A Runner with the Wrong Orthotics
by Dr. Kirk A. Lee, D.C.
Today the doctor of chiropractic has many choices when choosing the type of Spinal Pelvic Stabilizers, or custom-made orthotics, to use in his office. We must first and foremost use orthotics from a company that also supports our profession. Secondly, these orthotics must be custom made, semi-flexible and have high doctor-patient satisfaction.
Remember, we want to support all three arches of the foot and, if possible, prescribe an orthotic that is designed for the patient’s specific activity. Another important factor in choosing an orthotic type is making sure it matches well with the shoe. You have heard before that a good orthotic is even better when used with a high-quality shoe. This is especially the case for running, since those shoe types are based on foot structure. There are typically three types of running shoes:
1. The shoe for the supinator: This shoe usually ranges from curved to semi-curved and has additional shock absorbing capabilities.
2. The shoe for the neutral foot: This shoe is usually designed with a semi-curvature having adequate arch support and adequate shock absorbing capabilities.
3. The shoe for the hyperpronated foot: This is usually designed with maximum arch support or referred to as a "motion control" shoe to assist the foot as it moves through the gait cycle. From heel strike through pronation, the foot rolls inward and shifts weight-bearing forces to the first and second tarsal heads to allow normal toe off. The goal of this shoe’s design is to prevent excessive inward or hyperpronation movement. This shoe is usually straight in appearance.
Let’s look at a case study of a 46-year-old female runner whom we will refer to as Mrs. J. She began developing foot pain, which began affecting her gait cycle, which led to symptoms of low back pain. She consulted with her family allopathic physician, who referred Mrs. J. to a podiatrist. The podiatrist made non-weight bearing, hard, 3/4 length orthotics. These were made with your typical high medial arch, no lateral arch support and a minimal anterior arch support. After wearing her orthotics for a couple days to break them in, she attempted to run while wearing them. She was unable to complete her normal workout and developed severe foot pain and low back pain.
She entered our chiropractic office two days later while still in severe foot pain and low back pain and she was walking with a considerable limp within her gait cycle. We scanned Mrs. J with our Associate® Platinum digital scanner to identify what biomechanical changes had taken place within her foot structure. In the next column, you can review a balanced, symmetrical scan while comparing them to Mrs. J’s scan.
As you review the symmetrical scan, you see that the only place the foot touches is in the toes, forefoot and heel areas. As you look at Mrs. J’s scan, what do you see? The primary difference is the breakdown of her lateral arches, followed by her anterior arches and slight breakdown of the medial arches.
Below you can review the scans in a "colorized" version, where the red indicates where the most pressure is placed. As you look at the symmetrical scan and then at Mrs. J’s scan, you can see that the majority of Mrs. J’s arch breakdown or weight distribution is placed laterally.
So why did Mrs. J’s condition worsen when she was placed in the non-weight bearing orthotics made by the podiatrist? As I mentioned, those orthotics were made with a high medial arch; however, you can see from the above images that Mrs. J’s problem was not a medial arch problem, and instead it was more of a lateral arch problem. The use of the non-weight bearing orthotics caused Mrs. J. to force her weight bearing even more laterally—aggravating her present condition.
We placed Mrs. J. in a set of custom-made, flexible, Full Length Spinal Pelvic Stabilizers. Wearing these Stabilizers, along with chiropractic adjustments and rehabilitation of the lower leg musculature, she was able to return to a normal, healthy lifestyle that included "pain-free running."