WELCOME TO CLINICAL PEDORTHICS
Clinical Pedorthics is a specialty that uses foot orthotics, shoes and other foot
devices to alleviate, treat or correct biomechanic deficits of the foot and its
consequences. Clinical Pedorthics also focuses on the accommodation of nonfunctional
It is interesting the role that the longitudinal arch of the foot plays in walking and running. A lowered or fallen arch could sometimes prevent people from walking well or running and can be in some cases the source of pain in the foot(heel, midfoot or forefoot) at the ankle, knee, in the hip and back.
This type of pain can start and continue with no X-ray or MRI findings of pathology (click on Ankle and Knee Pain with normal MRI on the side bar).
Well, we all know the conventional treatment for that: " take NSAID or do nothing."
Clinical Pedorthics is the unconventional approach to this situation.
By using foot orthotics to support the arch and by using special orthopedic shoes designed for that purpose clinical pedorthics has come to become part of treatment plan for people with foot, ankle, leg, knee, hip and back pain. If you have foot pain see your doctor. There are a lot more that pedorthics can do for you.
The average person takes about 6,000 steps a day. Assuming
average body weight of 130 lbs, the amount of force exposed to the feet in
a day is enormous about 780,000 lbs(130 x 6,000).
Now imagine a 300 lbs individual being asked to lose weight by increasing
his activity by taking about 10,000 to 12,000 steps a day, an equivalent of
about 5 to 6 miles a day by walking, running or on a Treadmill, imagine
this amount of force or weight on the feet everyday, pressure could be
concentrated at certain points on the plantar surface for example at the
metatarsal heads and cause pain. This could further develop into calluses
and latter on ulceration. For individuals with flexible flat feet it is a nightmare of painful experience. I cannot over-emphasize the importance of a good
and supportive shoes in this respect otherwise the whole undertaking may
become enduring, painful and meaningless. Just because your
cardiovascular physiologic state is alright as confirmed by your physician
is not sufficient reason that you would be able to undertake a workout.
It only means that you would not collapse and maybe die during a
workout. What about if you have leg length discrepancy, excessive
pronation or supination, hallux limitus, foot length and width inequality,
collapsed arches, calluses etc. These are some of the things that
many people have and they don't know and are not normally checked by
a physician. These factors or conditions can pose a real setback in your
quest for physical fitness. Nobody wants to be a square peg in a round
hole. Some of the things that look simple are not entirely simple. Get
expert advice even in the things that you believe you can do. Be evaluated.
Get fitted. It is true that not everybody would have all the problems listed
above but if you are one of those that does have these problems and you are not aware as often the case then your workout could be hectic and perhaps very painful.
One of the things a physician should do after prescribing a patient an
exercise program is to refer that patient to a pedorthist for gait analysis
and proper footwear determination. Read more in my book: Biomechanic
Also in many people who are above the age of 60 the fatty layer of the plantar surface may begin to thin exposing the bones of the feet to the presure of body weight. The developing pressure points then could become a source of foot pain, calluses and eventual ulceration. This is where foot inserts or orthotics become necessary for redistribution and relief of pressure. Other reasons why
foot orthotics are prescribed are for control of excessive foot pronation or
supination otherwise known as BIOMECHANIC INSUFFICIENCY.
Biomechanic insufficiency in itself can also be the source of Foot, Ankle, Leg, Knee, Hip, or Lower back Pain.
When it comes to sports, foot orthotics can serve a dual function of:
1. Preventing injuries and
2. Enhancing performance.
We design and make foot orthotics for all type of sports including but not limited
to: Baseball, Basketball, Cross Country, cycling, Football, Golf, Hockey,
Racquetball, skiing, Soccer and Sprint sport.
We also make Dancer's Orthotics.
Stockings are classified into:
1. TED stockings( Total Embolic Deterrent ) 8-18 mmHg
2. Support stockings 15-20 mmHg
3. Graduated Compression stockings:
Class I 20-30 mmHg
Class II 30-40 mmHg
Class III 40-50 mmHg
Class IV 60+ mmHg
After taking into consederation the indications and contraindications,
TED stockings are prescribed for bed bound
patients as they need little squeeze to move blood back to the heart when they
are in horizontal position. This is the only stockings patients can wear lying down.
If a person can walk vertically, the minimum he/she needs is a support stocking.
Graduated compression stockings selection or prescription depends on the
indications for each class.
CONDITIONS THAT MAY REQUIRE PEDORTHIC APPROACH
CHARCOT-MARIE TOOTH DISEASE
DIABETIC NEUROPATHY OF THE FOOT
EXCESSIVE FOOT PRONATION OR SUPINATION
LEG LENGTH DISCREPANCY
PARTIAL FOOT AMPUTATION
POSTERIOR TIBIAL SYNDROME
ROCKER BOTTOM FOOT
All questions about this website should be directed in writing to:
Dr. Aniekan Umanah
P. O. 690305
Bronx, NY 10469
Dr. Aniekan Umanah is a Medical Doctor and a Pedorthist
SUMMARY OF BIOMECHANIC CAUSE OF PAIN SYNDROME AS A
RESULT OF EXCESSIVE FOOT PRONATION.
1. The rolling-in of the foot during midstance phase of the gait cycle.
2. The reduction in height of medial longitudinal arch of the foot.
3. The response of iliopsoas muscle.
4. Others include anatomical or functional Hallux Limitus.
5. Anatomical or functional leg length discrepancy.
For more information click on Anatomical Chart - Biomechanic
Pain Syndrome on the side bar.
Unlike adults, prescription footwear for young children are for corrective
purposes. There is a lot of debate about this; some (1st group) say that
foot defects will correct by itself as the child grows up, others (2nd group)
argue against that notion and believe that kids with foot deformity or
defect need corrective shoes. I would go with the 2nd group as long as I
am seeing adult with severe supination, pronation and even clubfoot.
Kids shoe are usually Straight last with a round toebox. Most kids shoes
come with Thomas heels, long medial counters and rigid shanks.
Other types of children shoes are Reverse last or Outflare shoe for
in-toeing children and Inflare shoe for out-toeing children.
Very young children can use Denis Browne Splint.
It is also a good thing to combine children shoe with Gait plates to maximize
the effect. Gait plates can be made to induce out-toeing when the child is
in-toeing or it can be made to induce in-toeing when the child is toeing out;
the idea being that in trying to induce in- or out-toeing the foot is brought back
to the midline. Other gait plates are Whitman Roberts, Reverse Roberts
and Heel stabilizers
Always consult with your doctor and obtain a prescription.