“A central element”

John Göddertz is the head of the department for Foot and Ankle Surgery at 360° Specialist Hospital in Ratingen, Germany, and also works as a sports scientist. He knows the feet of patients suffering from rheumatism of competitive athletes and of children, and he treats foot misalignments, results of accidents as well as degenerative changes. For him, high-quality foot orthoses are an important component of innovative concepts for the treatment of foot problems.

life: What type of problems or symptoms do the patients have who visit you?

John Göddertz: My focus is on sports medicine. Even before my medical degree, I completed a degree in sports science. Like here in Ratingen, I was the Head of the Foot and Ankle Surgery Department at Hellersen Sports Clinic in Lüdenscheid. That’s why a lot of athletes still come to see me. They often suffer from chronic instability of the upper ankle as a result of lateral collateral ligament injuries. But pain in the area of the Achilles tendon is also a common problem for athletes. My department also focuses on forefoot surgery. In this area, the hallux valgus deformity is the most common misalignment. The most notable hindfoot misalignment is flat foot deformity. In these cases, we can use minimally invasive surgical techniques to preserve the joint. This can often prevent fusion surgery. When treating osteoarthritis of the upper ankle, it’s important to proceed according to the stage of the condition. During early stages, arthroscopic techniques and the insertion of modern cartilage membranes deliver good results. In cases of severe wear, it makes sense to implant an artificial joint. State-of-the-art technologies allow for highly precise implants with good medium-term outcomes. In this way, it is often possible to preserve the range of motion of the upper ankle and prevent subsequent osteoarthritis.

What influence does your sports science expertise have on your work with athletes?

John Göddertz: Athletes, especially competitive athletes, make high demands on medicine, and they can’t afford long periods away from their sport. In these cases, effective, innovative follow-up treatment concepts are essential. High-quality foot orthoses with a precise fit play a crucial role.

What criteria do you use to select the appropriate foot orthosis for a patient?

John Göddertz: It goes without saying that, in a department specializing in foot and ankle surgery, we don’t just prescribe – if I may say so – run-of-the-mill foot orthoses. High-quality foot orthoses are incredibly important, after surgery in particular. Therefore, the TRIactive foot orthosis concept is a central element in the post-operative care of my patients.

How well do the TRIactive versions address your patients’ needs?

John Göddertz: Strain in the foot can be very different, depending on the activity. Especially in athletes, the individual misalignments, but also specific force distribution patterns must be considered depending on the sport. It’s important to assess the foot misalignment using pedobarographic analysis as well as to have a foot orthosis concept available that corrects the misalignment and, at the same time, takes into account the force distribution pattern of the particular sport. For everyday activities, I prescribe the TRIactive walk. For those playing ball sports, we have TRIactive play, and for runners, TRIactive run.

When do you favor a cushioning foot orthosis and when a supporting one?

John Göddertz: It really depends on the deformity when we use which foot orthosis. For flexible misalignments, correcting or supporting foot orthosis concepts can be chosen. Once the deformity has become rigid, i.e. it cannot be manually returned into an orthograde foot position, cushioning foot orthoses have to be used.

Can a foot orthosis be a substitute for surgery?

John Göddertz: The prevention of surgery always takes top priority. The appropriate foot orthosis concept plays a crucial role here. I recommend a detailed pedobarographic examination of the foot. Once the type and the extent of the misalignment have been determined, the deformity should be treated with high-quality foot orthoses that fit precisely. These goals can be realized using TRIactive foot orthoses.

Prescription is one thing, but what’s the next step? How is the product selected at the medical supply retailer?

John Göddertz: As a specialized foot surgeon, I have a precise idea of the foot orthosis concept that should be used. I give patients a very detailed report on what is required. After all, their symptoms can only be alleviated if they receive the right foot orthosis model, and this model needs to offer a precise fit.

How do patients literally get back on their feet after foot surgery?

John Göddertz: For me, prescribing foot orthoses is an essential element in post-operative follow-up treatment. With specifically manufactured foot orthoses, I’m able to provide targeted support to fused joints for example, or relief to degenerated joints. This can generally accelerate recovery, and patients will regain their normal gait again more quickly, even after extended immobilization.

What type of shoes should your patients wear?

John Göddertz: I recommend shoes that are as comfortable as possible. Support elements integrated into shoes is not something I would recommend. Foot orthoses can be made with precise details. They are able to cushion or support weak areas in the foot much more effectively. But patients need shoes in which foot orthoses will fit and that offer a good degree of cushioning.

Do you have any personal experience with foot orthoses?

John Göddertz: I don’t have foot problems myself, but during jogging, I tend toward “hyperpronation”. That means my heels twists inward when running. So I use neutral running shoes with sports foot orthoses that support the heel on the inside and keep it in the correct position. Even without any condition, foot orthoses can be useful tools and have a preventive effect during activities that subject the feet to strain.

TRIactive foot orthosis: The puzzle that provides well-being

PowerWave Technology integrates three materials of different shore hardness in one foot orthosis and takes different patterns of strain into account during everyday activities and exercise. The differentiated functional zones guide the foot in the heel area, they support the foot arches and cushion impact. This balanced cushioning protects both the supporting and locomotor system, alleviates strain injuries and delays the onset of muscle fatigue. The distinctive interlocking transitions create soft, unnoticeable transitions between the individual zones. The TRIactive is available in the versions Walk, Heel, Run, Play and Golf, and now also as TRIactive OA for lateral or medial osteoarthritis of the knee.

Images: Bauerfeind, Stefan Durstewitz