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Over millions of years Man has developed the ability to stand on two legs rather than four.
In so doing our eyes are at a higher level than the predators from our past, giving us the option to run from them or hunt them.

In order to run efficiently feet must adapt to the eneven surface when they contact the ground. As the body weight moves forward of the leading foot, the trailing foot is lifted and the leg swings forward whilst the weightbearing foot lifts at the heel, then pushes at the toes giving propulsion to the movement. Weight is transferred from the foot behind to the foot in front of the body. This is known as 'walking'.

picture of podiatrist using a treadmill for biomechanical analysis of the feet at The Stevenage Podiatry Clinic in hertfordshire uk

If this sequence of movement is not smooth and balanced, physical stresses will cause changes to bone shape, joint alignment and soft tissues such as stretched ligaments and muscle imbalance (e.g. Right calf muscle larger than the Left). In other words, the body will adapt itself for example if one leg is shorter than the other, the individual will walk differently to other people in order to compensate for the difference in limb length. (Gait analysis is the examination of the way a person walks/ runs).

In modern life the alignment of joints, the twists and curves of bones and muscle imbalances may cause painful injuries and deformities.
Using the example again of an indivdual with a short leg, when standing, the pelvis will be closer to the ground than on the long leg side. The body being the complicated structure that it is, will aim to keep the head level in order to maintain balance and keep the eyes level in order to judge distance accurately. Between the head and the 'not so level'pelvis we have the spine which compensates by curving to the long leg side of the body. The curvature of the spine becomes permanent (scoliosis) as the young body develops and the years pass by.
'Nothing complicated in that!' you may think. 'The body has adapted well to having a short leg!'. Now add lifting heavy weights to the scenario, playing sport e.g. rugby, football, squash or simply bending to retrieve a TV remote from the floor.

Backaches and even headaches due to muscle struggling to cope with the effort of keeping the head level on the top of a curved spine, have been shown to be caused by having one short leg. Clearly, the body isn't coping as well as you may have originally thought.

So. What can be done? Operations are generally reserved for extreme cases. For the individual with the short leg, a simple heel raise inside the shoe or an extra layer to the heel of the shoe applied by a shoe repairer may be sufficient to compensate for the short leg and resolve the backache. More complicated cases where bones are curved or twisted, or joints mal-aligned may require a prescription insole (orthotic) in order to change the way the foot contacts the ground allowing even distribution of body weight across the foot and a more efficient walking pattern.

Any sport that involves a well balanced posture e.g. archery or sports such as football, rugby, athletics where running is involved can become more efficient when using orthotics. They're not magic though... orthotics will not change an average footballer into a David Beckham.
Orthotics are also used to rest sports injuries, some of which are listed below.

- Shin Splints (compartment syndrome)
- Achilles Tendonitis
- Plantar Fasciitis / Heel Pain
- Knee pain
- ITB Syndrome
- Hip Discomfort and Tightness
- Lower Back Pain and Stiffness

On arriving at the clinic you will be taken in to the clinic for a biomechanical assessment, this isn't as scary as it sounds and is very straight forward, usually involving taking a history of any pain, injury or symptoms you have experienced and then the practical assessment of looking at physical function. A biomechanical assessment will determine if the position of the foot and ankle whilst standing and during the gait cycle contributes or causes pain or discomfort. The assessment would include looking at the knees, hips, back, ankles and feet as a whole to look for any weaknesses or structural issues, you would be observed standing and also asked to walk or run (if you wish) on the treadmill to establish what may be occurring during your gait.

Orthotics or insoles may be prescribed to you to correct your position and realign the lower limb if this is thought necessary. There are various types of orthotic that can be used and we would discuss this with you depending on your preferred footwear, foot type and activities that you take part in. We have an Osteopath on site to whom we often refer our patients as osteopathy often speeds up the recovery process and improvement of motion. We would inform you of this if we felt it may be necessary.

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