Use a strecthing program with foot orthotics?

Members do not see these Ads. Sign Up.

What are your thoughts on giving each patient who gets new orthotics a stretching focusing on glutes, hams, quads, triceps surae, plantar fascia, toe extensors, and toe flexors?

From a subjective perspective (not having read any literature), I feel that it could definitely be beneficial during the "wearing-in" period of the orthotics since the orthotics will be altering (no matter how slight) the muscle and joint function of the legs. So stretching could help keep the joints and muscles flexible enough to allow for the slight adjustments given by the orthotics.

If you do use stretching exercises, which ones do you advise your patients to do?

If you don't believe in stretching exercises, why not?

 

Re: STRETCHING PROGRAMME WITH ORTHOTICS

Why would you want to give someone stretching exercises if its not part of the problem they presented with? I fail to see how stretching a muscles that is not tight is going to make any difference in the wearing in-period of foot orthotics. The orthotics will not be taking the muscles to "end ROM", so increasing it I fail to see how stretching is going to help, unless I am missing something from your question?

Of course, probably all of us use stretching, mobilization and other manual therapies if its part of the presenting problem.

 

Hi JaY,

If there are soft tissue restrictions interfering with the orthoses' ability to improve biomechanical efficiency, then I think specific stretching can be beneficial.

I recommend a couple of plantar tissue stretches along with calf stretching for cases where there are clinical signs of soft tissue restrictions interfering with optimal joint motion and orthotic adaptation.

Here they are:

 

I think that providing orthoses is enough of an encroachment into some people's lives. Why, if it is not appropriate to their pathology would you want to encroach any further by giving them stretching exercises

One could make more of an arguement for providing blanket gluteus medius recruitment/strengthening exercises for any pronation related pathology as it might have a positive effect on outcomes.

I know a physio who, regardless of pathology, does lumbar spine manipulations. Some people it helps and others, it makes them worse. I'm sure he loses business because he is viewed as something of a one trick pony. Patients, in my experience, like to feel individual and that their particular problem is being treated as such. This type of approach decreases patient confidence in the practitioner.

Just my tuppence worth

Robin

 

Also, keep in mind new research that points to 'cold' stretching (before exercise) being potentially damaging to structures..