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The Use of Rigid Plates to Stiffen the Shoe for Hallux Rigidus

A inflexible plate, usually made of carbon is frequently employed to stiffen footwear to help a variety of painful conditions of the feet. These carbon plate are very stiff and firm since they have to restrict up the sole of the foot, mainly over the front foot. These plates can be found in several distinct layouts with one being only the same shape as a basic insole pattern. This particular one can be used when you need to restrict the entire foot which will help prevent all of the metatarsophalangeal joints within the ball of the foot from bending. The other principal design is one that the inflexible plate simply goes underneath the big toe or hallux and not the rest of the front foot. This has the main benefit of helping with discomfort in the great toe or hallux joint by restricting its motion, but still permit some standard movements in the other joints in the ball of the foot. This is often referred to as a Morton’s extension rigid insole.

One of the common conditions that these kinds of inflexible carbon insoles are used for may be arthritis with the big toe or hallux joint which frequently gets called hallux rigidus. The inflexible carbon plate functions by limiting movements of the hallux joint, in order that restriction of motion would mean the big toe joint is significantly less uncomfortable. Another problem that they maybe used in is known as turf toe. This means there is a traumatic hyperextension damage of the great toe joint, so the joints really does need to be restricted from flexing for quit some time to allow the injury to improve and these carbon insoles are really good just for this. Also there is a disorder known as Freiberg’s disease and that is a challenge in the growing area of the joint, usually with the bottom of the second toe. This is among those conditions that have to have the full width carbon plate to restrict movement over the ball of the foot.

Just what footwear must you have these rigid carbon plates in? Many people find that they can wear them in just about any footwear since they do not occupy much room. Lots of people find shoes which use a rocker action to be pretty beneficial to wear these in. A good example would be the Hoka One One running shoes which have a rocker beneath the ball of the foot. As these plates restrict the shoe that will help restrict motion to lessen discomfort, the rocker does help the foot move forwards when walking as you can not bend the foot over the ball of the foot. There are a few adverse reactions coming from using the carbon insoles and this has to be considered versus the benefit of wearing them. They can change the way you walk, so you could have to take time to get used to them. Maybe you will need to cut back on the time period for you to wear them so you can get used to them after which begin progressively increasing the wear time. They could be to some extent awkward since they do not allow for normal foot motion, but may just need to be tolerated and balanced against the pain that could be emanating from the reason why you might have to wear the carbon insole.

Biomechanics, Foot Problems

What is a Plantar Plate Tear

A plantar plate tear is a relatively common problem under the ball of the foot. The plantar plate is a strong thicker ligament below the metatarsaophalangeal joints in the ball of the foot. There can be a tear, strain or what often is described as a ‘dysfunction‘ of that ligament that causes pain under the joint and just distal t the joint. One weird sensation that often get describes is that of the feel of a sock bunched up under the toes, when its not.

A plantar plate problem is more common in those who are over weight, who are more active and have foot problems such as bunions.

The treatment of a plantar plate tear is to rest the area by holding the toe plantar flexed with strapping. A rocker sole shoe also stops the toe from bending so much and is often helpful. This “rest” of the strain on the ligament usually helps most cases. In the few that this does not help, then a surgical repair of the small tear is often indicated.

Foot Problems

The Accessory Navicular

The accessory navicular is an extra piece of bone on the inside of the foot just above the mid-foot ( arch ) in close proximity to its top point. The bone is enclosed within the tibialis posterior tendon that inserts to the navicular bone towards the top of the mid-foot. The additional bone is also referred to as os navicularum or os tibiale externum. It is congenital, so is present from birth. There are various types of accessory navicular and the Geist classification is frequently used. This categorization divides the accessory navicular into 3 variations:

Type 1 accessory navicular bone:
This is the typical ‘os tibiale externum’ making up 30% of the occurrences; it’s a 2-3mm sesamoid bone embedded inside the distal portion of the tendon with no connection to the navicular tuberosity and may be divided from the bone by up to 5mm

Type 2 accessory navicular bone:
This type makes up about 55% of the extra navicular bones; it’s triangular or heart-shaped and linked to the navicular bone via cartilage material. It may well eventually merge to the navicular to create one bone.

Type 3 accessory navicular bone:
Pronounced navicular tuberosity. This might have been a Type 2 that’s merged to the navicular

The common symptom associated with an accessory navicular is the enlargement on the inside side of the arch. Because of the extra bone there, this affects how well the mid-foot muscles do the job and can lead to a painful foot. Rigid type shoes, such a ice skates, may also be very uncomfortable to use because of the enlarged pronounced bone.

The treatment is usually geared towards the signs and symptoms. If the flatfoot is a concern, then ice, immobilisation and pain relief medication may be required initially. Following that, physical therapy and foot orthotic inserts to aid the foot are used. If the soreness is due to pressure from the type of footwear that must be worn, then doughnut type padding is used to get load off the sore region or the footwear may need to be modified.

If these non-surgical treatment options fail to minimize the symptoms of the accessory navicular or the issue is a continuing one, then surgical procedures might be an appropriate option. This involves taking out the accessory bone and restoring the insertion of the tibialis posterior tendon so its function is improved upon.