Do you have pain in your feet or lower limbs? Is it something you’ve meant to get checked but never got around to? Don’t worry, our podiatrists are experts in lower limb biomechanics - i.e. the way we move and walk. We can help get you walking or running pain free once again. Read on to find out how we can help and what to expect during your podiatry appointment.
Finding out about you
A full and detailed history is a vital starting point for a podiatrist to make a diagnosis. Here we ask questions, such as:
What was the cause of the pain?
Was it a sudden occurrence or did it gradually appear over time?
When did the pain begin?
What type of shoes were you wearing at the time?
Have you experienced this pain before?
What makes the pain better or worse?
Any previous surgeries or broken bones?
To help your podiatrist make an accurate diagnosis, it may be helpful to think about these answers prior to your appointment.
Thinking about your footwear
Your podiatrist will then assess your shoes, their wear patterns (are they worn away in a particular part of your shoe?) and ask you questions about them:
What footwear do you wear on a regular basis?
Is your footwear a choice or a necessity?
Do you choose to wear high heels, causing ball of foot pain?
Can you limit or avoid wearing these shoes, even for a short period of time to allow healing?
I always advise patients who have to wear high heels to work, for occupations such as solicitors or office based jobs, to wear runners to and from work and change into dress shoes when work begins. People usually report a significant pain reduction when they follow this advice.
What is a biomechanical assessment?
It is an examination of the movement of the bones, joints and muscles and how they affect our walking, running and standing posture. The examination is not focused solely upon the foot (pun intended) but includes the pelvis, legs and knees, assessing the relationship between them. It is performed by podiatrists, generally if you are experiencing pain in the back, lower limbs or feet.
However, you do not have to experience pain to visit a podiatrist, some attend as they have questions about foot deformities such as bunions or hammer toes. People also attend who aim to improve posture or prevent injury and pain.
What happens during a biomechanical assessment?
Your podiatrist will examine the range and quality of movement achievable, in comparison to the opposite limb, when performing some of the following tests:
Joint assessment - checks the range of motion of the joints in the lower limb and feet.
Static assessment - evaluates foot posture and alignment in a relaxed position when standing.
Dynamic assessment - this is a gait analysis which assesses the way we walk, to determine biomechanical or structural abnormalities in the lower limbs. Pronation (fallen arches - ankle rolling inwards movement) and supination (walking on the outside of the feet) are evident at this stage.
Muscle strength - tests muscle tone, strength and tightness.
Leg length measurement- checks for a difference in leg length.
What happens next?
Your podiatrist will compile all of the information obtained throughout the assessments and explain the cause, diagnosis and treatment plan. Some treatment options are as follows:
Footwear - Your podiatrist may provide you with advice on good properties of footwear and what styles/brands to look out for when buying your next pair of shoes. Equally, they would inform you what you should avoid e.g. over-flexible, thin soles. An expensive shoe does not mean it is good for your feet!
Exercise programme - Your podiatrist will explain and demonstrate the exercises advised as part of a stretching/strengthening programme. This is a crucial step in becoming pain free, especially if muscle tightness or weakness is noted during the assessment. They may provide you with an exercise handout or email this to you to help you perform the appropriate exercises in the correct manner.
Insoles - You may be advised to wear either an over-the-counter (OTC) insole or a customised orthotic. An OTC is a ready-made, off-the-shelf insole designed for people with mild biomechanical issues. Customised orthotics are insoles which are tailor-made for an individual, according to the podiatrist’s prescription at the end of the assessment. These are the best long term treatment option for many, as they are inserted into accommodating footwear, correct your alignment, provide pain relief and allow you to get back to your day-to-day activities.
Referral - In a minority of cases, the podiatrist may refer you to your GP to request imaging such as an X-ray, ultrasound or MRI for further investigation.
How do I prepare for the appointment?
You should expect the biomechanical assessment to take 30 minutes. It is recommended to wear loose clothing which can be easily rolled up to the knees, or to wear shorts. It is advised to bring 2-3 pairs of footwear you wear most often to the appointment. E.g. work shoes, casual shoes and football boots. Insoles require footwear to have removable footbeds/inners. It is beneficial to bring in one pair of comfortable shoes, which have removable footbeds and can accommodate an insole, if needed.
References
- Feet in Focus. 2020. Biomechanical Assessment With Video Gait Analysis. [online] Available at:
- London Foot and Ankle Centre. 2020. Biomechanical Assessment - London Foot And Ankle Centre. [online] Available at:
- Moyer DPM, C., 2020. How To Treat Severe High Arch Foot Pain. [online image] Verywell Health. Available at:
- Podiatryfirst.com.au. 2018. [online] Available at:
- Walden, M., 2019. Overpronation (Foot Biomechanics) - Signs, Symptoms & Related Injuries. [online image] Sportsinjuryclinic.net. Available at: