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Feet on the Move
 Your
heel swings from side to side as your foot moves. When the heel
swings correctly, your foot can flatten and regain its arch as you
walk. But if your heel swings too much, your foot may flatten more
than it should. Over time, such excess movement may cause foot
problems.
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When the heel hits the ground,
its outer edge touches first. Soft
tissues (muscles, tendons, and ligaments) relax. Your foot is
able to flatten, adapt to uneven surfaces, and absorb the shock
of touchdown. |
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During midstance, your
heel is below the anklebone, and the front and back of your
foot are aligned. Your foot easily bears your weight. |
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As the heel lifts, it
swings slightly to the inside. Muscles, tendons, and ligaments
tighten. Your foot regains its arch, allowing your toes to push
your weight off the ground. |
Too Much Movement
Causes Strain
When your foot flattens too much (overpronation), some bones are
forced to support too much weight. The muscles pull harder on these
areas, making it more difficult for tendons and ligaments to hold
bones and joints in place. Over time, you may develop swelling or
pain on the bottom of your foot or near the heel. Or a bony bump
(bunion) may form at your toe joint.
Your Foot Exam
To determine the best treatment, your podiatric physician looks
for the cause of your symptoms. You’ll be asked if you have
pain or swelling and whether it limits your activities. Your podiatric
physician will also examine your feet for skin changes or signs
of injury.
Checking Your Feet
During the exam, your podiatric physician feels for displaced bones
or swollen soft tissue. Your feet may also be checked for sores
or other skin changes. Strength, reflexes, and sensation may also
be tested.
Testing Your Range
of Motion
Your podiatric physician may test how far and how smoothly your
joints move. Depending on your symptoms, joints from your hips to
your toes may be tested.
Watching You Walk
To learn if your heel swings too much, your podiatric physician
may watch you walk in bare feet. T soles of your shoes may also
be checkea for unusual patterns of wear.
Can Shoes &
Inserts Help?
Mechanical problems can often be improved by controlling foot movement.
Supportive shoes, over-the-counter inserts, and orthoses (custom-made
shoe inserts) can all help. Your podiatric physician may suggest
one or more of these, depending on how much correction your feet
need.
Supportive Shoes
To control mild problems, your podiatric physician may recommend
shoes with good arches and low heels. For extra support, choose
shoes that hold your heel firmly, so it won’t slip and slide.
Shoe Inserts
Shoe inserts are for sale in many drugstores and shoe shops. These
arch supports and heel cups may control mild to mod-erate problems.
In some cases, your podiatric physician may recommend a splint or
brace for additional support.
Orthoses
Unlike drugstore inserts, orthoses are crafted to meet your special
needs. Made from casts of your feet, orthoses allow only a prescribed
amount of foot movement. They may also help absorb the shock when
your heel strikes the ground. Some orthoses even help compensate
for a knee or hip problem that affects the way your feet move.
Other Treatment
In some cases, your podiatric physician may prescribe physical therapy,
surgery, or a combination of both types of treatment. For the best
results, keep all your physical therapy appointments and carefully
follow your podiatric physician’s instructions for recovery
after surgery.
Physical Therapy
Physical therapy can help reduce pain and swelling caused by poor
foot mechanics. Ultrasound, whirlpool, and stretching all bring
benefits. After surgery, physical therapy exercises can increase
strength and flexibility.
Surgery
Your podiatric physician may recommend surgery when poor mechanics
causes a problem, such as severe bunions, that can be controlled
by other means. In many cases, orthoses or physical therapy is prescribed
along with surgery.
Consultant: Brad L. Naylor, DPM, MS With contributions
by: James R. Black, DPM, PhD, Richard P. Jacoby, DPM, ABPS and Michael
J. Trepal, DPM, FACFAS
This information is not intended as a substitute
for professional health care.
©1995, 1998 The StayWell Company
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