What do orthoses do and why do I need them?

  • By Judith Sullivan
  • 04 Apr, 2017
  • 21 Sep, 2016

By Matthew Collison

Foot orthoses are often prescribed for foot and lower limb pain. The main way that orthoses work is by altering the way your foot interacts with the ground when you walk or run. The aim of an orthosis should be to reduce pathological forces acting on the foot, whether that be to pain in a tissue such as the plantar fascia (heel pain) or to prevent skin breakdown in patients with diabetic neuropathy (sensory loss related to diabetes).

The way forces act on an object (such as the foot) are called kinetics, and the movement and angle of these forces is called kinematics. Often, orthoses are sold to ‘improve alignment’ or to ‘straighten’ feet and joints with the hope of reducing pain; however often it is not necessary or achievable or desirable to modify kinematics with an orthosis. The focus of treatment should be on reducing the kinetics or forces within tissues to reduce pain, rather than purely on alignment.

Different materials and shapes of orthoses can have different effects on tissues, some materials such as low density foams can provide cushioning, whereas other materials like carbon fibre or polypropylene provide more support. Even the top covers can affect the way the orthosis works.

Foot orthoses have been shown to be useful in the management of foot pain in chronic conditions such as rheumatoid arthritis and juvenile idiopathic arthritis as well as specific lower limb pathologies such as plantar fasciitis (heel pain), medial tibial stress syndrome (shin splints), pes cavus (high arches), to name a few.

What kinds of orthoses does Betafeet Podiatry offer?

We offer a wide range of orthoses, ranging from simple wedges, pads or props added to your existing footwear, to prefabricated devices and fully custom devices made from moulds of your feet. Following a biomechanical assessment, your specialist podiatrist at our Tring or Hemel clinic will advise you on what is most appropriate for your needs, and will often offer you a choice of appropriate interventions based on your condition. The key is finding the right tool for the job. You may also find that you need different devices for different footwear or activities. For example, a runner, cyclist or hiker taking on the roads in and around Ashridge or the Tring reservoirs will likely need different devices for his or her running shoes and for their work shoes. Betafeet Podiatry also sees clients who are on their feet most of the day such as those who work in restaurants in Tring and Hemel, and surrounding areas, as well as hairdressers, builders and others.

Orthoses will almost always be prescribed alongside other advice and interventions such as activity modification, stretching and strengthening exercises, self-massage advice and footwear advice.

Stayed tuned for further orthoses blogs.

By Judith Sullivan 09 Dec, 2017
By Reggie Simpson
By Judith Sullivan 28 Sep, 2017

We are delighted to announce that prose written by our Practice Business Manager, Reggie Simpson, will be featured in the Rennie Grove Hospice Care’s Rhyme & Reason 2018 diary, now in its 26th year. The theme for this forthcoming year’s diary is ‘Freedom’. All proceeds from sales of the diary go to support this worthwhile charity.

Reggie says: ‘Although my entry wasn't among the top poetry and prize winners, I was chuffed to be selected for the 2018 diary. The theme was quite broad, but my degrees in politics and love of writing invariably drew me to entering the competition. In the end I settled on a focus of freedom in healthcare, no doubt inspired by my current employment at Betafeet Podiatry and the noble work of Rennie Grove Hospice Care ( www.renniegrove.org ).

Rennie Grove Hospice Care, formally known as Iain Rennie Hospice at Home, merged with Grove House, St Albans in 2010 to integrate services in south western Hertfordshire. The ethos and values of the two charities were closely aligned with the principle of allowing patients to lead a good quality of life at home for as long as possible, helping patients and their families avoid the distress of unnecessary hospital visits whenever possible.

The diaries can be ordered from the Rennie Grove website, payment by debit/credit card. It's part of their annual Christmas/holiday promotion. There will also be copies in local Rennie Grove shops. They are £5 each with additional postage if bought online. Shop locations can be found here: http://www.renniegrove.org/support/our-shops/online-shop/page/2/ .

Here is Reggie’s entry (to appear in the month of September 2018): 

‘Do not count the days; make the days count.’

Muhammad Ali. Professional Boxer.  Audacious. Charismatic. A winner in the ring.

But even when you have won it all, life throws you a few more punches.

Yes, his name opened doors and wealth, but the bombastic man of his younger years was humbled in later life, and following retirement, he dedicated himself increasingly to charitable work. Parkinson’s was already taking hold.

He received the Presidential Medal of Freedom in 2005, the highest honour the USA can bestow.   He died in June 2016, aged 74.

Now the news is about boxing helping dementia sufferers.

So what does this mean for freedom? Does getting battered around the head spell freedom and choice? One would say yes; a boxer is free to take such risks. When the consequences deal you a fatal blow as a result, when do you lose your freedom? Is it when you have been reduced to a shadow of your former self, a normal human being, and have to rely on others? Muhammad Ali likely had plenty of resources to ensure his final days would help him on his final journey.

We tend to think of freedom in political terms. It is hard to remove freedom in healthcare from politics. Think NHS reform, among others. Freedom in a healthcare environment means more to the individuals and families when they have life-limiting illnesses and need the care of volunteer-run hospices such as Iain Rennie Grove.

The NHS gives patients the rights to make choices about different aspects of the care they receive, from the different treatment options available. How these are chosen is individual, although for those with life threatening or limiting illnesses this choice will fall on family members. 

I quote the following:

‘In health there is freedom. Health is the first of all liberties’.

Henri-Frédéric Amiel, Philosopher

September is World Alzheimer’s Month.




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