PromoPT plays an expert role in designing custom biomechanical orthotic devices. Physical therapist Michel Kane is a nationally recognized speaker on the evaluation of the foot and lower extremity and on the design and application of biomechanical orthotics.
Many of the injuries we treat are created or sustained by the way our patient’s stand, step, walk, stoop, bend, squat, twist, jump and run. Our Physical Therapy staff has developed an expert knowledge and understanding of the biomechanics of walking, and foot function. Proper function of the foot is necessary for normal posture and normal movement. Abnormalities in foot structure or in the way it functions can create foot pain as well as problems in the shins, knees, hips and low back.
The word orthotic has become a generic term for any arch support placed in a shoe. A custom biomechanical orthotic is much more. First, orthotic therapy begins with a thorough examination of your walking mechanics, foot posture, and an assessment of your specific foot type. We will assess the mobility of your feet to make sure they react efficiently with your legs, hips, and low back. Secondly, we take a neutral cast impression of your feet. This slipper cast provides a standard on which the laboratory can create a custom biomechanical orthotic device. Finally, the cast is sent to a biomechanical laboratory where your orthotics are fabricated.
The key to designing the proper orthotic is an understanding of how orthotics influence the foot.
The injured tissue: Tissue injury and dysfunction is often times the reason a patient comes to Pro-Motion. Tissue injury or dysfunction occurs when a healthy tissue is loaded or stressed in an abnormal way, when an abnormal tissue is loaded in a normal way, or when an abnormal tissue is loaded in an abnormal way. Every tissue in the body has a “zone” or tolerance for optimal stress. The tissue, if loaded in this zone stays healthy and pain free. The aim in orthotic therapy, when a tissue is injured, is to help facilitate a more normal load on the target (injured) tissue so that it can heal.
How do we design an orthotic to facilitate normal stresses to the tissues?
The orthotic reaction forces on the foot help control abnormal load, redistribute forces across the foot, alter the way the foot and lower leg moves (biomechanics), and optimize the forces created by the muscles. We can alter the surface geometry of the device by altering the contour and shape of the device. We can modify the forces on the foot by canting or angling the device in the front or the back and modifying the stiffness of the device to reduce abnormal loads on tissues, modify the speed or amount of abnormal motion, and reducing the work stress on the foot and leg. We can alter the frictional and shock absorption characteristics of the device by modifying what kind of top cover we put on it.
The device is built of a mold of your foot. How do we get a mold of your foot?
The physical therapist is the designer of the device while the laboratory is the builder. The design of your orthotic is based on the evaluative findings and the positive mold of your foot, using custom craftsmanship. The type of orthotic manufactured is based on your height, weight and shoe wear. The plastics, foams, graphite, and fiberglass materials used to construct the device are based on the type of activities the orthotic will be used for. The primary goal of orthotic therapy is to improve foot and lower extremity function, and to eliminate pain. The orthotic selectively controls stresses to the foot and lower legs, attenuates ground reaction forces, and promotes normal movement. Orthotics can be worn in most shoes without any modification.
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