Foot Alignment & Orthotic Therapy

We have used the Foot Alignment Clinic model of orthotic therapy for over 20 years. Integrating the science of gait analysis, orthotic casting, myofascial release and exercise therapy to get you moving pain free.

Postural Biomechanics

At EastWest Physio we have searched long and hard for an orthotic solution that aligns with our values. Neil Smith (Pedorthist and inventor of the Vertical Foot Alignment System) and Gavin Johnston (Physiotherapist) have collaborated to create the Foot Alignment Clinic.

The Foot Alignment Clinic is passionate about providing solutions for panful conditions effecting  the foot, legs and back. We believe in creating optimal biomechanics to relieve stress placed on bones, joints, muscles, fascia and nerves. Postural evaluation is carried out by physiotherapists using nerve and muscle testing, static postural and dynamic gait analysis.

Treatment includes manual therapy, myofascial release, orthotic therapy, exercise acupuncture and shockwave.

Fusion of Hands On, Exercise and Orthotic therapy.

To fix your pain we must examine the whole person. We need to know how your individual muscles nerves and joints are working. Then we need to see how they work as a whole and under load. 

We use this information to formulate a treatment plan. This plan may involve hands on myofascial manipulation, exercise and orthotic prescription. 

Casting Performed Weightbearing with Precision

After we have diagnosed you issue and have evaluated how you move, we proceed into a treatment pathway. Typically we spend time releasing tension from your myofascial system, with the aim of establishing a more neutral alignment (from the ground up). When this is achieved we can proceed to casting your foot into the posture/alignment we believe will serve you best. The posture to offload or support your symptomatic tissues is unique to every person. This position will have purpose and be different from left to right, especially if your  symptoms are one sided.

Conditions Treated

Explore all the conditions that can be treated by Foot Alignment & Orthotic Therapy.

  • Morton's Neuroma

  • Facts on Morton’s neuroma:

    • Morton’s neuroma involves a growth of nerve tissue, but it is not cancerous.
    • It causes pain in the ball of the foot, often shooting into the toes.
    • Surgery is an effective solution, but it is only used if other treatments fail.
    • Having a short first toe can contribute to overload and irritation of toes 2,3 and 4.

    Treatment at the Foot Alignment Clinic is dependent on the individual but may include:

    • Orthotics with inbuilt domes to align and offload the metatarsals
    • Cold laser
    • Myofascial release/Joint mobilization.
    • Shockwave therapy
    • Prescription of home exercises
  • Bunions

  • Doctors call that bump hallux valgus, but you might know it as a bunion. Bunions form when the bone or tissue at the joint at the bottom of the big toe joint deforms. Years of abnormal motion and pressure on the joint forces the metatarsal to spread outward and the big toe to bend toward the others, which causes an often-painful lump on the joint.
    This joint at the base of the big toe carries much of your weight while walking. Balance problems may develop. The joint may become so stiff and sore that function is lost.

    Bunions often run in families, but they also can be the result of the way we walk or the shoes we wear.
    If you are getting a bunion be sure to choose low-heeled, comfortable shoes that provide plenty of space for your toes at the widest part of your foot (called the toe box).

    At the Foot Alignment Clinic, we consider the following approach to managing bunions:

    • Keep your foot strong and mobile.
    • Use custom orthotics to align the foot correctly or to off load pressure from the joint.
    • In severe or acute pain wear a splint at night to hold the toe straight and ease discomfort.
    • Soak your foot in Epsom salt bath.
    • Try acupuncture, massage, myotherapy and cold laser. (Available at the Foot Alignment Clinic, Hunters Hill)

    When it’s time for surgery

    If your bunion is causing pain and conservative therapy fails, we may recommend surgery.

  • Plantar Fasciitis / Plantar Fasciosis

  • The plantar fascia is strong and thick fascial tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the foot’s main arch.

    Syndromes of pain in the plantar fascia have been called plantar fasciitis; however, because there is usually no inflammation, plantar fasciosis is more correct. Plantar fasciosis may involve acute or chronic stretching, tearing, and degeneration of the fascia at its attachment site.

    Plantar fasciosis can be caused by:

    • Playing sports that put stress on the heel bone, like running, dance and aerobics
    • Pronated / flat-footed or high arches
    • Being overweight
    • Pregnancy
    • Spending a lot of time on your feet
    • Wearing shoes with poor arch support or stiff soles
    • Morton’s foot

    The main symptom of plantar fasciitis/fasciosis is pain under the heel, which can be dull or sharp. The medial arch may ache or burn and your heel may be slightly swollen.

    The pain is often worse:

    • In the morning, as you take your first steps
    • After prolonged standing or sitting
    • After intense activity

    Treatment should include a combination of the following:

    • Specific loading and mobility exercises
    • Strapping
    • Cold laser/acupuncture
    • Shoes with good support and cushioning
    • Moderate reduction in activity
    • Custom orthotics

    If these measures don’t work and you have had the pain for over three months shockwave therapy is available at EastWest Physiotherapy.

  • Achilles Tendonitis

  • Achilles Tendon Pain: tendonitis/tendinopathy

    Most commonly affects:

    • Sedentary (tendon weakens due to underuse)
    • Distance runners
    • Track athletes
    • Multidirectional sports

    The most common pathology occurs in the mid portion of the tendon 3-5 cm above the attachment of the heel. May be accompanied by pain in the para tendon (sheaf) Fat Pad, Sural Neuritis, Bursitis, Haglund’s deformity(spurs).

    Assessment of gait and posture is essential in diagnosis.

    Walking/Running/hopping assessment is carried out on out force and pressure video treadmill.

    Our therapists are looking out for risk factors including stride length, foot posture, muscle control and timing, big toe activation, hip and knee alignment.

    Treatment Principals

    Short term measures to reduce pain

    Heel raise, taping, night splint, load management, myofascial release, acupuncture, orthotic therapy, and shockwave

    Long term measures to rehabilitate tendon function (essential)

    Progressive loading program

    • Stage 1 Isometrics 30-45 second hold (max effort) x 5 sets, every day.
    • Stage 2 Isotonic 3×8 (tempo 3:0:3) Single leg 1.5x bodyweight
    • Stage 3 Return to sport. High and fast load.
  • Short First Metatarsal / Mortons Foot

  • This is also known as a Mortons foot or a Rothbart foot. For a variety of reasons the first metatarsal does not align alongside the rest of the metatarsals. This may cause a problem if the weight then shifts to the much narrower second metatarsal. Postural compensations then occur as a result of not utilising the big toe in standing and walking.

    Self Diagnosis:

    If you feel how thick the skin is under your metatarsal heads (dotted line in first picture) you may notice it is relativly soft and thinner under your big toe.

    You may have a wider than average gap between your first and second toe.

    You probably pronate(collaped arch) in an attempt to get your big toe down onto the ground.

    You may walk and stand in an out toed position ( to increase your base of support ) to compensate for poor balance.

    Difficulty standing on one leg.

    Tension and pain in the lateral compartment of the shin and lateral hamstring.

    If you suspect your big toe is contributing to some postural problems then come in for an assessment.

    This condition is easily treated with a combination of myofascial release, orthotic therapy (may be a simple wedge) and exercise.

    Results can be life changing.

  • Foot arthritis

  • Feet have a complex structure consisting of 26 bones, more than 30 small joints (where bones meet) and many muscles, tendons, ligaments and nerves. Feet have several arch shapes that spreads the body’s weight evenly over many bones and joints.

    There are two general types of Arthritis.

    Osteoarthritis

    Osteoarthritis can affect any joint in the foot. Osteoarthritis is a chronic problem that may cause episodic pain and swelling in a joint or joints; it can also cause bone enlargement.

    Osteoarthritis often affects the big toe joint. The joint will become stiffer and the range of movement will be reduced. (Generally, 60 degrees dorsiflexion is considered normal) Often the bones become larger and knobby due to an overgrowth of new bone. These changes may accompany a bunion.

    Inflammatory arthritis

    There are various forms of inflammatory arthritis, which can affect feet in different ways. Rheumatoid arthritis can affect many joints in the feet. Reactive arthritis usually affects the ankle or the area around the heel. It may also affect the toes, causing pain and swelling, which is known as dactylitis. Psoriatic arthritis affects the skin and the joints. Gout most commonly affects the big toe joint. It is a very painful type of arthritis. Gout causes severe inflammation and makes the joint red, hot and swollen during an attack, which typically lasts one to two weeks. It is caused by the formation of urate crystals in a joint. However, gout can usually be well controlled with medications. Ankylosing spondylitis mainly affects the spine but may also affect the heels.

    The Foot functions as a lever and a shock absorber. When the joints of your foot stiffen, become inflamed and degenerate you will notice a decline in your function. This may be pain, loss of balance, and swelling.

    Initially an assessment of gait, posture, balance and muscle function is required.

    A primary goal of retaining/and improving optimal foot function is standard. Typically, the myofascial system requires some mobilization type work (deep massage). Joint mobilization is often required. Then prescription of exercises usually follows. This may be in the form of self-mobilization techniques, stretches or strengthening exercises.

    You may need custom orthotics in your shoes for a number of reasons. An orthotic can help to support the arches of your feet. If you have loss of arch integrity the small bones of the feet are often in a closed packed position(jammed together). This causes a loss of the shock absorbing function and pain.

  • Leg Length Difference

  • A majority of people have a measurable leg length difference of 5mm or more, although most people adapt to the difference with no apparent ill effects. Unfortunately, some do not, and the effects range from low back or sacroiliac pain to hip, knee, or foot problems. A number of causes can contribute to leg length discrepancy, including: Any bone in the leg ever broken, particularly during growth years, Congenital differences or uneven growth, Disease-caused shortening of the muscles and connective tissue, a common after-effect of polo. Surgically-induced differences, especially common after hip replacement surgery, Compensation for problems elsewhere in the body, such as pelvic or spinal scoliosis. Short leg syndrome or anatomical (structural) or functional (adaptive) leg length discrepancy, is often treated using custom orthotics. A CT scanogram is routine for diagnosing leg length difference.

  • Running Injuries

  • Muscle imbalance refers to the balance between strength and length of muscles acting around one or more joints. Muscles respond to the stresses placed upon them. Therefore, it is of utmost importance to balance the stresses received by the body from the ground up. (Especially for runners with forces up to six times body weight being common). Overloading muscular compartments leads to micro trauma, myofascial restriction, tightness, weakness, and pain.

     If your base of support is not stable then the muscles of the lower limb, pelvis and back are overworking to compensate. A pronated foot is likely to overwork the lateral compartments of the calf and thigh (quads, ITB, hamstrings and hip rotators.)

    Treatment for running injuries begins with expert diagnosis using muscle testing and observation of gait and posture. Modalities such as myofascial release, stretching and strengthening and orthotic therapy may be requires to resolve imbalance and treat pain.

  • Shin Splints

  • Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain on palpation of the shin. Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

    Shin splints are caused by: Inflexible calf muscles and tight Achilles’ tendons, overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, Incorrect or worn shoes overtraining, or a rapid increase in training load or intensity. Custom orthotics can reduce soft tissue loading. As measured on our Zebris gait analysis system which measures ground reaction force while you run.

  • Foot Alignment

  • Flat feet / Over-pronation, is a common biomechanical problem that occurs in up to 80% of the population. This motion can cause extreme stress or inflammation on entire lower limb, pelvis and spine. There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, standing, walking or running becomes awkward and painful. Over-Pronation is effectively treated conservatively (non-surgical treatments) with custom orthotics.

  • Back Pain

  • Back pain is a very broad term for a multitude of problems. Diagnoses such as slipped disc, facet joint sprain, muscular weakness, sacroiliac up/down slip, in flare or out flare are very common. As a physiotherapist I have seen many chronic conditions described as these improve significantly with good orthotics. Commonly uneven or excessive forces are placed upon the hips which arise from faulty foot posture or real leg length differences. If your back pain gets worse with standing or gets relief by stretching tight hip muscles (iliopsoas, piriformis, glute medius) then long-term alignment from orthotics can help. A rehabilitation plan would also be prescribed to restore normal muscle balance, regarding relative strength and mobility characteristics of the leg, pelvis, and core muscles. Examination of your gait cycle (walking and running) can reveal common causes of back pain.

  • Knee Pain

  • Excessive rotational forces coming from the ground up are transmitted throughout the entire body. The first port of call is the knee, and there are many structures which are prone to excessive wear and tear if the foot posture is not ideal . Ligaments, meniscus, cartilage and tendons can all degenerate with faulty biomechanics. Custom orthotics are designed to realign the body in its most efficient weight bearing posture. Casting the foot in a weight bearing process enables real time corrections to be implemented and testing of output.

Facts on Morton’s neuroma:

  • Morton’s neuroma involves a growth of nerve tissue, but it is not cancerous.
  • It causes pain in the ball of the foot, often shooting into the toes.
  • Surgery is an effective solution, but it is only used if other treatments fail.
  • Having a short first toe can contribute to overload and irritation of toes 2,3 and 4.

Treatment at the Foot Alignment Clinic is dependent on the individual but may include:

  • Orthotics with inbuilt domes to align and offload the metatarsals
  • Cold laser
  • Myofascial release/Joint mobilization.
  • Shockwave therapy
  • Prescription of home exercises

Doctors call that bump hallux valgus, but you might know it as a bunion. Bunions form when the bone or tissue at the joint at the bottom of the big toe joint deforms. Years of abnormal motion and pressure on the joint forces the metatarsal to spread outward and the big toe to bend toward the others, which causes an often-painful lump on the joint.
This joint at the base of the big toe carries much of your weight while walking. Balance problems may develop. The joint may become so stiff and sore that function is lost.

Bunions often run in families, but they also can be the result of the way we walk or the shoes we wear.
If you are getting a bunion be sure to choose low-heeled, comfortable shoes that provide plenty of space for your toes at the widest part of your foot (called the toe box).

At the Foot Alignment Clinic, we consider the following approach to managing bunions:

  • Keep your foot strong and mobile.
  • Use custom orthotics to align the foot correctly or to off load pressure from the joint.
  • In severe or acute pain wear a splint at night to hold the toe straight and ease discomfort.
  • Soak your foot in Epsom salt bath.
  • Try acupuncture, massage, myotherapy and cold laser. (Available at the Foot Alignment Clinic, Hunters Hill)

When it’s time for surgery

If your bunion is causing pain and conservative therapy fails, we may recommend surgery.

The plantar fascia is strong and thick fascial tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the foot’s main arch.

Syndromes of pain in the plantar fascia have been called plantar fasciitis; however, because there is usually no inflammation, plantar fasciosis is more correct. Plantar fasciosis may involve acute or chronic stretching, tearing, and degeneration of the fascia at its attachment site.

Plantar fasciosis can be caused by:

  • Playing sports that put stress on the heel bone, like running, dance and aerobics
  • Pronated / flat-footed or high arches
  • Being overweight
  • Pregnancy
  • Spending a lot of time on your feet
  • Wearing shoes with poor arch support or stiff soles
  • Morton’s foot

The main symptom of plantar fasciitis/fasciosis is pain under the heel, which can be dull or sharp. The medial arch may ache or burn and your heel may be slightly swollen.

The pain is often worse:

  • In the morning, as you take your first steps
  • After prolonged standing or sitting
  • After intense activity

Treatment should include a combination of the following:

  • Specific loading and mobility exercises
  • Strapping
  • Cold laser/acupuncture
  • Shoes with good support and cushioning
  • Moderate reduction in activity
  • Custom orthotics

If these measures don’t work and you have had the pain for over three months shockwave therapy is available at EastWest Physiotherapy.

Achilles Tendon Pain: tendonitis/tendinopathy

Most commonly affects:

  • Sedentary (tendon weakens due to underuse)
  • Distance runners
  • Track athletes
  • Multidirectional sports

The most common pathology occurs in the mid portion of the tendon 3-5 cm above the attachment of the heel. May be accompanied by pain in the para tendon (sheaf) Fat Pad, Sural Neuritis, Bursitis, Haglund’s deformity(spurs).

Assessment of gait and posture is essential in diagnosis.

Walking/Running/hopping assessment is carried out on out force and pressure video treadmill.

Our therapists are looking out for risk factors including stride length, foot posture, muscle control and timing, big toe activation, hip and knee alignment.

Treatment Principals

Short term measures to reduce pain

Heel raise, taping, night splint, load management, myofascial release, acupuncture, orthotic therapy, and shockwave

Long term measures to rehabilitate tendon function (essential)

Progressive loading program

  • Stage 1 Isometrics 30-45 second hold (max effort) x 5 sets, every day.
  • Stage 2 Isotonic 3×8 (tempo 3:0:3) Single leg 1.5x bodyweight
  • Stage 3 Return to sport. High and fast load.

This is also known as a Mortons foot or a Rothbart foot. For a variety of reasons the first metatarsal does not align alongside the rest of the metatarsals. This may cause a problem if the weight then shifts to the much narrower second metatarsal. Postural compensations then occur as a result of not utilising the big toe in standing and walking.

Self Diagnosis:

If you feel how thick the skin is under your metatarsal heads (dotted line in first picture) you may notice it is relativly soft and thinner under your big toe.

You may have a wider than average gap between your first and second toe.

You probably pronate(collaped arch) in an attempt to get your big toe down onto the ground.

You may walk and stand in an out toed position ( to increase your base of support ) to compensate for poor balance.

Difficulty standing on one leg.

Tension and pain in the lateral compartment of the shin and lateral hamstring.

If you suspect your big toe is contributing to some postural problems then come in for an assessment.

This condition is easily treated with a combination of myofascial release, orthotic therapy (may be a simple wedge) and exercise.

Results can be life changing.

Feet have a complex structure consisting of 26 bones, more than 30 small joints (where bones meet) and many muscles, tendons, ligaments and nerves. Feet have several arch shapes that spreads the body’s weight evenly over many bones and joints.

There are two general types of Arthritis.

Osteoarthritis

Osteoarthritis can affect any joint in the foot. Osteoarthritis is a chronic problem that may cause episodic pain and swelling in a joint or joints; it can also cause bone enlargement.

Osteoarthritis often affects the big toe joint. The joint will become stiffer and the range of movement will be reduced. (Generally, 60 degrees dorsiflexion is considered normal) Often the bones become larger and knobby due to an overgrowth of new bone. These changes may accompany a bunion.

Inflammatory arthritis

There are various forms of inflammatory arthritis, which can affect feet in different ways. Rheumatoid arthritis can affect many joints in the feet. Reactive arthritis usually affects the ankle or the area around the heel. It may also affect the toes, causing pain and swelling, which is known as dactylitis. Psoriatic arthritis affects the skin and the joints. Gout most commonly affects the big toe joint. It is a very painful type of arthritis. Gout causes severe inflammation and makes the joint red, hot and swollen during an attack, which typically lasts one to two weeks. It is caused by the formation of urate crystals in a joint. However, gout can usually be well controlled with medications. Ankylosing spondylitis mainly affects the spine but may also affect the heels.

The Foot functions as a lever and a shock absorber. When the joints of your foot stiffen, become inflamed and degenerate you will notice a decline in your function. This may be pain, loss of balance, and swelling.

Initially an assessment of gait, posture, balance and muscle function is required.

A primary goal of retaining/and improving optimal foot function is standard. Typically, the myofascial system requires some mobilization type work (deep massage). Joint mobilization is often required. Then prescription of exercises usually follows. This may be in the form of self-mobilization techniques, stretches or strengthening exercises.

You may need custom orthotics in your shoes for a number of reasons. An orthotic can help to support the arches of your feet. If you have loss of arch integrity the small bones of the feet are often in a closed packed position(jammed together). This causes a loss of the shock absorbing function and pain.

A majority of people have a measurable leg length difference of 5mm or more, although most people adapt to the difference with no apparent ill effects. Unfortunately, some do not, and the effects range from low back or sacroiliac pain to hip, knee, or foot problems. A number of causes can contribute to leg length discrepancy, including: Any bone in the leg ever broken, particularly during growth years, Congenital differences or uneven growth, Disease-caused shortening of the muscles and connective tissue, a common after-effect of polo. Surgically-induced differences, especially common after hip replacement surgery, Compensation for problems elsewhere in the body, such as pelvic or spinal scoliosis. Short leg syndrome or anatomical (structural) or functional (adaptive) leg length discrepancy, is often treated using custom orthotics. A CT scanogram is routine for diagnosing leg length difference.

Muscle imbalance refers to the balance between strength and length of muscles acting around one or more joints. Muscles respond to the stresses placed upon them. Therefore, it is of utmost importance to balance the stresses received by the body from the ground up. (Especially for runners with forces up to six times body weight being common). Overloading muscular compartments leads to micro trauma, myofascial restriction, tightness, weakness, and pain.

 If your base of support is not stable then the muscles of the lower limb, pelvis and back are overworking to compensate. A pronated foot is likely to overwork the lateral compartments of the calf and thigh (quads, ITB, hamstrings and hip rotators.)

Treatment for running injuries begins with expert diagnosis using muscle testing and observation of gait and posture. Modalities such as myofascial release, stretching and strengthening and orthotic therapy may be requires to resolve imbalance and treat pain.

Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain on palpation of the shin. Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

Shin splints are caused by: Inflexible calf muscles and tight Achilles’ tendons, overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, Incorrect or worn shoes overtraining, or a rapid increase in training load or intensity. Custom orthotics can reduce soft tissue loading. As measured on our Zebris gait analysis system which measures ground reaction force while you run.

Flat feet / Over-pronation, is a common biomechanical problem that occurs in up to 80% of the population. This motion can cause extreme stress or inflammation on entire lower limb, pelvis and spine. There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, standing, walking or running becomes awkward and painful. Over-Pronation is effectively treated conservatively (non-surgical treatments) with custom orthotics.

Back pain is a very broad term for a multitude of problems. Diagnoses such as slipped disc, facet joint sprain, muscular weakness, sacroiliac up/down slip, in flare or out flare are very common. As a physiotherapist I have seen many chronic conditions described as these improve significantly with good orthotics. Commonly uneven or excessive forces are placed upon the hips which arise from faulty foot posture or real leg length differences. If your back pain gets worse with standing or gets relief by stretching tight hip muscles (iliopsoas, piriformis, glute medius) then long-term alignment from orthotics can help. A rehabilitation plan would also be prescribed to restore normal muscle balance, regarding relative strength and mobility characteristics of the leg, pelvis, and core muscles. Examination of your gait cycle (walking and running) can reveal common causes of back pain.

Excessive rotational forces coming from the ground up are transmitted throughout the entire body. The first port of call is the knee, and there are many structures which are prone to excessive wear and tear if the foot posture is not ideal . Ligaments, meniscus, cartilage and tendons can all degenerate with faulty biomechanics. Custom orthotics are designed to realign the body in its most efficient weight bearing posture. Casting the foot in a weight bearing process enables real time corrections to be implemented and testing of output.

Free Foot Alignment Advice

Request a free 10 min telehealth consultation with one of our physios using our online booking portal.

4 Steps to Pain Relief & Correct Alignment

1. Postural Assessment

With a holistic approach to medicine, We view each patient as a whole rather than a single symptom to be treated.

There is no single treatment for each condition we encounter. The foot and lower limb is extremely complex. We take the time to asses your nervous system, your myofascial system and your skeletal system . We use a range of medical tests including gait analysis, nerve and muscle testing, static and dynamic postural evaluation, pressure analysis and if necessary medical imaging to clarify certain parameters such as leg length.

2. Body Work

Practitioners at Eastwest physiotherapy are skilled in myofascial manipulation. The principal Physiotherapist Gavin Johnston is a certified Structural Integrator. This means he has studied in depth the myofascial relationships within the layers of muscle, bone and nerve and how they perform the complex output of postural control. This study has helped form the backbone of how we asses and treat all of our clients.This is in alignment with the latest scientific explanation of orthotic therapy and tissue stress.

As part of the process in improving tissue balance and postural correction myofascial manipulation is usually employed.

3. Casting and Orthotics

At Eastwest We have been using Neil Smiths patented Foot Alignment System to take a weight-bearing and corrected cast of the foot. We are able to observe and test the changes to the structure of the lower limb and pelvis as we go in real-time. A very different process to non-weight-bearing casts or impressions captured on 2D pressure mats.

Eastwest was established in June 2000, we have been working with this orthotic system for almost as long. We have now topped the 4000 mark for orthotics prescribed and fitted in this clinic using this model.

We are extremely happy with the consistent and predictable results we are able to achieve.

4. Loading Program

Evidence cantered around pain and dysfunction has shifted its focus towards a tissue tolerance model. Put simply, human tissue (muscle, fascia, cartilage, and nerve) has a certain amount of range of motion and strength (load tolerance). If the tissue load is outside this range, the tissue fails and causes pain.

Thankfully our tissues can be trained to increase its loading characteristics and hence move out of the pain zone. At EastWest Physio, we have expertise in diagnosing which tissues are in distress and have scientific based exercise programs for each tissue. Orthotics are fantastic at alignment and redirecting load but exercise is critical for a full return to function after injury or immobilisation.

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