our toe nail fungus products help get rid of this completely. Here the fungus is growing underneath the nail which makes the nail act as a hard shell. This is similar to a turtle being covered by its shell. Our best Tri-Pod Labs 2-Step Lotion product helps soften the nail first and then penetrates deep inside the nail to reach the fungus underneath.

Traditional ointments can be expensive and risky to the organs (chemical based prescriptions). If your fungus is really bad, see your doctor to get quick serious treatment with shots (under the nail) or removing the nail(s) etc.

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Warning: Some fungal infections can be spread under the skin and also into tissue inside the body until it reaches vital organs. Be careful to watch your feet regularly and talk to your doctor if you are concerned.

Hammer Toes
Hammer toes can be helped through the use of orthotics because a lift underneath the metatarsal area is usually all that is needed. The lift can help support the fallen metatarsal arch, or the stressed imbalance which is occurring across the metatarsal arch (usually because of too high arch or too low arches) .

A common myth is hammer toes can never be healed. Doctors during surgery, snip the muscle which connects the hammer toes to the bone behind the toes. This process can affect the toes and overall balance of the entire foot and body though! With orthotics, hammer toes can actually return to normal for some people.

Heel Cracking
Cracking of the heel can stem from the feet being misbalanced on one side more than the other, or if a person is leaning back on their heels and the skin tends flattens out around the sides of the heel. Obesity where excess skin is protruding on the side of the heel is also a major cause of this condition. Orthotics help because the foot will become balanced across the heel. With obesity, our orthotics offer support to help keep the skin from protruding outward.

The problem can also stem from wearing sandals too long or walking barefoot on hot surfaces etc.. Doctors may recommend putting ointment on the feet (Aloe Vera, Vaselineor even "Tea Tree Oil"). Also, you can try using shoes more often instead of sandals, or wearing socks with sandals. Crackling can be similar to chapped lips.

Heel Spurs and Heel Pain
The two most common causes of heel pain are heel spurs and plantar fasciitis. The chief diagnostic sign of these problems is: pain in the bottom of the heel when first standing, which gradually improves with walking. This pain may return with continued walking. The treatment involves correcting the underlying causitive problems. Please read the following section for more information on the problem and its treatment. A spur is actually a calcium deposit in the heel shaped like a sharks tooth.

Description: The two most common causes of pain in the bottom of the heel are heel spurs and plantar fasciitis. The plantar fascia is the thick ligamentous band in the bottom of the foot which is attached to the heel, and runs forward to insert into the ball of the foot. Plantar fasciitis is an inflammation of this band at its attachment to the heel.

The pain is most intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of walking, the pain becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated by the spur, or inflammed due to the swollen plantar fascia, this pain may radiate into the arch or the ankle.

Causes: Each time we take a step forward, all of our body weight first rests on the heel of one foot. As our weight moves forward, the entire foot begins to bear the body's weight, and the foot flattens and this places a great deal of pressure and strain on the plantar fascia. There is very little "give" to the plantar fascia, so as it stretches only slightly, it pulls on its attachment to the heel. If the foot is properly aligned this pull causes no problems. However, if the foot is "pronated" (the foot rolls inward, causing a break down of the inner side of the shoe), the arch falls excessively, and this causes an abnormal stretching of the relatively inflexible plantar fascia, which inturn pulls abnormally hard on the heel.
The same pathology occurs with "supination" (the rolling of the foot outward, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible, usually have a high arch, and a short or tight plantar fascia. Thus as weight is transferred from the heel to the remainder of the foot, the tight plantar fascia does not stretch at all, and pulls with great force on its attachment to the heel.

Permanent relief can only be accomplished with the use of custom orthotics in most instances.

Neuroma
As far as healing the Neuroma pain, our orthotics can help by taking the pressure off the nerves and reducing the swelling within just a few hours to days. The Neuroma is a swelling of the nerve between usually the 3rd and 4th metatarsal bones (3-4th toes). It is mostly caused by bones/joints rubbing against the nerve like in a vice, or imbalances of leaning from one side (pronation/supination) and compressing the nerve so it swells. The swelling then causes the shoes to become very tight. Tights shoes usually perpetuate the condition and make it worse.

Orthotics can help by lifting and separating the metatarsals off the nerve which is being rammed and pinched between the bones on every step. Because of the nature of Neuroma pain, when you first wear our orthotics, your nerve in that region usually feels still very sensitive at first. Later on, the sensitivity subsides and healing begins.

Follow the wearing plan closely and be sure to take the orthotics out whenever your feet get sore. The condition will usually be completely and easily healed (naturally) and we have had plenty of testimonials to show for it!

Pain In The Arch
The arch functions as a shock absorber for our entire body. Each time we step down, we place up to 5 times our body weight on the foot, depending on whether we are walking, running, or jumping. If there was no shock absorber in the foot, the force of each step would fracture or dislocate the bones of the foot, leg, and lower back. When pain occurs in the arch, it is telling us it is "sick" and cannot function properly. If left untreated, this will lead to a fallen arch, which will cause constant pain throughout the entire foot, and eventually the knee, hip, and lower back.

Description: The most common causes of arch pain are: (1) Repetitive activities, such as walking or running too far; jumping; or standing on hard surfaces for long periods of time. (2) Injury. (3) The natural aging process. (4) Biomechanical defects of the foot, or abnormalities we are born with, such as very high or low arches, or pronation (a turning out of the foot, causing us to walk more on the inner border of the foot).

Symptoms: (1) Repetitive exertive activity arch pain is usually sharp, and localized to a specific area, rather than the entire arch. The pain is present when first standing on the foot, and gradually becomes worse with continued walking or running. Swelling may be present. The pain subsides with rest, but stretching the arch while resting may cause the pain to return. (2) Injury pain is constantly present, but worse when standing on the foot. This pain is localized to a specific area, but may radiate out from this area to the entire foot. The pain is sharp, and usually accompanied by swelling and occasionally "black and blue" discolorations. (3) The pain due to the natural aging process is usually dull and aching, or stiff, and can be felt throughout the entire arch area, rather then in just one spot. This pain is present whenever weight-bearing, and usually becomes worse with continued walking. The pain gradually subsides when resting, and usually does not return with stretching. (4) Biomechanical defect pain is usually localized to a section of the arch, such as the inner, middle, outer, front, or back of the arch. This pain may be sharp or dull, but is always worse with continued walking.

Cause: The normal arch is made up of bones and joints which are held tightly together, in a precise relationship. When this relationship is subjected to repeated abnormal weight, or the normal weight of a lifetime, the force breaks up this normal relationship, causing bones to shift and joints to buckle. This allows the arch to collapse, and produces pain. The ability of the arch to absorb the shock of each step is reduced, so that continued walking will eventually produce pain in the knee, hip, and lower back. All four of the above categories will eventually cause this to happen.

Posture
Good posture is usually when a persons feet are balanced and stable. When the arches in persons feet collapse, the result may become a bad posture. Arches collapsing can put a persons entire balance off center. When arches fall, ankles may lean inward/outward, knees lean inward/outward, hips begin to get sore, the back goes crooked, shoulders and neck go out of position. If the problem goes on for many years, over time problems can keep getting worse.

Alignment (on the left) can become better, toward looking like the picture on the right. Even weight distribution across feet and body can help keep ones posture sturdy and balanced. Pains should not be experienced with the person on the right.

If your symptoms look ANYWHERE NEAR THESE ABOVE see your podiatrist A.S.A.P.!! Otherwise purchase orthotics from us and rest assured this will likely not happen any longer. When orthotics are used, they help take the uneven weight off of the toe area. When the weight doesn't ram against the side of the toe, the nail no longer protrudes into the skin!

Plantar Fasciitis
Similar to heel spurs. Here the heel muscle is pulling from the bone usually. This condition is mostly associated with pain in the mornings when first standing on the foot, and then pain goes away later on.

The two most common causes of heel pain are heel spurs and plantar fasciitis. The chief diagnostic sign of these problems is: pain in the bottom of the heel or arch when first standing, which gradually improves with walking.
This pain may return with continued walking. The treatment involves correcting the underlying causitive problems. Please read the following section for more information on the problem and its treatment.

Description: The two most common causes of pain in the bottom of the heel and arch are heel spurs and plantar fasciitis. The plantar fascia is the thick ligamentous band in the bottom of the foot which is attached to the heel, and runs forward to insert into the ball of the foot. Plantar fasciitis is an inflammation of this band at its attachment to the heel.

Symptoms: Plantar fasciitis pain is usually located in the center or the inner side of the bottom of the heel. The pain is most intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of walking, the pain becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this pain may radiate into the arch or the ankle.

The same pathology occurs with "supination" (the rolling of the foot outward, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible, usually have a high arch, and a short or tight plantar fascia. Thus as weight is transferred from the heel to the remainder of the foot, the tight plantar fascia does not stretch at all, and pulls with great force on its attachment to the heel.

In both cases, the abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain, inflammation, and swelling. If this process continues, the plantar fascia partially tears away from the heel. The body will fill in this torn area with calcium; eventually it becomes bone, and a heel spur results.

Treatment: Treatment must be directed towards realigning the foot as it goes through the gait cycle, and reversing the abnormal effects of pronation and supination on the plantar fascia and heel. In doing this, the abnormal pull of the plantar fascia on the heel will be made to disappear. This in turn, alleviates the pain and inflammation at the heel. Realignment, or proper postioning of the foot, is accomplished through the use of custom-made orthotics. Custom-made orthotics gently hold the foot in a proper or neutral alignment when it strikes the ground, preventing pronation or supination. Custom-made orthotics will also: reduce the pull of the plantar fascia on the heel, by supporting the arch; and cushion the heel, to provide an immediate decrease in pain. Custom-made orthotics will not only relieve the pain, but they will also prevent it from returning.

Immediate pain relievers: Some things you can try to give yourself immediate relief are:

Before stepping down after sleeping or resting, stretch the arch of the foot by pulling up on the ball of the foot and toes, as far as you comfortably can, and holding the foot in this postion for ten seconds. Repeat at least ten times. You should feel a pull on the bottom of the foot, especially in the arch. This stretches the plantar fascia, and reduces its pull on the heel.

Decrease your standing and walking as much as possible.

If the pain becomes intense, applying ice will reduce it. Place the ice directly on the heel and arch for at least 30 minutes (you can keep the ice in place by wrapping the ice against your foot with an elastic bandage).

Elevating the heel will reduce the pull of the plantar fascia, thus reducing the pain. Women can accomplish this by wearing a shoe with a 2-inch heel; or by placing heel pads in the shoe.
These treatments will give temporary relief, but permanent relief can only be accomplished with the use of custom-made orthotics.

Pronation
(opposite of the above picture labeled 'supination')
is when the ankles turn inward.

Pronation is a turning outward of the foot at the ankle, so that one has a tendency to walk on the inner border of the foot. When a foot and ankle pronates to a great degree, we call it over-pronation. You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.

Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. If left untreated, pronation may be the cause of heel spurs, plantar fasciitis, frequent ankle sprains, shin splints, weak and painful arches, and eventually knee, hip, and lower back pain.

Causes of Pronation:

The most common cause of pronation is heredity —— we inherit this biomechanical defect. The second most common cause is due to the way our feet were positioned in the uterus while we were developing; this is called a congenital defect. In either instance, the following occurs in our feet during our development:

The muscles, ligaments, and other soft tissue structures which hold our bones together at the joints become looser than normal. When the bones are not held tightly in place, the joints are not aligned properly, and the foot gradually turns outward at the ankle, causing the inner ankle bone to appear more prominent. The foot moves in this direction because it is the path of least resistance.

It is more difficult for the foot to move in the opposite direction (this is called supination). As we develop, the muscles and ligaments accommodate to this abnormal alignment. By the time growth is complete, the pronated foot is: abnormally flexible, flat, and its outer border appears raised so that as you step down you do not come down equally across the entire foot; instead, you come down mostly on the inner border of the foot. Normal aging will produce further laxity of our muscles which causes the pronation to become gradually worse.

Results of Pronation:
Due to the laxity of the soft tissue structures of the foot, and the fact that the joints are not held together properly, the bones of the feet shift. When this occurs, the muscles which attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles which attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. This twisting of these muscles will cause: shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). The problems we see in the feet, which are due to pronation include: bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammer toes, and calluses.

Treatment of Pronation:
1) Children: If pronation is diagnosed before the age of five it can usually be treated in such a manner that the bones and joints will be aligned properly as growth continues. This will prevent the arch from collapsing, as well as allowing the muscles of the leg to enter the foot without twisting. With proper and early treatment, the foot will not turn out at the ankle, and the child's gait will improve. Treatment for pronation in children may include: night braces, custom-made orthotics, and exercises. These treatments usually continue until growth is complete, and then the adult may need to wear custom-made orthotics to prevent the pronation from returning (the foot, as every other part of our body, tends to return to its original form if preventive measures are not taken). One side note: frequently, pediatricians will wait too long, hoping that the child will "outgrow" the problem. By the time they realize that the child's feet will not improve, it is too late to change the foot. In these cases, custom-made orthotics are used to prevent the pronation from becoming worse.

2) Adults: The only effective treatment for pronation is custom-made orthotics.

a. Pronation forces us to bear most of our weight on the inner border of our feet. Custom-made orthotics gently redistribute the weight so that the entire foot bears its normal share of weight with each step we take. The foot will not twist out at the ankle, but will strike the ground normally when the orthotics are used. This action of the custom-made orthotics will help to prevent: shin splints, ankle sprains, knee and hip pain, lower back pain, nerve entrapments, tendonitis, muscle aches, bunions, generalized fatigue, hammer toes, and calluses.

b. Custom-made orthotics support not only the arch as a whole, but each individual bone and joint that forms the arch. It is not enough to use an over-the-counter arch support, as these generic devices will not provide the proper support to each specific structure of the arch and foot. Each pronated foot's arch collapses differently and to different degrees. The only way to provide the support that you may need is with a custom-made device. This action of the custom-made orthotic will help to prevent: heel spurs, plantar fasciitis, calluses, arch pain, and weakness of the entire foot.

c. Custom-made orthotics will reduce the twisting of the leg muscles as they enter the foot, by maintaining a normal alignment of the bones and joints of the foot. If the bones and joints are aligned properly, by reducing the pronation, the muscles can run straight to their attachments in the foot, without twisting to get to these bones. This action of custom-made orthotics will reduce Achilles Tendonitis; shin splints; ankle, knee, hip, and lower back pain; and leg cramps. This action will also allow the leg muscles to work more efficiently, thus allowing you to walk and run with less effort.

d. With every step we take, we place at least half of our body weight on each foot (as we walk faster, or run, we can exert more than twice our body weight on each foot). As this amount of weight is applied to each foot there is a significant shock passed on to our body. Custom-made orthotics will absorb some of this shock, helping to protect our feet, ankles, knees, hips, and lower back.
Custom-made orthotics for pronation and over-pronation:
Our custom-made orthotics for pronation and over-pronation are constructed of thin,

Supinating or pronating can affect the knees, the hips, the back and then the neck! Orthotics can help this condition by supporting the areas of the foot which are most prone to turning in either direction while standing and walking. Your whole body should straighten just like a high-rise building on a straight, sturdy and supported foundation.

It is best to start with a new pair of shoes along with the use of orthotics, and then the ankles will be straight. Try buying shoes which have a higher support around the ankle as well to reduce wobble in the ankle.

This problem is a combination of pronating (turning inward) and supinating (turningoutward) while a person walks. This can be corrected with the regular use of our orthotics. This condition causes extremely sore ankles, as well as ankle sprains etc. Watch your ankles closely! Orthotics can help with this condition as ankles simply need something to help assist in their support. Try our orthotics.

Shin Splint
Anterior Shin Splints: The muscle in the front of the leg which usually becomes painful is the Tibialis Anterior Muscle, which is encased in a thin sheath. This muscle attaches to the foot, and flexes your foot upward, or back towards the shin; and as long as the foot is in proper alignment with the leg, the muscle functions efficiently and pain-free. However, when the foot is pronated (the foot rolls outward at the ankle and you walk more on its inner aspect), the Tibialis Anterior Muscle twists within its sheath. This twisting of the muscle within its sheath can cause tiny tears in the muscle, or the muscle rubs abnormally against its sheath, and produces inflammation and pain.

Posterior Shin Splints: The muscles most affected in this type of pain are the Soleus and the Tibialis Posterior. In the leg, these muscles are firmly attached around the back of the knee. They run down the back and inner side of the leg, and attach to the foot. If the foot is in a proper alignment to the leg, these muscles function efficiently and pain-free. However, when the foot is pronated (the foot rolls outward at the ankle and you walk more on the inner aspect of the foot), these muscles are forced to become twisted as they attach to their respective foot structures. The twisting of these muscles can cause tiny tears in the muscles, or the muscles become "pulled" and inflamed. This will produce pain.

Sprained Ankles
Sprained ankles may occur frequently and become a serious medical problem, destabilizing your every step and putting you in jeopardy of taking a disastrous fall.

Causes: There are two types of feet which are very suseptible to frequent ankle sprains, and if left untreated they can cause a lifetime of pain and disability. Most ankle sprains affect the outer side of the ankle, which has just three small ligaments supporting it. The method of injury is a turning of the foot inward at the ankle (an inversion sprain). In the first foot type, these ligaments are weak or thin, they cannot provide proper support, and any twist or turn of the ankle will tear or injure these ligaments, causing a painful sprain. Each subsequent sprain will weaken these ligaments further.

The second foot type suseptible to ankle sprains is the pronated foot (the foot rolls outward and you walk on the inner side of the foot). This foot type causes a shortening and weakining of the the ligaments on the outer side of the ankle. Thus, any twist of the ankle will injure and stretch these shortened ligaments until they tear, causing pain and serious sprains. If ankle sprains continue to occur, the ankle ligaments may be completely destroyed.
For immediate pain relief:

If the pain or swelling is intense, or if you are not sure, you may have a fracture. In this case go to your podiatrist or the emergency room immediately.

Rest and elevation. Reduce weight-bearing activities (use crutches). Elevate the leg to help reduce swelling.

Apply ice to the ankle for 30 minutes every two hours, for the first three days. Then apply mild moist heat twice daily for 30 minutes. Heat must be mild!

Apply mild compression to the ankle with a 3-inch elastic bandage. This will support the ankle ligaments and reduce swelling. Compression must be mild (do not apply so tight that it will reduce circulation).

After two days, your ankle should be less painful, and the swelling and discolorations should be going away. If not, see a podiatrist immediately.

Treatment: Treatement must be directed at supporting the ankle ligaments, and preventing further sprains. The first two products which follow are recommended by podiatrists, orthopedists, trainers, and physical therapists. However, the only sure method of treatment for weak ankle ligaments is custom-made orthotics.

Custom-made orthotics maintain the foot in its normal position to the ankle, thus preventing ankle sprains from occurring. This orthotic gently holds the heel in a normal or neutral position. This prevents the foot from twisting, and protects the ankle ligaments from the trauma of the twist; thus they cannot be injured or torn. Whether the cause of your frequent ankle sprains are loose and weak ligaments, or pronation, custom-made orthotics will stabilize your foot and ankle, and prevent injury, pain, and swelling from occurring.

Stress Fracture
A stress fracture is largely the result of the arches having too much pressure on certain points along the gait/stride cycle. When too much weight is exerted upon the arches, like a foundation of a house on shifting ground, the arches of the structure will crack and collapse. Use orthotics to help prevent yourself from ever having to deal with this problem. If you suspect you have a stress fracture and the top of your foot is swelling all over or a specific area, then see a doctor as soon as possible! Otherwise, use orthotics!

Fractures and dislocations differ from stress fractures. Stress fractures usually do not result from one serious injury, but are due to repeated lesser traumas. True fractures and dislocations, on the other hand, are usually the result of one severe injury. True fractures and dislocations of the foot are serious problems, and if they are not treated properly, they can result in life long pain and disability. They must be treated immediately by a doctor, especially if you are a diabetic, have poor circulation, have decreased sensation in your feet (neuropathy), taking blood thinners, or have other serious medical problems. Sometimes it will be difficult to decide whether you have a fracture or not; at these times it is best to see a doctor and let him/her decide. Here are some tips to follow after a severe foot injury:

1. Fractures are disruptions or breaks in a bone, and can include the following types:
a. Hairline breaks, where there is no separation of bone —— just a crack is present.
b. Complete break with separation of bone.
c. Complete break with the bone sticking out of the skin. This is a true medical emergency; go immediately to the emergency room or call 911.

2. Dislocations are disruptions in one or more joints. A joint is a location where two bones come together and are bound by tissue called a joint capsule. Certain injuries rip this capsule and allow the bones to separate and move. When this occurs, the joint is said to be dislocated.

3. Immediate treatment includes seeing a doctor immediately! If you think you have sustained a fracture or dislocation, immediately do the following:

a. If possible, remove your shoe and inspect the area for an open wound. If there is a wound present and it is bleeding, apply mild pressure with a clean bandage.

b. Immobilize the foot with an elastic bandage so that there is no movement at the injured site. Do not apply too much pressure or you will cut off the circulation to the foot.

e. Do not drive! Call someone to take you to the doctor or emergency room immediately. If you cannot find someone to take you, call 911.

Tendonitis
Tendonitis is an inflammation of a tendon caused by an injury. Muscles end as tendons, and it is the tendons which allow muscles to attach to the bones or joints of the body. You can easily see tendons on the back of the hand, or top of the foot, by moving a finger or toe. The tendon moves back and forth as you move the finger or toe. Most of the tendons in the feet, especially those on the top, are very close to the skin and are not well protected. Thus, they can easily be injured. Injuries which frequently cause tendonitis include:

1) Twisting injuries of the foot and ankle.
2) Dropping an object on the foot (it does not have to be a heavy object, all it has to do is hit the tendon directly).
3) Tight shoes.
4) Tying shoe laces too tightly.
5) High heel shoes (especially if you are not used to wearing them).
6) Overdoing any weight-bearing activity, such as running too far.
If there is a cut or break in the skin associated with a tendon injury, see a doctor immediately. Tendons have few blood vessels, and an open wound down to the tendon can cause a severe infection. Because of their poor vascularization tendons heal slowly.

Self Treatment should begin immediately after the injury, with a careful examination of the foot.
1. Make sure that the tendon is not torn through and through. If it is severed, you must see a doctor immediately so that the tendon can be repaired. Severe injuries can sever a tendon, without a skin laceration being present. Testing involves moving the toes and foot to see if the tendon moves. If the tendon does not appear to move, it may be severed (comparing the injured tendon and its movement to the same tendon on the un-injured foot may help).

2. If there is extreme swelling and pain (out of proportion to the amount of trauma received), you may have sustained a vascular injury. This type of injury must be seen immediately by a doctor. If you are not sure, see a doctor.

3. If you have multiple injured areas see a doctor immediately, in order to prevent excessive swelling and pain.
If the above exam is negative, then you may proceed with self-treatment.

4. The sooner you begin to treat your injury by following "R.I.C.E.", the better you will feel:

b. Ice should be applied as soon as possible. Never apply ice directly on the injurued area, as the cold may make the pain worse. Ice should be applied close to the injured site, between the heart and the injury, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the injured area will help to reduce the swelling and pain. Apply the ice, wrapped in a cloth or over an elastic bandage, to the foot for 30 minutes, every 2 hours, for the first 3 days after an injury. If the ice is uncomfortable, or causes increased pain, do not continue to use it, and see a doctor. If you have poor circulation do not use ice, as this may cause a serious problem.

c. Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot, starting first at the toes and working back to the ankle. If it is applied just to the injured area, increased swelling will occur in front and behind the wrapping. Compression should be applied with a 3 inch elastic bandage, begining around all the toes, and then going around the foot and ankle. Compression reduces motion in the injured area and foot, and this decreases the pain, and allows for quicker healing. The bandage should not be so tight that it causes increased pain or throbbing in the toes or foot. It should be comfortable! Do not remove the elastic bandage for the first 12 hours, unless it becomes to tight, or the pain increases, or the toes become pale, blue, or cool. If any of these things happen, immediately remove all bandages, and leave them off for several hours. The normal color and temperature of the toes should return immediately. If not, see a doctor immediately! Continue until the swelling and pain subsides; it could take from several days to several weeks.

d. Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells which aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides, when you lower the leg.

5. Healing will occur more quickly if there is no pressure on the injured tendon, and if the foot is at least partially immobilized.

6. Do the above for at least 3 days. If there is no improvement, see a podiatrist immediately. If you see gradual improvement, continue the above course of treatment until the pain and swelling are gone. It can take inflammed tendons 2 to 4 weeks to heal, so be patient!

1) A pair of feet contain: 52 bones, 66 joints, 38 muscles and over 200 ligaments.

2.) 3 main weight bearing points: The Heel, the Little Toe (on 5th metatarsal) and then the Big Toe (on first metatarsal).

4.) Weight bearing factoid: A person who weighs 150 pounds jogs three miles, the cumulative impact on each foot is over 150 tons!!! (Jogging is extremely strenuous on the feet. It may be best to fast walk.

When the arches in persons feet collapse, the result can a very bad posture. This is mainly because a collapse of the arch in the foot can cause the balance of a person to become off center. This means the ankles can lean inward/outward, knees may lean inward/outward, hips may begin to go out of center, the back may go crooked, shoulders and neck may go out of position and so on. This can continue for years; causing severe injury over time.

When orthotics are worn as much as possible, a persons alignment (on the left) should become much better, like the picture on the right. The person on the right has a more even weight distribution across their feet and body, which helps keep their body sturdy and balanced. This is considered 'ideal' or normal. With the person on the right pains should not be experienced.