SAPPHIRE PHYSICAL THERAPY

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1 SAPPHIRE PHYSICAL THERAPY

2 PRESENTATION OUTLINE Foot Facts Foot & Ankle Anatomy Shoe Anatomy Common Foot Injuries Orthotics Sport & Activity Specific Shoes Questions & Answers

3 FOOT FACTS Average person logs 1,000 miles per year. One hour of running transfers 1 million lbs. of force through the feet. Walking places 1.5 times your body weight through your foot. Over 11 million medical office visits in 2003 due to foot and ankle problems.

4 FOOT ANATOMY 26 bones in each foot. The ankle is composed of the talus and the distal end of the tibia and fibula and their associated supporting ligaments. Most commonly sprained ankle ligament is the anterior talofibular ligament. Muscles located in the lower leg and foot move the ankle and foot. The arch of the foot is a supporting structure composed of bones, muscles, and the plantar fascia. Foot pronation and supination- which do I have and does it matter?

5 Bones FOOT ANATOMY Ankle Foot Ligaments Muscles The arch of the foot Plantar fascitis Muscles Bone structure Foot pronation and supination - which do I have and does it matter?

6 FOOT ANATOMY

7 FOOT ANATOMY

8 GAIT ANALYSIS Pronation or Supination? Toe-in or Toe-out? out? Knees-in or Knees-out? Heel (rear foot) Motion? Antalgic (limp) Gait Present? Arch Height? Right Foot Compared to Left Foot?

9 SHOE ANATOMY Your shoes should allow for appropriate foot and ankle motion while controlling inappropriate or inefficient motion. Shoe cushion vs. shoe support Mid sole materials (gel, air, EVA) Heel counter Last -straight vs. curved Shoe tread Torsional stability test Insole vs. over the counter orthotic vs. custom-casted casted orthotic

10 SPORT & ACTIVITY SPECIFIC SHOES Walking shoes Running shoes Work shoes/boots Hiking shoes/boots Cycling shoes Sandals Dress shoes

11 ORTHOTICS Custom made vs. prefabricated

12 ARE ORTHOTICS FOR ME? 50% of all Americans will miss a day of work due to foot pain. Foot pain is not normal and should not be ignored. Orthotics help reduce pain, provide support, improve biomechanical function of the foot & ankle.

13 OVER THE COUNTER ORTHOTICS Provide additional support for the average foot. Includes: Spenco insoles Super feet Pre-fabricated arch supports

14 CUSTOM ORTHOTICS Provide support and/or cushion to decrease pain and improve function. Casted in ideal ankle position to insure a custom fit. Three types: Rigid Semi Rigid Soft

15 WHO MAY BENEFIT FROM ORTHOTICS? People with foot problems People who must walk or stand excessively on the job. People who are active in sports Overweight individuals People with diabetes Older adults It is important for patients to follow the doctors instructions on when to wear them to obtain the greatest benefit.

16 RIGID CUSTOM ORTHOTICS Provide necessary support and stability in order to decrease excessive foot and ankle motion causing pain. Rigid plastic or carbon fiber arch. Top cover usually extends to the metatarsal heads and is composed of Spenco, Coolflex,, or suede. Indications include cycling, soccer, baseball shoes, ankle instability.

17 SEMI RIGID CUSTOM ORTHOTICS Provide support while allowing appropriate, dynamic foot and ankle motion. Semi rigid plastic or carbon fiber arch with variable density EVA or cork material. Full length top cover for cushion and air flow composted of suede, Spenco or Coolflex. Indications include activities such as running, walking, hiking, plantar fascitis, work settings requiring frequent walking (work shoes, work boots).

18 SOFT CUSTOM ORTHOTICS Provide cushion and support. Indications: Diabetic foot Arthritic foot Variable density EVA, PPT, cork. Full length Spenco, Coolflex,, or suede top cover. Indications include activities requiring prolonged standing

19 COMMON FOOT INJURIES Plantar fascitis Metatarsalgia Ankle sprain Hammer toe Bunion Blisters & calluses Overuse injuries stress fractures shin splints tendonitis

20 QUESTIONS & ANSWERS What should I look for when shopping for new shoes? What is the torsion test? What should I avoid when purchasing shoes? Will custom orthotics benefit me?

21

22 LOWER LEG AND FOOT ANATOMY

23 LOWER LEG AND FOOT ANATOMY

24 LOWER LEG AND FOOT ANATOMY

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