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Tight soleus muscle and gait problems causing heel pain--what should I look for in casting for an orthotic?

Posted by Julia M on 2/24/05 at 12:20 (169795)

I've been working lately with a naprapath who suspects that my heel pain is related to my stance and gait (I have very low arches, I overpronate when I walk, and I tend to walk and stand with my feet pointed out like a duck). I've been walking this way for years without heel pain, but started running three or four months ago, and it appears that is what tipped me into having heel pain.

In general, my pain is mild. I can walk and stand without severe pain, but I notice pain after I've been walking for a while or standing around a lot. My naprapath found that I don't have any pain when I flex my feet, and no pain at all in my arches, but I have lots of pain when the spot where the soleus attaches near the knee is pressed. That spot is actually more tender than the spot in my heel. I also have some pain in certain areas on my shins. My naprapath is working to eliminate the trigger points through friction massage of the soleus near the knee, which hurts when she does it but feels much better afterwards in both the knee area and the heel. She is also trying to help me learn to change my gait so that I don't put so much stress on the attachment point in my heel.

I've been wearing arch supports which seem to help, and I'm thinking I'd like to get orthotics made to further help my overpronation. I searched out a podiatrist who specializes in gait problems, because I think that is a big factor in my pain, and while my naprapath can make orthotics, she hasn't been doing that very long and I want an expert. I've been reading on these boards about how a tight soleus contributes to heel pain, and how that can effect whether orthotics are painful or not.

My question is, if I know that I have a tight soleus, is there anything special that needs to be done when casting for my orthotics? Should I wait to complete the naprapathic treatment first and get my leg and foot in the best possible shape? Or will the orthotics help the treatment by reducing the overpronation? I guess this is a chicken and egg problem. I just want to give the orthotics the best possible shot at helping me with my pain.

Any advice you can give would be very much appreciated.

Julia

Re: Tight soleus muscle and gait problems causing heel pain--what should I look for in casting for an orthotic?

Ed Davis, DPM on 2/25/05 at 12:19 (169879)

Julia:
A tight heel cord/ gastocsoleus achilles complex will make any orthotc work less well. The tightness generally must be dealt with first either by agressive non-weight bearing stretches or a night splint.
Ed

Re: Tight soleus muscle and gait problems causing heel pain--what should I look for in casting for an orthotic?

Mike W on 2/25/05 at 12:49 (169881)

Hello Julia,

If you are interested in some effective non weight bearing exercises please go to my website http://www.foottrainer.com and click plantar fasciitis or achilles tendonitis. We also have some new pronation exercises as well.

We also offer a results based money back guarantee which you will never get with any orthotic or night splint.

Regards,

Mike W

Re: Tight soleus muscle and gait problems causing heel pain--what should I look for in casting for an orthotic?

Julia M on 2/25/05 at 17:07 (169913)

Thanks, Ed. Very helpful to know.