Orthotics 4 Foot and leg Pain

If you are researching illio-tibial band syndrome, chances are you did not come by this diagnosis on your own.  This is not an easy diagnosis to make and it generally takes a health care practitioner some thought and exploration to come up with this diagnosis.

The illio-tibial band as pictured below is a large ligament type structure that extends on the outside of the thigh from the hip down to the lateral part of the knee joint.  Its purpose is to stabilize the knee joint and works in conjunction with flexion at both the level of the knee and hip joints.

illio-tibial band syndromeIt can manifest itself as pain either in the hip joint or on the outside of the knee joint and in both cases may actually send pain down to the foot.

Exercise more than just every day walking will cause illio-tibial band syndrome.  Almost any sport can create symptoms but cycling in particular and running seem to top the list.  Cycling because the abnormal angle set at the hip and the excessive strain on the knee.

Running on the other hand can set off this condition either due to a limb length disecrepancy or a muscle imbalance in one leg versus the other.  This can be an actual difference or a difference created from outside forces.

A typical example of an outside force would be a runner who constantly runs on a banked track or even in the street for that matter.  Most streets, in an effort to promote water drainage, will be higher up in the center of the street and lower by the side, allowing water to drain away from the street.

Because of the pitch that is created by this situation, someone who is running in one direction will exhibit a pronation tendency in the foot closest to the center of the street, while the foot furthest from the center will exhibit more of a supination position.

Even if the difference in pronation of one foot and supination of the foot is miniscule, it is the repetitive nature of running that will exacerbate the problem.

This creates a relative limb length discrepancy as well as poor shock absorption on the part of the feet which then may lead to an illio-tibial band syndrome.

Of course there are a number of ways to treat this condition involving oral and injectable medication as well as physicial therapy and rest, but in order to get to the heart of the problem, an orthotic is usually in order.

             how does an orthotic help illio-tibal band syndrome?

An orthotic works in two distinct ways.  The first is to biomechanically control the foot so that the foot hits the ground at heel strike in its ideal position and then further allows the foot to go through foot-flat to toe-off in its "neutral" position or ideal relationship of the foot to the ground so that the foot functions at its optimum.  By doing so it then sets forth in motion ideal functioning of the ankle, knee and hip joint.

This is of particular importance in the above example of training on a banked track or running in the street.  An orthotic can be made to make up for the defects in the running surface.  

The importance here is that if there is a problem in the foot biomechanics that is causing illio-tibial band syndrome all the rest in the world and all the medication in the world will only offer temporary relief as long as the feet are not working in sync with the rest of the leg.

The second way an orthotic is helpful in illio-tibial band syndrome is to help absorb shock.  In running, as well as walking, when the heel hits the ground and then goes to foot-flat, there is motion within the foot that helps absorb shock.  If the foot is not adequately absorbing shock, this shock can travel all the way up the leg and be a major cause of illio-tibial band syndrome.


ORTHOTIC RATING:

store bought arch support if the device has adequate cushioning which most of these tend to have and has a modest degree of support they may work.  The only exception would be foot structures with very high or very low arches.

medical grade off the shelf orthotic would be indicated for this problem in most foot structures. Obviously the orthotic would have to be of the athletic nature and most of the ones I have seen have adequate shock absorption

prescription orthotic very effective in all foot types but the average person will probably do fine in one of the other two options.

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MEDICAL GRADE ORTHOTICS

best buy in pre-made orthotics for sneakers, work boot and casual lace shoes

KLM SuperStep Orthotic    

best buy in pre-made orthotics for womens flats, low heel pumps and mens dress shoes

Redithotics 3/4

medical grade off the shelf childrens orthotics because kids outgrow orthotics so quickly

childrens orthotics



Copyright © 2013. All Rights Reserved.Marc Mitnick DPM