Ok the day before the opening of the Paris Olympics may not possibly be considered the best time to post a blog on Hockey skates and orthotic control. But the puck drops on the Toronto Maple Leafs new season on October 9th so consider this a little warm-up for that visit to Montreal and the Canadians.
There are many sports involving the use of sports footwear with zero flexibility like ice skates, ski-boot, snowboard boots, and roller blades. In all of these sports, the term “edge control” appears, concerning directional control, the production of power and acceleration.
Skis, Skates and snowboards have two edges, the transfer of pressure from one to the other allows for control when turning and producing propulsion. Its a pretty cool process and countless hours can be spent perfecting and refining the process. The transfer of pressure is initiated by the upper body and communicated to the boot and the contact surface by controlled foot and ankle motion. That control is achieved by muscles and an exquisite neurological feed back system which we crudely can simplify as balance.
For those individuals with flat feet or high arches, control and performance become diminished or even inhibit their ability to participate. These functional instabilities in the example of hard skis and skates frequently present clinically as severe pain on the inside of the ankle and back of the heel bone.
Many times when we get involved in treating situations like these. The athlete is someone we are already treating for postural or functional symptoms in their non-sporting everyday life. Where orthotic therapy is required, the design of these devices should be significantly different from those in their everyday footwear. Clearly, the mechanics of skiing, skating and blading require a completely different foot function from walking, the orthotic should reflect those needs.
The fun thing about dealing with athletes, is they are trained to be analytical regarding performance. Our performance as well as their own. Quite often during follow-up orthotic visits, we vary the degrees of correction relative to perceived comfort, control and performance. We can measure performance against the stopwatch but little compares to the performance enhanced by confident stability.
An effective orthotic requires, first and foremost a proper diagnosis of the source of the functional instability. This requires a proper examination both on the couch and standing. If anomalies are identified at this stage then a gait analysis must be performed and the sports equipment examined. The equipment may require adjustment, customization or replacement. For a proper functional orthotic the shape of the foot should be captured non weight-baring using proper plaster casting techniques or 3D scanning ( not all 3D images are some are projected 2D and inferior). Last but by no means least the prescription to the laboratory should indicate the unique nature and design of this custom orthotic, with clear directions regarding degrees of inversion or eversion to be applied to the shell.
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