Orthotics and Rehabilitative Exercise
practitioner should be looking to re-establish
proprioceptive awareness, muscle activation
and control before increasing the resistance of
the exercise and looking to develop strength.
Strength development should be the basis of
all sport specific exercise programs. Strength
development is a neurological adaption to
repetitive force production and as such is the
underpinning principle for the development
of Power Production (Force x Speed) and
Muscular Endurance (Repetitive Force x Time).
Developing a good report with the patient’s
sports coach or strength and conditioning
coach will really help in creating an
understanding of what you wish to achieve
as a practitioner and what the coach or club
needs from the athlete.
By instigating the use of offloading devices,
correct footwear and appropriate exercise
program, most of which can be placed back
on the responsibility of the patient to comply
with, your time as a practitioner can be used
to help maintain and improve tissue viability
through the use of soft tissue management.
SOFT TISSUE TREATMENT
Different types of soft tissue treatments
have been used to help people’s quality of
life and athletic performance for centuries,
many of which are still used today. From
eastern medicine based practices such as;
acupuncture, acupressure, cupping and
reflexology, to their westernized counter-
parts of dry needling, slides & glides and
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Pedorthic Footcare Association www.pedorthics.org
trigger point therapy. Soft tissue therapy
helps an individual relax and prepare for
further activity by releasing adhesions within
muscle tissues. This in turn can contribute to
an increase in a client’s range of motion and
a decrease in the muscular inhibition as a
result of pain. Additionally, for those who are
continuing to train during their rehabilitation
process, massage may help disposed of
by-products and blood pooling.
A multi-faceted and, at times, multi-
discipline approach to patient management
should be taken when looking to both prevent
and rehabilitate lower limb injury. The use of
a number of injury management strategies can
lead to a faster and more complete recovery
of a patient, setting them up for the season or
competition ahead.
Using offloading devices such as custom
orthotics, wedging or domes to attenuate
forces in areas of high stress can limit the
impact of repetitive trauma to an athlete.
Simple shock absorbing insoles have been
found to have no effect on the prevention of
lower limb injury.
A lot of time and effort goes into creating
sport specific footwear to help athletes of
all levels get an advantage in play as well as
trying to protect them from both intrinsic and
extrinsic influences which may contribute
to injury. This can be seen in something as
simple as a lateral forefoot flange on a tennis
shoe to interchangeable studs on football
cleats.