In today's episode of Workshop Live, I am adjusting an orthotic for a customer with F24 (left) and F23 (right) foot types who is experiencing neck and shoulder pain and post tibia tendon weakness. Luckily, this customer is not experiencing ankle, knee, hip, or back pain. This customer has navicular drop pressure (navicular and first cuneiform bone dropping down and not rotating too much), abduction (feet pointing outward), pronation (feet rolling inward too much), and a flat-flexible arch (flat feet) with an outward rearfoot (valgus) and an inward forefoot (varus).

The neck and shoulder posture issues are most likely coming from the mechanics of the customer's feet and their gait or how they walk. There is a lot of rotation with this customer. Comparing the arch contour of this customer's left and right orthotics, I can tell that their left foot has much more deterioration and much more of a navicular drop than their right foot, which is relatively stable and structured. I am going to modify this customer's orthotics and make sure it accommodates their Drew Aaron shoes.

To reduce pronation, I am going to add a full medial wedge (midfoot, rearfoot, heel, outside heel, and side of orthotic coverage) to the left orthotic and a medial rearfoot wedge (heel coverage ending at the navicular bone) to the right orthotic using a heat moldable multi-cork material called J cork for both. To correct abduction, I am adding a lateral forefoot wedge (outside forefoot coverage that extends past the metatarsals) to both the left and right orthotics using EVA FM material. Once the glue dries thoroughly, I will use the grinder to create a small navicular drop cutout to alleviate navicular bone pressure and to smooth out the edges of the orthotic wedges.

People with severe abduction tend to take shorter steps, which makes it easier to fall forward. Taking steps with the full heel to toe motion creates more balance and the center of gravity is much better. This customer has always felt better with work boots because they are more firm and stiff. Most work boots have a metal shank, which increases rigidity and support. Everybody is going soft in the athletic world, but soft cushion is not the answer for everything. Sometimes feet need firm stability shoes like this customer.

This orthotic modification will now help this customer restore proper alignment and posture to relieve their neck and shoulder pain.

If you or someone you know is experiencing neck or shoulder pain caused by foot misalignment issues like abduction or pronation, our certified pedorthic experts are here to help! We offer free foot assessments, make custom orthotics in-house, and provide free orthotic adjustments and modifications.

References:

"Duck-Footed: Out-Toeing, or the Opposite of Pigeon-Toed." Healthline.

"Pronation, Overpronation, and Supination in Walking and Running." VeryWellFit.

"What is Foot Supination?" WebMD.