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ErgoPad weightflex “The foot orthosis acts like a trampoline”

Issue 02/2019

If the mobility of the tarsal bones is restricted, this can lead to considerable discomfort. life spoke with Dr. med. Frank-Detlef Stanek about the movement mechanisms in the foot and the activating ErgoPad weightflex foot orthosis. He is a physician in private practice and a specialist for physical and rehabilitation medicine, sports medicine and chirotherapy from Jena, Germany.

Dr. med. Frank-Detlef Stanek values the ErgoPad weightflex for the physiological support of the tarsus.
Dr. med. Frank-Detlef Stanek values the ErgoPad weightflex for the physiological support of the tarsus.

Bauerfeind life: How often do you diagnose a blockage in the tarsal joints in your practice?

Dr. Stanek: About 70 to 80 percent of the patients have functional problems in the area of the tarsus. The term “blockage” refers to a hypomobile functional disorder of the joint. In this case, it means that the movement of the joints is restricted in parts of the tarsus, scaphoid and cuboid bones as well as the cuneiform bones in the coupling to the talus and metatarsal bones. The movement of the joints between the navicular and cuboid bones is very frequently impaired, which leads to an impairment of the forefoot-hindfoot rotation and to a shift of pronation in the upper ankle. However, the “compacted” cuneiform bones, particularly the intermediate cuneiform bone, also induce movement disorders with an effect on the functioning of the metatarsophalangeal joint of the toe and the metatarsal bones.
Among my patients, I commonly observe tarsal disorders in runners, in particular, who train on hard surfaces or at high intensity over hurdles or around bends. Basketball players and volleyball players also frequently show these conditions. They occur almost regularly in supination traumas of the upper ankle, but also in pain syndromes of the knee joint and the pelvis. Patients with insufficiencies in the posture of the foot or who spend long periods of time standing are also prone to these problems.

What impacts does restricted mobility of the tarsal bones have?

Dr. Stanek: Many! The functionality of the transverse and longitudinal arches suffers, and the heel-to-toe movement of the foot as well as the inversion/eversion movements are restricted or overemphasized. Misalignments and hypermobilities are forced unconsciously, the shock absorber effect is reduced, the proprioception of the sole and eventually the movement pattern of the foot are impaired. The caudal dysfunction is transmitted and becomes a cranial dysfunction, and this leads to ramifications at the articular, myofascial , viscerofascial and neuronal levels, with the result that joint positions, muscle balances, fascia qualities and motor stereotypes change. The consequence is functional pain syndromes like metatarsalgia, plantar insertional tendinoses, achillodynia, patellofemoral pain syndrome, hip pain and sacroiliac forms of pain or low back pain. Ultimately, the body scheme and the neuromuscular coordination change.

What do the feet require in this case?

Dr. Stanek: First , a diagnosis to determine the conditions and their causes. Treatment then has to take place in light of the results – with removal of the dysfunction through manual therapy, combined with a physiotherapy exercise program to strengthen the foot muscles, as well as regular self-mobilization of the foot , using a tennis or golf ball , for example. Particularly in the initial phase of treatment , there is, however, a risk that the myofascial protection is insufficient when the tarsal bones are mobilized, and the functional disorder of the joint sets in again. Temporary reduction of the load and/or passive support for the arch of the foot is therefore often required.

Variable support: the weightflex orthotic core is available in soft , medium and strong.
Variable support: the weightflex orthotic core is available in soft , medium and strong.

How can an orthopedic foot orthosis provide support here?

Dr. Stanek: A foot orthosis can assume this passive support function, but must ideally be adjusted in a condition of unrestricted mobility of the transverse and longitudinal arches and to the individual posture of the leg. It should not overcorrect or undercorrect. It must allow the spread in the longitudinal and transverse directions, be able to adjust to the spiral heel-to-toe movement , act as a shock-absorber and straighten the foot again sufficiently after the load phase. Foot orthoses with a proprioceptive effect are useful to actively influence the muscular straightening of the foot arch and the posture at the same time.

You have already been prescribing the ErgoPad weightflex for a number of years. What has your experience of these foot orthoses been?

Dr. Stanek: The design of the ErgoPad weightflex means that it has the positive effect of suitably cushioning the longitudinal and transverse arches, in a plastic and elastic manner. The foot orthosis supports active walking, but also assisted standing thanks to its rebound properties. Load-induced excessive strain on the muscles is reduced, and dysfunctional movements of the small tarsal joints are rarer. The foot orthosis acts like a trampoline, i.e. it induces a return to an initial physiological position of the tarsus and its adjacent structures.

The orthotic core is available in various densities. What criteria are important for you in selecting the optimal version?

Dr. Stanek: On the one hand, body weight plays a role, but on the other, so does the load requirement. If the feet are regularly exposed to additional loads or compression, a harder orthotic core is required. Hypermobile feet and feet with insufficient muscles also usually need more support. Low densities help in the case of a normal foot position with moderate requirements for straightening. Individual testing of the densities can be useful , however.

What feedback do you receive from the patients?

Dr. Stanek: The feedback is positive. For example, women who often wear high-heeled shoes praise the relieving, relaxing effect , but also the possibility of swapping the foot orthosis to other shoes easily. Use in the flat , casual shoes common nowadays is unproblematic and comfortable. The ErgoPad weightflex is unobtrusive in the shoe and has the advantage that the foot’s center of gravity is not shifted upwards too far.

 

For further information

about the ErgoPad weightflex foot orthosis, please visit:
www.bauerfeind.com/weightflex

Images: Frank Steinhorst , Bauerfeind


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