BIOMECHANICAL ORTHOTICS

I have been in practice nearly 18 years and take great pride in the orthotics I dispense. Over the years I experimented with every brand, style, material and impression system available.

I have had the most success at altering a runner's abnormal time sequence responsible for their injury, be it from spending too much time in shock and converting to propulsion late or prematurely converting to propulsion when they should still be in shock absorption, with a suborthalene recoil plastic module, crepe/korex extrinsic posts, with a spenco full length top cover.

The most superior impression taking system I have found is the 90 degree, semi-weight bearing, resting calcaneal stance position into cast-o-foam, supported in the August 2000 issue of Biomechanics on page 72.

The walk over matts and grids that give peak plantar pressure and a colorful shape and picture of a patient's foot, in my experience, do not give enough information to build an equal correct time symmetry biomechanical orthotic. They seem to be a convenience system for the doctor to get patients in and out as fast as possible while at the same time, impressing patients with "high tech" bells and whistles.

I've replaced quite a few of these orthotics with their main reason for failing to relieve symptoms because the orthotics prescription was "watered" down and too weak to alter the patient back to correct time symmetry.

Maybe I'm old fashioned, but hand made is still the best, and I know solving a runner's biomechanical problem is a lot harder than walking across a pressure mat.

Your running injury is not caused by your running. It has a specific cause, or error, that must be found and corrected. It is important to treat the cause, not the effect, of the injury. For example, injuries of the foot, lower leg and knee are almost always due to a faulty time sequence. Fortunately, in expert hands, the injuries can be eliminated by correcting the abnormal biomechanics. A biomechanical approach works best because it corrects the roots of the problem: your foot type and time sequence. The treatments might include some of the following: The appropriate shoe style for your particular problem, orthotic inserts or heel lifts for leg-length inequalities. In knee injuries, it's best to start by ignoring the knee and treating the foot.

The Osborne Running Analysis Lab will provide you with the chance to see your running motion, velocity, cadence and stride length in order to take steps to enhance your running. One picture is worth a thousand words. Armed with the appropriate information, I can assess your particular problem and treat it.

How do I know if I need orthotics?
Foot function is a time sequence phenomena. Events must happen at the proper time to be efficient. Imagine a line with normal foot function time sequence in the middle. To the left are people who spend too much time in the shock absorbing phase and convert to propulsion late. To the right are people who prematurely convert to propulsion at a time when they should still be absorbing shock. If you are left or right of a normal time sequence, you stand an excellent chance of breaking down and getting injured within eight weeks after you start averaging 25 miles per week.

What is responsible for my injury?
There are six major foot types I see in runners:
1) Neutral
2) Forefoot Varus  
3) Rearfoot Varus  
4) Rigid Forefoot Valgus
5) Flexible or Plantar Flexed First Metatarsal
6) Equinus

Every foot type can breakdown with over-training, but types 2,3,4,5 and 6 cannot do the mileage a neutral foot can do.

How do orthotics work?
First, someone has to classify your foot. Second, someone has to pick the right material. Then, depending on your foot type, they either enhance or de-enhance the time sequence of your feet, putting you close to neutral functioning. This decreases the stress on your parts, making you able to run higher mileage with less risk of breaking down.

Will orthotics help my knee pain?
If the pain is superficial, yes, most likely. If the pain is deep in the knee joint, then you need to see a knee specialist.