Non-Surgical Treatments

Custom foot orthotics are specially designed corrective devices to restore the natural position of the feet. The orthotics acts as an interface between the feet, the shoe and the ground. The purpose of the device is to support the bones and joints of the feet to maintain optimal neutral position and to eliminate or compensate any misalignments or structural problems of the feet.

Orthotics are usually prescribed by a specialized doctor according to the requirement, lifestyle or shape of the feet of the patient. There are many different types of orthotics such as rigid types to increase the control of the feet and soft or flexible types to provide comfort. Certain specially designed orthotics for different sporting activities provide balance and control during sport, prevents high impact stress or injury to the feet, knees or spine and also enhances performance.

Functions of Custom Foot Orthotic

• Prevent abnormal foot function
• Restore proper weight distribution
• Improve overall biomechanical function of the foot
• Compensate for deformities or other abnormalities related to leg and foot
• Prevent further damage of joints, muscles and ligaments
• Prevents sports injuries and enhance performance

Indications

Orthotics are commonly indicated for prevention or correction of various foot conditions. Usage of orthotics depends on the symptoms of the condition ranging from general aches to foot conditions such as Achille’s tendonitis, plantar fasciitis, heel spurs, diabetic neuropathy, calluses or corn’s formation, Morton’s neuroma and sesamoiditis. Sometimes orthotics are also recommended as an alternative to surgery or may be used after surgery to preserve the alignment.

Feet support your body weight, help maintain proper posture and help in movement. As the feet bear the entire weight of the body and are involved in most activities, they are more prone to problems such as calluses, corns, cracks, infections and traumatic injuries. To maintain good health of your feet, you should always wear comfortable, good quality and proper fitting footwear. Specially-designed shoe inserts, called orthotics, help in alignment and stabilization of the feet and can also reduce foot pain.

Tips for foot care

The basic instructions for maintaining healthy feet include:

• Keep your feet clean and dry. Scrub them to remove dead skin.
• Check your feet regularly for signs of injuries such as redness, discoloration, cracks or other abnormalities.
• Wear appropriately-sized foot wear that are comfortable.
• Footwear should have adequate ventilation to prevent fungal infection.
• Regularly cut your toenails straight and slightly curved at the edges.
• Never try to remove a corn, callus or ingrown toenail at home, as it can induce infection.
• Moisturize your feet properly to prevent cracks.
• While sitting for long periods, move and stretch your feet and ankles at regular intervals to promote circulation of blood in the feet.
• Stretch your feet daily and perform foot exercises.
• Never ignore foot pain. Consult a physician for appropriate treatment.

An injury or small wound over the skin will normally heal within a week or two. However, sometimes due to an underlying medical condition, a small wound on the leg may take months to heal and may even increase in size. Such a wound on the leg that takes more than six weeks to heal is called a chronic leg wound. Chronic leg wounds can become infected and threaten the functionality of the patient’s limb and even life.

Most leg wounds are due to an underlying venous disease that usually affects the legs. Though, in some patient’s arterial disease or other conditions such as diabetes and rheumatoid arthritis may also cause poor healing leg wounds. In venous disease, the valves in the legs veins do not function properly or are damaged by clots in the vein. This causes the blood to flow backwards resulting in abnormally high pressure in the vein while standing for a long time. This high pressure damages the skin of the legs and leads to small breaks in the skin that develop into wounds.

The treatment of leg wounds involves regular dressing of the wound to promote healing and use of compression bandaging or stocking to reduce the high pressure in the leg veins. During the dressing changes, the wound is also cleaned by gentle washing in either warm water or saline water. Debridement may be performed under local anesthetic if there is a large amount of dead tissue over the wound which needs to be removed to promote healing. Compression bandage or stockings are to be worn at all times during the day. Whenever possible the legs should be kept slightly elevated above heart level, putting pillows or cushions under the feet while lying down. .

The dressing and compression bandages are initially changed once every week. The progress in healing is carefully monitored and the type of dressing used is changed depending on the stage of healing. If the wound is infected a course of antibiotics may be prescribed. Pain medication may also be prescribed, if required. Skin grafting may be considered in few rare cases with very large or treatment resistant leg wounds.

Even after the wound heals, there is a chance that the wound may recur as the underlying problem still persists. Thus the following precautions should be taken to prevent the recurrence of leg wounds:

• Compression bandages and stockings should be used at all times during the day. Legs should be kept elevated, whenever possible.
• Moisturizing cream should be applied regularly, to prevent dryness.
• Eating a nutritious diet and exercising regularly is important for general health.
• If you are obese, talk to your doctor about healthy ways to lose weight.

• Quit smoking as it delays healing.

Legs should be regularly examined for any minor skin condition such as blisters, broken skin, swelling or redness and these should be treated at the earliest, to prevent the development of a wound.

A foot injury or foot surgery may leave you immobile for a period. To return to your regular activities and more strenuous recreational activities, it is necessary for you to follow a well-planned activity and exercise program.

You are encouraged to start walking with crutches or a walker following your surgery. Your doctor will help to structure and supervise an exercise routine that is ideal for you. A good exercise program to rehabilitate foot and ankle conditions, focuses on strengthening and stretching the muscles and tendons of the lower leg, feet and ankles to relieve pain and soreness, keep the muscles flexible, provide stability and prevent future injury.

Begin with a few warm-up exercises, followed by stretching, then move on to the strengthening exercises, followed again by stretching. If you experience pain, stop and contact your doctor, who will modify the routine to suit you. Some of the exercises that are prescribed include:

• Heel cord stretches: Stand with a wall in front of you. Put your unaffected foot ahead of you with the knee bent and your affected foot straight behind you. While supporting yourself on the wall, urge your hips forward with your feet flat on the floor and your back straight. Hold this stretch for 30 seconds. Perform 2 sets of 10 repetitions.
• Ball rolling: Sit on a chair with both feet on the ground. Use your affected foot to roll a ball under the arch of the foot. Perform this activity for 2 minutes.
• Towel stretching: Sit on the floor with the legs straight in front of you. Hook a towel under your affected foot and holding both ends pull towards yourself, keeping the leg straight. Hold this stretch for 30 seconds with 2 sets of 10 repetitions.
• Calf raises: Stand behind a chair and support yourself as you raise your unaffected leg behind you putting all your weight on the affected foot. Lift the heel and raise your body up. Perform 10 repetitions.
• Toe writing: While sitting down on an elevated chair use the big toe of your affected foot to write alphabets in the air. Perform 2 sets of this activity.
• Marble activity: Sit down on a chair and place 20 marbles on the floor near your affected foot. Use your toes to pick up one marble at a time and place it into a container.

Follow the routine three to five times a week for four to six weeks or as specified by your doctor. After this, you may continue the program to maintain strength and range of motion.

Following rehabilitation, you can gradually start walking, running and return to sports activities, as advised by your doctor.