Foot and Ankle Biomechanical Deformities

Foot and ankle biomechanics is the science of how the musculoskeletal structure and movement of the foot and ankle work together to produce movement.  Biomechanical dysfunction is an acquired change in musculoskeletal mechanics that result in faulty movement patterns.  Most chronic bone and joint or ligament and tendon problems originate from a biomechanical abnormality of the foot, ankle or lower extremity.  

A biomechanical abnormality or dysfuntion may be from an inherited condition such as flat feet or high arches.  It may be developmental, in the case of hallus rigidus (an acquired condition due to arthritis of the big toe joint), tendonitis or heel spur formation from excessive tension of the plantar fascia ligament due to gradual collapse of the arch.  A traumatic injury, such as rupture of a ligament or tendon, may leave residual gait dysfunction even after repair and healing.

Effects of Biomechanical Abnormalities

Your body has to adapt and compensate for various biomechanical dusfunction when you stand, walk or run. As your body adjusts, the altered alignment can throw off the normal function your lower leg, knee, hip and spine causing pain in those joints as well.  It is this chain reaction of compensations that put structures such as muscles, joints, ligaments and tendons under undue strain as they begin functioning in an abnormal or compromised manner. Over time these structures become inflamed or injured. 

Typical foot and ankle problems caused by biomechanical dysfunction are:

  • Heel Pain


    Plantar Fasciitis


  • Calluses & Corns

    Posterior Tibal Tendon Dusfunction

    Heel Spur

    Achilles Tendonitis

  • Flat Feet

    Heel Spur

    Hallux Rigidus

    Peroneal Tendinosis

  • Metatarsalgia


    Chronic Lateral Ankle Pain

    Pediatric Complaints

The Starting Point Of Conservative Care

A Foot and Ankle Biomechanics assessment is designed to look closely at your foot and ankle function – for abnormalities and compensations, structural or functional. The objective is to identify the underlying biomechanical causes of foot, ankle, heel, knee or back pain.

Once our physicians have identified the causes of your problems, we can design a tailor made treatment plan to improve your symptoms with the goal of avoiding surgery if possible. This may involve one or more of the following:

  • Exercises to stretch or strengthen muscles

  • Over the counter shoe insert recommendations, if appropriate

  • Prescription Custom Orthotics, if medically indicated. These are specially made devices for you to wear inside your shoe to control, realign or cushion the abnormalities. See more information about when Custom Orthotics are medically indicated below.

  • Proper footwear recommendations

  • Diabetic Shoes and Socks, if applicable

Foot Orthotics

Foot orthotic is a medical term which describes a device that supports, realigns or assists in the musculoskeletal function of the foot, ankle and lower limbs during gait. Functional orthotics apply forces to the feet enabling the orthotic to alter certain movements or off-load stress within tissues. Non-functional orthotics may be designed to improve skin and tissue viability or off-load painful pressure areas.

Shoe Inserts versus Prescription Custom Orthotics

There is a major difference between shoe inserts and medical prescription custom orthotics.  Both are effective in the treatment of foot ailments for specific conditions.  Shoe inserts are any kind of non-prescription foot support designed to be worn inside a shoe. Pre-packaged arch supports are shoe inserts. So are the “custom-made” insoles and foot supports that you can order online or at retail stores. Unless the device has been prescribed by a foot doctor and hand crafted for your specific foot, it's a shoe insert, not a custom orthotic device—despite what the ads might say.

Shoe inserts can be very helpful for a variety of foot ailments, including flat arches and foot and leg pain. They can cushion your feet, provide comfort, and support your arches, but they will not correct biomechanical foot problems or cure long-standing foot issues.

Prescription Custom Orthotics

Prescription Custom Orthotics ordered for you by Texas Foot Surgeons are devices hand made from a custom mold of your foot and designed to place your foot and ankle into their correct musculoskeletal alignment. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Custom Orthotics are only manufactured after a foot and ankle specialists has conducted a complete evaluation of your feet, ankles, and legs, so the orthotic can resolve your unique foot and/or ankle biomechanical abnormality and pathology.

Prescription orthotics are divided into two categories:

  • Functional orthotics are designed to control abnormal motion. They may be used to treat foot pain caused by abnormal motion; they can also be used to treat injuries such as shin splints or tendinitis. Functional orthotics are usually crafted of a semi-rigid material such as plastic or graphite.

  • Accommodative orthotics are softer and meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, painful calluses on the bottom of the foot, and other uncomfortable conditions.

Texas Foot Surgeons use orthotics to treat foot problems such as plantar fasciitis, bursitis, tendinitis, diabetic foot ulcers; and foot, ankle, and heel pain. Clinical research studies have shown that physician-prescribed foot orthotics decrease foot pain and improve function.

Prescription custom orthotics typically cost more than shoe inserts purchased in a retail store, but most insurance plans help cover the cost and prescription orthotics are made of top-notch materials that last many years when cared for properly. Unlike shoe inserts, orthotics are molded to fit each individual foot, so you can be sure that your orthotics fit and addresses the problem causing your pain

When to Visit a Foot and Ankle Specialist

If you feel extra cushioning or support will alleviate your symptoms you may wish to try an over-the-counter shoe insert first. If you have serious pain or discomfort, or if pain persists after wearing a shoe insert for a few weeks make an appointment with our practice. An appropriate medical evaluation by one of our foot and ankle specialists will determine if a biomechanical abnormality is the cause of or is contributing to your problem.

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