BY It’s been more than a month since we first dropped in to see podiatrist Tim Maiden at The Foot Practice. Fiona had been suffering from a pain in her foot arch over long distance runs, and what she thought was simply a problem with a collapsed arch was diagnosed by Tim as essentially an issue at the knee and hip.
After doing the prescribed strengthening exercises over the course of a month, we are back at the clinic for a follow-up.
Has the issue been tuned out or is something else needed?
Fiona reports that she appears to have had limited success with her conditioning exercises, and covering distances of more than 5km still causes pain in her foot. Tim then went through the full range of motion screening actions again and noted that the knee joint was still falling "In the hole".
He explained that this was often due to muscle strength: the body sometimes doesn’t fire the muscles the right way after many years of doing it the ‘other’ way. In Fiona’s case, she has covered so much mileage running over the years without actively using her glutes to pull, that her body has simply become conditioned to maintaining this state of motion.
This resulted in her knee rotating inwards with each stride, pushing her foot into a state of pathological pronation at landing. This, in turn, not only puts extra pressure on the arch but also increased the workload of the large toe in maintaining proper balance.
Tim further explained that this is not a problem if you never do any running; as you could likely walk around town all day, every day and it would unlikely cause pain or damage. Once you start running for longer distances, however, the added dynamic impact made for a more volatile situation.
A way for Fiona to get back to training without pain and to condition her glutes to pull in the right direction would be to fit her out with custom moulded orthotic insoles fitted to her running shoes.
This would properly lift and support the inside of her foot, forcing the knee joint to track in a proper fore and aft motion, and by extension, allowing her muscles to retrain themselves.
A 3D scan of both feet was taken for the construction of orthotic insoles, which are handled by a specialist maker.
So now we’re off as Fiona continues her strengthening exercises, and we will return for another follow-up and see how the orthotic insole will help.
Meanwhile, if you’re having foot troubles of your own, check out The Foot Practice at www.thefootpractice.com. The clinic is located in the heart of the CBD and is easily accessed from Raffles Place and Tanjong Pagar MRT stations, or Novena Mt Elizabeth.
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