Case Studies
» Lateral Knee Pain (ITB)
» Plantar Fasciitis
» Numb Toes & Neuromas
» Lower Back Pain
» Shin Splints
Lateral Knee Pain (ITB)
Name: Katie Hughes
Age: 27
Weight: 58kgs
Sex: Female
Mileage per week: 10 miles. (Main sports are cycling and karate)
Current footwear: New Balance, 834, UK 7 primarily lightweight, cushioned neutral shoe
Injury Status: Bilateral lateral knee pain, more so right side. Potential ITB friction syndrome.
Goals: Keep fit, 10k in 4 months
1D) Analysis
Video: Revealed that both feet pronated to a significant degree. The shoes offered no mid-foot support. The knee tracked inwards along with the foot and caused a large flick out on swing phase.
Footscan: Large degree of separation on footscan, causing the foot and leg to work hard to stabilise. Higher force under big toe. Conclusion was that the large knee movement, caused by high rate of pronation, puts high strain on the ITB (Fibrous, stabilising structure running down the outside of the thigh) creating friction. The soft shoes, offering little support were contributing to the injury.
2D) Custom insole
Moulded to maintain and stabilise both feet with extra support to help with foot roll.
3D) Footwear
Asics Kayana was found to support and hold the foot best using video analysis. Fitted size UK 7.5. custom insoles were inserted to the shoes to complete the 360° of fit.
A combination of stretching and core exercises were given to help. A massage roller, to use on the ITB, was also purchased.
Plantar Fasciitis
Name: Paul Higgins
Age: 45
Weight: 100Kg
Sex: Male
Mileage per week: 5 miles. Starting walking to lose weight.
Current footwear: Nike Air Max 10UK, usage approx 2 years, primarily a cushioned neutral shoe
Injury Status: (diagnosed by GP) Plantar fasciitis. Pain on the insertion at the back of the heel
Goals: Weight loss, fitness
1D) Analysis
Video: Revealed that both feet were very neutral with a lower arch. His current shoes are both worn out on the lateral border creating a supination effect, not evident in the barefoot video. There is a lack of flexion through the ankle joint and pain in the heel causes a flat landing and slightly altered gait.
Footscan: High pressure on the heel on both sides. Good centre of pressure tracking, until the forefoot where the foot wants to flick towards the outside.
Conclusion was that the shoe was far too soft for a man of 100kg, the lack of cushioning from the amount of wear was a key contributor to the injury. Also the lack of flexibility through the lower leg (calf area) creates a pull on the plantar fascia increasing chance of pain at the insertion point (heel).
2D) Custom insole
Moulded insole to maintain good alignment and relax the foot. Extra foam added to give more stability and support.
3D) Footwear
Mizuno creation was found to support and hold the foot best using video analysis. His foot measure a UK 10.5 and was a D width. Custom insoles were inserted to the shoes to complete the 360° of fit.
A combination of stretching and core exercises were given to help.
Numb Toes and Neuromas
Name: Anna Porter
Age: 55
Weight: 60kgs
Sex: Female
Mileage per week: 5 - 8miles. (Mainly power walking)
Current footwear: Adidas Adistar control, UK 5, narrow, motion control shoe
Injury Status: Pain on the underside of foot, in between 2nd and 3rd toe
Goals: To walk pain free
1D) Analysis
Video: (Fast walking video) Revealed that both feet pronated slightly. The shoes offered good support for the pronation. The heel lifted very quickly and the stride was very short.
Footscan: The early heel lift causes weight and pressure to build up on the forefoot. Large pressure under the 2nd and 3rd toe. Centre of pressure tracking well.
Conclusion was that narrow shoes were potentially restricting the forefoot. Spending the majority of the stride on the forefoot was also highlighting the problem. The heel lifting earlier than ideal and the lack of length in stride could be addressed with some light stretching.
2D) Custom insole
Moulded to maintain and stabilise both feet. The forefoot is softened to reduce pressure around the problem area and a small met-dome is inserted under the 2nd and 3rd toe to lift the transverse arch.
3D) Footwear
Mizuno Nivana was found to support and hold the foot best, whilst offering a wide toe box area for the neuroma. Fitted size UK 6 (one size larger than originally wearing). Custom insoles were inserted to the shoes to complete the 360° of fit.
A combination of stretching and core exercises were given to help.
Lower Back Pain
Name: Amelia Connell
Age: 35
Weight: 70kgs
Sex: Female
Mileage per week: 5 miles. (Main sports are cycling and karate)
Current footwear: Asics 1070 UK 5.5, usage approx 2 years, a light motion control shoe
Injury Status: Right side lower back pain
Goals: Run To resume fitness after childbirth (6 months ago)
1D) Analysis
Video: Revealed that both feet pronated to a high degree and that her current shoes are not functionally stable for the amount of motion. Heavy landing. Large hip drop on the left hand side. And a significant knee drop towards the midline on both side. Considerable flick out of the leg on both sides.
Footscan: Large pressure on impact, signifying heavy landing and lack of flexibility. Lateral contact and excessive, quick pronation from rear - mid foot. Conclusion was that the lack of support and too much movement around the problem area (through the hip and lower back region) was contributing to the injury. The large hip drop signifies a dysfunction in the glute (med).
2D) Custom insole
Moulded to maintain and stabilise both feet with more support under both arches to support the level of pronation.
3D) Footwear
Brooks Adrenaline was found to support and hold the foot best using video analysis. Custom insoles were inserted to the shoes to complete the 360° of fit.
A combination of stretching and core exercises were given to help. We also referred her to a chiropractor to check alignment and posture beyond our expertise.
Shin Splints
Name: John Jepson
Age: 31
Weight: 85kgs
Sex: Male
Mileage per week: 25 miles
Current footwear: Nike Air Pegasus UK 9.5, usage approx 700miles, primarily a cushioned neutral shoe
Injury Status: (diagnosed by physio) Left side medial shin splints
Goals: Run London marathon, recreational runner
1D) Analysis
Video: Revealed that left foot pronated to a higher degree than right and that his current shoes are both warn out and lack sufficient mid-foot support. Lack of flexion through the ankle joint caused a flat landing.
Footscan: Confirmed that left foot pronated more than right in the mid to forefoot area with higher pressure on the heel on heel strike.
Conclusion was that the lack of support and too much cushioning from the shoes was a key contributor to the injury, as well as lack of stretching through the calf and hamstrings.
2D) Custom insole
Moulded to maintain and stabilise both feet with more support under left arch to reduce left side pronation.
3D) Footwear
Mizuno Inspire was found to support and hold the foot best using video analysis and he actually measured UK 8.5 and not UK 9.5 and that he had a D width foot. Custom insoles were inserted to the shoes to complete the 360° of fit.
A combination of stretching and core exercises were given to help.
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