Unfortunately not all injuries respond to interventions the way you want them to. In these cases we need to use a combined approach to injury management. This page will discuss some of the options that are available if the orthotic insoles don't work as expected, and when to seek them.
A physiotherapy assessment and treatment should be conducted prior to the treatment of any injury. This will allow the physio to determine the best intervention for the treatment of your pain both in the short and long term. In some instances physiotherapy may be more beneficial to the treatment of these conditions than orthotic prescription as it may lead to improved short or long term outcomes.
A physiotherapist will also be able to guide you on the best type of orthotic to help treat your condition and may even be able to use the orthotics as part of your physiotherapy treatment to gain better outcomes.
Physiotherapy will also be able to use different modalities such as dry needling, massage and exercises to help create a better muscular balance and posture in the foot and legs. In the long term this may lead to a successful treatment of the condition and reduce the need for orthotics.
One of the primary benefits of orthotics is their ability to support and correct the position of a fallen arch. The strengthening of the correct muscles can lead to improved foot posture and the reduction of stress on the leg muscles and joints. Strength training should also be used when prescribing orthotics as it may help reap better rewards in the reduction of your symptoms. In this case, specific muscles that are weak will need to be strengthened, while muscles that are overused and shortened will need to be stretched – an individualized rehab program will be needed.
Shockwave therapy is a relatively new form of therapy and it is used to increase the healing of injured tissues. Shockwave therapy helps to stimulate the body to repair an isolated area of damaged tissue by increasing the blood supply and breaking down scar tissue. This therapy helps to stimulate the repair of the damaged area reducing pain, however ongoing support from orthotics may be needed in the future.
In moderate to severe cases of injury medical intervention may be required. This intervention may range from advice, cortico-steroid injection, PRP injection, to surgical intervention. Orthotics and physiotherapy intervention may not be suitable in these cases however they may play a role in pre or post intervention rehab.