Orthotics for Healthy Feet

Foot orthoses are specially designed shoe inserts that help support the feet and correct any imbalances. To tell us more about them is Dato’ Dr. Edmund Lee, PhD, Certified Orthotist and Prosthetist.

What are Orthotics? What does an Orthotist do?

Foot orthoses are custom foot supports. They are designed to fit your feet more efficiently than over-the-counter arch supports and balance the biomechanical inadequacies of your feet and legs. The most common reasons people use foot orthoses are for arch and heel pain (Plantar Fasciitis), lower leg tendonitis (problem with the Achilles and posterior tibial tendon and “shin splints”) and for knee pain, such as chondromalacia patellae, iliotibial band syndrome and “runner’s knee.” Foot orthoses are made from casts or scans of the feet, and incorporate measurements of your foot and legs and limb length assessment, as well as your exact medical condition.

What are the statistics of pes planus/other deformities affecting population in Malaysia, or even Asia?

Based on our daily-seen patients, adult and children, almost 70% of Malaysians suffer from flat feet over time. Excessive pronation can lead to many unpleasant problems including heel pain, hammer toes, shin splints and even hip, knee and back pain. In fact, one orthopedic surgeon discovered that 95% of his total knee replacement patients and 90% of his total hip replacement patients had flat feet.

How do feet structural problems affect other part of our body? How do these limit our activity?

Flat feet can sometimes be associated with:-

• Pain in the feet, ankles, lower legs, knees, hips or lower back
• The feet rolling inwards too much (over-pronation) this can cause shoes to wear out quickly and lead to injuries
• An underlying problem with the bones, muscles or connective tissues in and around the feet
• Also flat foot causes secondary compensatory postural problems such as hunch back and rounded shoulders

Feet structural problems have different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch leading to it. It is also very common with athletes, especially runners and most of them nowadays use orthotics inside their shoes. A range of common complaints include:

• Sore, aching feet
• Ball of Foot Pain
• Heel Pain
• Achilles Tendonitis
• Bunions
• Shin Pain
• Tired, aching legs
• Knee Pain
• Lower Back Pain

How does orthotic help with these problems?

The most effective treatment solution for over-pronation is wearing an orthotic shoe insert. Orthotics correct over-pronation, thereby providing natural, lasting pain relief from many common biomechanical complaints.

Why is early treatment important?

For a young child, the condition is reversible. Thus, early intervention is necessary. Your body recovers easily when you are young. As you get much older your body tends to give way and that’s when the problem starts.

What are the sign and symptoms parents can watch out for?

Flatfoot can be apparent at birth or it may not show up until years later. Most children with flat foot have no symptoms, but some have one or more of the following symptoms:-

• Pain, tenderness, or cramping in the foot, leg, and knee
• Outward tilting of the heel
• Awkwardness or changes in walking
• Difficulty with shoes
• Reduced energy when participating in physical activities
• Voluntary withdrawal from physical activities

Orthotists also provide braces. Can you give some examples?

Thoraco-Lumbo-Sacral-Orthosis (TLSO)

The most common form of a TLSO brace is called the “Boston brace,” and it may be referred to as an “underarm” brace. This brace is fitted to the child’s body and custom molded from plastic. It works by applying three-point pressure to the curvature to prevent its progression.

Osteo Arthritis knee brace

OA knee brace applies stabilising and three point corrective forces. This helps maintain normal leg alignment and reduces joint compression. Knee brace applies stabilising and three point corrective forces. This helps maintain normal leg alignment and reduces joint compression.

Ankle Foot Orthoses (AFOs – short leg braces)

AFO are used to provide stability, decrease pain and increase mobility for a number of different neuromuscular and musculoskeletal issues.