Best Foot Forward

The benefits of custom orthotics.

Do you ever feel like you have balance problems when you ski? Or perhaps you have more difficulty turning one direction than the other? Have you ever considered that the problem may be originating at the foot? Proper footwear is important for performance and injury-prevention in any sport, and in a sport in which you also have to deal with the elements of nature, the right footwear becomes even more critical.

The advancements in ski-boot technology over the past few decades have resulted in significant decreases in foot and ankle injuries. The evolution of the hard-shell ski boot and release bindings has led to a relatively low occurrence of ankle sprains and foot injuries. However, these new advances don’t necessarily protect against knee and hip injury, and even a properly fitted ski boot doesn’t correct faulty foot mechanics. Abnormal foot mechanics may actually contribute to ankle tendonitis, muscle imbalances in the lower extremity, patellofemoral pain, ACL sprain or tear, and hip pain.

In some cases, over-the-counter orthotics can help correct minor issues in foot mechanics and provide for a better fit within the ski boot. Unfortunately, these orthotics may not correct all underlying issues and may actually make the problem worse. Semi-custom orthotics can help correct moderate to severe pathological rearfoot and forefoot problems. A properly fitted orthotic can help improve single-leg balance and control of the foot and ankle within a ski boot. A thorough lower-extremity evaluation by a physical therapist or other trained professional can help determine if a foot issue exists, how it may be contributing to lower extremity pain, and how orthotics may prevent further injury.

Regardless of the type of injury, prevention is much more effective than treatment, and results in much less skiing time lost.

Megan Peach, DPT, CSCS, OCS, works at Excel Physical Therapy in Bozeman.