Biomechanics is the study of the mechanics of living organisms and usually involves the application of engineering principles to biological systems. When applied to the foot, biomechanics is concerned with foot function and locomotion. A good functioning foot is pain free and allows efficient energy transfer during gait so that walking is easy and non-tiring. The foot is a complex structure made up of 26 major bones, associated joints and many soft tissue structures
The efficiency with which the foot functions depends on the way in which these bones and joints move in relation to each other. Problems may arise when the foot bones do not align correctly due to intrinsic abnormalities or may occur when the position of the body over the foot places abnormal forces on the foot such as occurs with a knee or hip deformity.
If the foot does not function correctly, soft tissue strain occurs resulting in pain, deformities such as hallux valgus (bunions) and toe clawing may develop, toenail damage and callous build-up is seen. In sports men and women, tendonitis and other over-use injuries are frequent problems.
Sporting people often have foot related pain due to the increased demands on the feet made during running. Incorrect foot function may also lead to pain in other joints such as the knee, due to the transmission of abnormal forces into neighbouring joints.
The aim of a biomechanical assessment is to identify functional faults by measuring the feet and legs with the patient standing and lying down and may include checking joint movements and assessing muscle strength and flexibility. It will often include watching the patient walk to assess the way in which the foot work. For athletes, assessment of running gait is essential.
Once a diagnosis has been reached your podiatrist will discuss the proposed course of treatment, giving options where appropriate. It may be possible that a programme of exercises and advice on footwear is all that is necessary.
Where longer-term correction is required you may need to wear an orthosis. This is a corrective insole designed to correct the foot deformity or the timing of the loading of the foot during walking. Orthoses position the foot structure to achieve optimum skeletal balance, reducing the stress on the soft tissues. There are many good prefabricated orthoses available which are relatively inexpensive and can be adapted for the individual foot type. These are useful as a first device if it is unclear whether orthoses will help your condition. When precision control of the foot is required, custom made orthoses are usually recommended and can be made in a variety of materials to suit the individual’s needs.
A biomechanical assessment and gait analysis usually requires a 1 hour appointment. Casting for orthoses is included in this time if required.