Orthotics 4 Foot and leg Pain

The human body's ability to move from point A to point B is known as the gait cycle.  Through out this site I make reference to the gait cycle, so I thought it should be discussed in some detail for a better understanding on how an orthotic may help with any abnormalities in the cycle.

We can discuss an ideal gait cycle but it is probably safe to say that every one has some variation in their gait.  This only becomes an issue when pain arises.  

Conditions that may cause severe variations in gait can result from congenital issues, such as an excessively flat foot or excessively high arch.  Perhaps a limb length discrepency can be at fault.  These are examples of situations that are normal for the given patient; some will have pain, others will go a whole lifetime without any issues.

Then there are problems that occur during life that can affect your gait pattern.  An example would be arthritis.  As a joint becomes arthritic, be it in your foot, ankle, knee or hip, in an effort to avoid pain you may change the way you walk and this will alter your gait.  In the case of arthritis, the reverse is also true.  An abnormal gait in many cases can lead to arthritic degeneration of any of the previously mentioned joints in the lower extremity.

By and large mankind was not designed to wear shoes but society, on many levels, dictates that shoes be worn.  So in an ideal world if every one wore "sensible" shoes there would certainly be less foot and leg issues to deal with.  It does not take a medical degree to realize that certain shoes are almost a guarantee for the development of some foot and leg issues as these shoes will certainly alter the gait cycle and end up causing pain.  

We all know the biggest culprit is the high spiked heel.  Sure they look great but talk about changing the biomechanics of gait!  I am sure most women who wear these shoes know they are not good for their feet but at the time of purchase, that is not a consideration.

I do have many older female patients who curse those shoes for what they have done to their feet and fortunately I even have younger women who no longer wear this style shoe simply because they are not willing to trade pain for fashion.

Looking at the x-ray of the foot in the shoe it should be obvious to any one that this is not a good situation.  Even though high heels are probably the biggest culprit in abnormalities in gait, other shoes as well can have a negative impact on the gait cycle simply because they do not allow the foot to maneuver in a normal gait cycle.

The gait cycle is divided into three phases.

The first is the contact phase also known as heel strike.  This occurs as the leg swings forward and hits the ground.  Normal heel strike is on posterior-outside portion of the heel.  So, if you notice your heels are wearing down on only the posterior section of heel or even worse, the posterior-inside of the heel then there is a problem with heel strike.  Does this mean you will end up suffering from foot or leg pain?  Possibly, but it is not guaranteed.

This part of the gait cycle accounts for 20% of the cycle and ends when your foot is flat on the ground.

The second part of the gait cycle is known as the midstance phase or foot-flat.  In this phase your body weight is passing over the foot that is planted on the ground, while the other foot is in the air.  In those individuals who exhibit excessive flat feet or high arched feet, this phase is where problems will occur.  Thirty percent of the gait cycle is represented in this phase.  Midstance ends as the body propels forward and the heel begins to rise.

These two phases together represent 50 percent of the total gait cycle and it is in these two phases where most heel, midfoot and arch problems will develop.

The last phase known as the propulsion phase or toe off is where the foot begins to push off the ground to move forward.  This part along with the leg swinging forward just before the heel hits the ground makes up 50 percent of the gait cycle.  Problems involving the forefoot generally occur at this level.

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