Do custom orthotics make feet/legs weak? Do they make you addicted?
Members do not see these Ads. Sign Up.
I got this idea that once i get used to my orthotics I will be less and less able to walk without them.... like even small walks without them will cause EVEN MORE damage when the feet/legs get used to them than before I started wearing them....
I think what I m trying to say is that it is quite proportional - the more the feet get dependant on the orthoses the more hardere and "risky" will it be to walk without them...
Right?
When I used to trained heavy... I used to train legs barefoot.... And I always felt more natural, balanced and stronger when barefoot...
Tags:
-
-
-
If anything, it is probably the opposite. Orthotics used to decrease pain and increase function can only enhance muscle performance as abberant firing patterns are avoided and the individual can train harder/longer.
The addiction that I see is in some docs who prescribe FFOs for everything ($$$$). -
Absolutely brilliant.
Next time you have back pain or knee pain, and your physical therapist prescribes you strengthening exercises...and they fail; go back and read this quote from Scorpio, and then find another practitioner.
Pain inhibits muscular activity. Full stop. -
Also, I thought the work of Janda demonstrated why we should focus on restoring muscle length as oppose to strength? Moving the length / tension curve "up", with strength training as oppose to "along" with length restoration. Thus, with restoration of length, tension is developed in the appropriate range position?Last edited: Jul 17, 2006 -
Long time since I was taught this, but this is how I recollect it.
This makes a touch more sense than the 'strength/control' panacea that is dished out today since the work of Jull and Richardson.
The issue will always be assess fully and accurately. Stretching is relevant only when the relevant tissue is short. Strengthening is relevant only when the relevant tissue is weak.
The next case of unilateral plantar fasciitis that presents will direct us to the recipe book. Page 68 will tell us to give gastro/soleal stretching. But should we do this when our assessment suggests that gastrocs and soleus are longer on the symptomatic side??? -
I don't think it is "risky" to walk without orthoses. Getting older, fatter, exercising more strenuously, and going barefoot is much more "risky" than not wearing orthoses.Last edited: Jul 18, 2006 -
Good point. -
Good question Buggs
Dear Buggs,
This is a very common concern among PT's, ATc's and exercise physiologists. It is their experience and training that the use of a back brace for example replaces the function of the transversus abdominus muscle and thereby weakens it. When the brace is removed the weaker back and abdominal muscles make further back injury more likely. Some orthoses, like the UCBL and some very rigid graphite orthoses or those with excessive flanges may indeed may cause such limitation of motion as to have a similar effect. The saving grace of most of these very rigid orthotics, in this respect, is that they are usually so “cast corrected” that by the time the foot hits them at the very end of pronation, they only reduce tissue stresses. Orthoses that aim to reposition the foot are in greater danger of having this effect because they are far more limiting in ROM. This is one reason why it is crucial to get the flexibility correct whenever you are trying to change gait. You want to control pronation, not block it. Very rigid orthoses that raise the MLA will therefore have that effect.
On the other hand, if flexibility of the orthoses is correct, orthoses that reposition the foot will have an added beneficial effect. Compare walking to other physical exercise. If you are lifting weights with very bad form, you may actually hurt yourself. If you use good form, the same exercise will build you up. That is why personal trainers and physical therapists and exercise physiologists stress good form when lifting. Walking with good form will do the same thing. It will build up muscles that are now working more efficiently. Some muscles that have hypertrophied in order to compensate for the poor position the over-pronated foot is trying to overcome… the inefficiency of walking with bad form. These muscles will return to normal tonus when the orthoses are removed.
In essence, you are right, orthoses ARE and should be addictive. That is, if they are making a real change in the gait cycle, they should be worn as much as possible. It hurts to go back to a collapsed arch and inefficient gait. There is one saving grace however and that is the adaptation of the soft tissues may be helpful. What I saw in practice and what our clients report is that after wearing orthoses for a prolonged period of time (greater than a year), they can tolerate longer periods without them before symptoms reappear. We theorize that it takes a few hours or days for the tissues to stretch out to the end of the ROM again and for the resulting trauma to reach the threshold of pain. Could being without orthoses after wearing them for prolonged periods then lead to possible injury. That is speculative and needs more study. I would certainly think it is possible….a good reason to continue wearing your orthotics.
Ed
:) -
A lot of good info in your post. -
Thak you all for the answers you gave...
But Im not talking about collapsed arch, or "inefficient" gait...
Can gait be "efficient" and an overuse injury still occur?
I dont mean abnormalities of inherited sort
A person who has plantar fastiitis without any severe or mild anomaly needs a different amount of support and control than a person who has an obvious disorder and illness.
I always thought that pronation is a "normal" thing in movement.
It just gets old and overused(like everything does with time)
Now what is the "right" next step sound dificult to answer.
It seems there are a lot of posibilities and variations of combinations when it comes to this. Does this look like there is need for more study or am I wrong? -
Thanks,
Ed -
Each person does need a different amount of support right to left. I do not think the amount of support that a person needs is dependant on the diagnosis. Ideally the force should be enough to supinate the foot (supination resistance) and make positional chanes throughout the gait cycle which will tend to bring the (lower, overpronated) graph of STJ pronation/supination during stance closer to the "ideal" graph. I think that is more a funcion of body weight, foot flexibility and momentum.
Each person has two of their own graphs (except amputees) and and two ideal graphs that are accessable to them now (and of course the goals may be re-evaluated following stretching and exercises).
You are right that pronation is a normal part of the gait cycle. preferrable to blocking it, is controlling it.
:) Thanks,
Ed -
I think that some orthoses work in this manner because of the following observations. 1) Postier tibial muscle soreness after initiating orthotic therapy. (This is "getting used to" the orthosis.) 2)Seeing increased resupination while wearing orthoses. Then watching the patient walk barefoot and seeing resupination for a number of steps and then reverting to the more pronated position during gait after a few more steps. 3)Orthoses with medial arches higher than the barefoot medial arch height with wear paterns on the top cover laterally. When you stand and supinate using your muscles the pressure is lateral. When an orthosis pushes you into a supinated position the force has to be medial to the STJ axis and hence the wear pattern would be more medial. (Medial heel skives, especially higher amounts, will sometimes show wear on the medial heel cup)
So, even though the gait "looks" more efficient, this does not necessarily mean that there is less chance of overuse injury. To prevent/ or treat overuse injury you have to reduce the stress on the injured structure. Resupination of the STJ, from the use of the posterior tibial muscle, can be a good thing if the injured structure is the first met head. However, if the injured structure is the posterior tibial muscle this would be a bad thing.
Cheers,
Eric Fuller
Loading...
- Similar Threads - Custom orthotics addiction
-
- Replies:
- 0
- Views:
- 835
-
- Replies:
- 4
- Views:
- 1,663
-
- Replies:
- 0
- Views:
- 1,421
-
- Replies:
- 0
- Views:
- 1,601
-
- Replies:
- 0
- Views:
- 2,005
-
- Replies:
- 6
- Views:
- 3,785
-
- Replies:
- 1
- Views:
- 2,793