Orthotic devices in running injuries.

The most significant problems that we found in our running population were hamstring contractures, which affected 80 per cent, and Achilles tendon contractures, which affected 40 per cent. On first seeing a running patient who has a connective tissue stress type of injury in his or her lower extremity, we first place the patient through a 6-week trial of stretching our contractures, as this will usually correct the problem. We can correct up to 50 per cent of the problems we see just by pursuing a good stretching program. In general, the running injuries most helped by orthotic devices are the posterior tibial syndrome and pes planovalgum. It is easy to understand how the orthotic device works in these situations because it actually controls the subtalar joints and prevents increased stress on the arch of the foot and the posterior tibial tendon. Orthotic devices are also very helpful for metatarsalgia and calcaneal spurs. By directly relieving the stress area in these two conditions, one can usually expect a good result.