Take Home Points: Shoes can be pleasurable or painful or both – shoes can alter the biomechanics of the ankle, knee and hip. The impact of the force going through the joints may cause long term pain and dysfunction that may eventually require physiotherapy and/or surgery to correct the biomechanical adaptations. Orthotics can be beneficial but are not for everyone – be wary of why you need to wear orthotics. If you are wearing orthotics to prevent lower limb injury then best to visit your expert, experienced, ethical and empathetic therapist for a screening examination to identify risk factors for lower limb injury prior to buying orthotics (see research below).

Look after your feet – as your feet are the first part of your body to touch the ground in the morning and the last in the evening, it is important to take care of them. Some simple exercises include ankle pumps, ankle circles and calf raises to keep your ankle and foot mobile and strong throughout the day (see exercises below).

Ankle Pumps

Image 1: Ankle pumps – hands holding thigh into 90 degrees hip flexion and 90 degrees knee flexion. Move foot up (toes to shin) and down (point toes to ground) for 3 sets of 30-40 repetitions.

Ankle Circles 2 Ankle Circles 3

Image 2: Ankle Circles – hands holding thigh into 90 degrees hip flexion and 90 degrees knee flexion. Rotate foot in a clockwise direction for 3 sets of 30-40 repetitions. Then rotate foot in an anticlockwise direction for 3 sets of 30-40 repetitions.

3 Position Calf Raises - Toes Outwards 3 Position Calf Raises - Toes Inwards 3 Position Calf Raises - Straight

Image 3: 3 Position Calf Raises – (i) toes facing forwards, (ii) toes facing inwards; and (iii) toes facing outwards. Start with feet flat on the ground then push up onto toes and slowly control descent down to the floor. Repeat for 3 sets of 10-20 repetitions. (Add a pause at the top of the movement for 10-30 seconds if you feel up to the challenge)

One of the questions I am regularly asked is whether orthotics prevent injuries and can relieve symptoms of back, hip and knee pain. Mattila et al (2010) performed a randomized-controlled trial, published in the Scandinavian Journal of Medicine & Science in Sports, to examine whether orthotics can prevent lower limb injuries. Their research found that “the use of orthotic insoles was not associated with a decrease in lower limb overuse injuries, with the findings suggesting that routine use of orthotics insoles does not prevent physical-stress-related lower limb injuries”. Marks & Penton (2004) performed a literature review, published in the International Journal of Clinical Practice, to examine the evidence base concerning the efficacy of wedged foot orthotics for improving the symptoms associated with painful osteoarthritis of the medial compartment of the knee. Their research found “a strong base of evidence for applying wedged insoles in attempts to reduce osteoarthritic pain of biomechanical origin”. References Mattila et al (2010). “Can orthotic insoles prevent lower limb overuse injuries? A randomized-controlled trial.” Scandinavian Journal of Medicine & Science in Sports. Marks R, Penton L (2004). “Are foot orthotics efficacious for treating painful medial compartment knee osteoarthritis? A review of the literature.” Int J Clin Prac 2004 Jan 58(1): 49-57 Mary Jesse. “The effects of footwear on lower extremity joint loading: a literature review.” Decatur Memorial Hospital, Decatur, Illionois[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]]]>

Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.