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Use of orthotic insoles for podiatic problems

By Dr Kanav Biagra

 

The field of podiatry is a specialised branch and it is practised widely in most of Europe and other western countries. In India, it is in its infantile stage though the doctors have started realising its importance due to the increasing number of foot problems among Indian population.

Most of the problems in the foot occur due to excess pronation. When standing, pronation occurs as the foot rolls inwards and the arch of the foot flattens. Pronation is a normal part of the gait cycle, but excess pronation causes over-use type of injuries and excess stress on the inner surface of the foot through over pronation can cause injury and pain to the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg. Over pronation causes various problems like shin splints, anterior compartment syndrome, patello femoral pain syndrome, plantar fasciitis, tarsal tunnel syndrone, bunion, achilles tendonitis and many more.

For the patients of diabetes, proper footcare is very important. Diabetics often suffer from poor circulation and loss of sensation in their extremeties — most commonly of the feet. As the diabetic process continues, neuropathy can lead to sensory difficulties, which causes excessive pressure and friction and even injuries to go undetected. The eventual result is skin ulcerations, infections and finally amputation in some cases.

All these problems can be checked by using orthotic insoles. Orthotics are orthopaedic devices that are used to alter or modify foot function and are designed to treat and support various biomechanical abnormalities. Some orthotics are simple prefabricated devices that are sold over the counter, but the most effective orthotics, are custommade devices that are crafted to meet a specific need of a particular individual.

Custom orthotics are made using an impression of the foot which duplicates the misalignments in the foot structure. Using the mould and computer technology, podiatrists design the device that balances out deformities and corrects misallignments. The finished orthotic insole is placed inside the shoe to support the foot and eliminate abnormal foot biomechanics by keeping the foot properly aligned. Depending on the patients’ needs, the orthotic insole may have padding to cushion the foot and make it more comfortable.

Boyner Clinic: AN introduction

The Boyner Clinic specialises in diagnosis and production of thermoformed plantar in-soles. Boyner Clinic uses the exclusive thermoforming concept, the "proform module". The machines, by which the process of diagnosis, testing, moulding and grinding takes places, are imported from France for best results.

The range of in-soles, especially thermoformed for every patient’s foot, offers numerous advantages:

Very fine quality, so they can be used in city shoes for men or women.

Unequalled comfort through precision in moulding.

A totally secured plantar support in case of vascular or neurological problems (arthritis, diabetes, polyarthritis and rheumatism).

The manufacturing of the customised insoles are divided into four categories:

Clinical and functional examination: Taking care of patient starts with a clinical and biomechanical examination. A good understanding of medical and functional problems is necessary for quality treatment.

Moulding in compensated dynamic posture: Moulding of orthoses is done in the standing position. The posture of the foot is compensated while respecting the neutral articular alignment. The patient benefits from idealised functional quality.

Progressive and comfortable functional compensation: The grinding method in one workshop allows precise control of the movement of the foot in the three phases of a step (taligrade, plantigrade and digitigrade).

Reliability, installation and evolution: The machines that Boyner Clinic has chosen for use are the result of podiatric research in Europe.

The writer is a podiatrist, Boyner Clinic, Gurgaon