In this age of insoles and orthotics for every activity and every shoe on the market; my patients often ask, "Does anyone walk normally?" And what is "normal gait" anyway?

In normal gait, your heel swings from side to side as your foot moves. When the heel swings correctly, your foot can flatten and regain its arch as you walk (normal pronation with resupination). But if your heel swings too much, your foot may flatten more than it should. (overpronation) Over time, such excess movement causes many foot problems. And yes, some people do walk normally, but not many.

When the heel hits the ground, its outer edge touches first. Soft tissues (muscles, tendons and ligaments) relax. Your foot is able to flatten, adapt to uneven surfaces, and absorb the shock of touchdown.

During midstance, your heel is below the ankle bone, and the front and back of your foot are aligned. Your foot easily bears your weight.

As the heel lifts, it swings slightly to the inside. Muscles, tendons, and ligaments tighten. Your foot regains its arch, allowing your toes to push your weight off the ground.

Too Much Movement Causes Strain!

When your foot flattens too much (overpronation), some bones are forced to support too much weight. The muscles pull harder on these areas, making it more difficult for tendons and ligaments to hold bones and joints in place. Over time, you may develop swelling or pain on the bottom of your foot or near the heel. Or a bony bump (bunion) may form at your toe joint.

When your foot flattens too much, the ankle and heel do not align during midstance. The foot strains under your body's weight.

Abnormal biomechanics causes overpronation. This is easily controlled with a custom orthotic. That is why most biomechanical foot pain and deformities are treated conservatively with custom orthotics. Change the biomechanics, decrease the stress and take care of the pain from the strain. Surgery is often avoided by simply changing the biomechanics of a person's gait.

Custom orthotics can make you walk normally too! These should be made from an impression of your foot in "neutral" or in simpler terms, the place where your ankle and foot are in proper alignment for weight bearing. The "gold standard" is a neutral suspension cast done by a podiatrist or a seasoned certified pedorthist. NOT a shoe store clerk trying to sell you an arch support for an outrageous amonut of money! For those with minor issues, many over-the-counter arch supports can do the trick....but remember...they are made for "normal people" and I have yet to meet very many!