Orthopaedics
This is the branch of medicine that aims to diagnose, treat, prevent and rehabilitate all types of injuries, alterations and diseases of the human locomotor system.
The locomotor system is made up of a complex combination of bones, tendons, ligaments, muscles and joints that allow movement. In practice, however, the focus is more on the spine and limbs.
At any level, different bone or joint disorders may occur in each anatomical area. Thus, the study of Orthopaedics has diversified with the development of several sub-branches dedicated to the study of pathologies and treatments of specific areas of the human body in greater detail.
Thus, the branch of orthopaedics dedicated to the study of bone and joint injuries of the foot has emerged: Orthopaedics.
Orthopaedics is a complementary branch of Podiatry which is responsible for solving orthotic and prosthetic problems of the foot or complementing surgical or chiropodic treatments.
There are numerous diseases and deformities that have orthotic treatment as an alternative, which are prepared individually at the Clínica San Román, for example:
Digital claw
Made-to-measure orthopaedic insoles under plaster moulds.
Silicone rings.
Minor foot surgery
Onychocryptosis (ingrown toenail).
Gel or silicone separators.
Minor foot surgery.
Clinodactyly: depends on the degree of deformity, but available:
Silicone orthodigital spacers, thin or thick.
Fifth varus:
Silicone fifth toe protectors.
Minor foot surgery.
Fractures
Immobilising bars (toe loops).
Hallux valgus (bunion): used for very mild cases.
Orthopaedic insoles to reduce the development of bunions.
Interdigital separator.
Minor foot surgery.
Metatarsalgia
Custom-made plantar supports to unload the metatarsal area that are adaptable to all types of closed footwear.
Silicone metatarsal pads with ring.
Minor foot surgery.
Open foot:
Orthopaedic footwear for correct foot support.
Metatarsal elastic bands with or without pads.
Plantar fasciitis
Heel elevation, with customised heel lift to reduce traction on the Achilles tendon and relax the plantar fascia.
Orthopaedic relief insoles.
Treatment with anti-inflammatory medication.
Talalgias
Custom orthopaedic insoles.
Customised calcaneal lifts.
Flat feet, cavus, equinus, clubfoot.
Custom-made orthopaedic insoles under plaster cast.
Frequent side effects of these devices include:
Discomfort in the initial stages, until adaptation to the orthosis.
Leg pain until the gait is corrected, which may improve with specific exercises.
Symptoms of mild leg pain and changes in gait or foot discomfort, which should not exceed 4 weeks.
Thickening of the skin or hyperkeratosis due to rubbing. These are relevant in cases of diabetes or peripheral circulatory disorders.
Hyperhidrosis or bromhidrosis.
Deformity of the footwear or localised wear.
Modification of gait or irregular gait.
Feeling of ankle instability or sprains.
Important considerations with the orthoses prescribed by your podiatrist:
Periodic revisions of the orthosis are always recommended.
At least every 6 months.
If the orthoses are used for sporting activities, the wear and tear is greater. In these cases, they should be checked every 3 months.
Careful hygiene measures and avoid exposing orthoses to extreme temperatures.
Wear stockings or socks.
The materials most commonly used for orthoses are important in case of allergies or local reactions:
Polyolefins
Polyethylene
Low density
High density
Polypropylene
Acrylics
Resins
Skins (calf, goat, lamb), for coatings
Foam and sponge rubber
Cork
Polyurethane foams: prosthesis linings and polyethylene foams.
Cornylon (cork 90% and nylon 10%)
Ethyl vinyl acetate
The combination of materials will be chosen by the foot professional taking into consideration the deformity to be corrected and its severity, as well as age, weight, degree of physical activity and associated diseases.
Sports podiatry
This is a discipline derived from podiatry and is responsible for the assessment, treatment and prevention of sports injuries to the feet.
The diagnosis therefore comprises two phases:
Static examination: with the patient lying down, the foot and ankle joints are assessed. A distinction must be made between the three types of stride: supinator, pronator and neutral. Most injuries occur in athletes with a pronator footprint.
Dynamic examination: this is carried out in movement, through studies of the stride in all its phases and assessing where the areas of greatest pressure are exerted and at what time this occurs. It is possible to determine whether the axis or centre of gravity is delayed or advanced.
Ideally, the gait should be symmetrical and the back of both feet should bear 2/3 of the pressure.
The physical examination in conjunction with dynamic studies allows a correct and precise diagnosis to be made, establishing the necessary corrective measures to prevent sports injuries or correct any orthopaedic problem already present.
All this leads to the design of customised insoles according to the defect to be corrected, providing the necessary cushioning and balance to improve sporting performance.
The biomechanical studies of gait and sporting gesture, gather a series of information through clinical and technological resources, namely:
Baropodometry: static and dynamic analysis of the foot on a pressure platform.
Detailed osteoarticular exploration.
Posture analysis.
Evaluation of the morphology and functionality of the athlete’s foot.
The aim is to produce a detailed report for the athlete with the following diagnostic, therapeutic and preventive information:
Advice on the type of footwear for sport.
Orthoses for deficiencies or alterations of the foot.
Treatment based on insoles adapted to the usual footwear or sports footwear.
Avoiding the appearance of injuries derived from structural alterations of the foot.
Planning podiatric care at pre-competitive, competitive and post-competitive levels.
Treatment of sports injuries if present.
At Clínica San Román we offer personalised rehabilitation treatments for the foot.
Foot fractures are common in certain sports, caused by blows whether playing football or martial arts, although they can also be caused by small stress fractures, generating what is called continuous micro traumatisms and affecting the bone.
In any case, rehabilitation is important due to the load that our feet have to bear, and exercising too soon or too intensely can aggravate the injury. The best option is to go to Clínica San Román where we are specialists in foot rehabilitation.
