Often the tipping point that brings patients into my clinic for treatment of their foot and lower limb pain is their leisure activity. Not surprisingly when patients learn the activity or sport they do for their physical and mental health has pushed them into an injury state they are frustrated, because what they love to do has helped injure them and also because they have been sidelined from their activity. This was definitely the case with Jennifer, one of the patients I have treated for the last six years. 
Jennifer is a keen recreational runner who loves getting out for a daily run. She has a history of hip and knee pain but she tried not to let it slow her down and she continued to run for many months despite the pain. Eventually the pain became intolerable so Jennifer consulted with a physiotherapist. After treating Jennifer for several weeks, her physiotherapist suggested she be assessed by a Canadian Certified Pedorthist as he felt something looked wrong with her feet. Canadian Certified Pedorthists work collaboratively as part of their patient’s healthcare team so Jennifer’s physiotherapist and I arranged a joint consultation.
As is standard with new patients, I conducted a full biomechanical assessment and analyzed the way Jennifer walked and ran. During my initial assessment, I determined Jennifer had a hypermobile foot and her feet rolled excessively inwards, especially on her right side. Because of her biomechanics Jennifer was unable to stabilize her foot so it allowed too much internal rotation of her right leg which put stress on her hip.
Based on my assessment, I recommended semi flexible orthotics that would slow down the rate Jennifer’s foot rolled inward and also limit the amount her foot could roll. As running was the main activity that contributed to her problem, I told Jennifer she didn’t need to use her orthotics all the time, only when she was going for a run or a long walk.
The orthotics made a tremendous difference to Jennifer. It was great having a motivated client like Jennifer because she was really willing to work with me to solve her problem. She followed the break-in instructions for her orthotics and started training again at a reasonable pace. She needed an adjustment in the first couple of weeks but soon was running pain free.  With her orthotics Jennifer has been able to train for numerous half marathons and a full marathon. I now see Jennifer, once a year for checkups and orthotic repairs or replacement when necessary.
If you are experiencing persistent hip, back, knee or foot pain during any of your regular activities ask your family doctor for a referral to a Canadian Certified Pedorthist. Your Pedorthist will conduct a full assessment of your feet and lower limbs and recommend a personalized treatment plan for you.
By Lisa Irish, C. Ped (C), Burlington, ON