Current Pedorthics | May-June 2017 | Vol.49, Issue 3 | Page 30

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 28 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.