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Foot Talk Fridays : Lifting arches of flat feet

January 25, 2020 by Dubai Podiatry Centre0


Welcome to Foot Talk Fridays!

So, Tri-Step is a system for flat feet.

The foot has three arches and what we want to do is squeeze the transverse arch back up again and raise the arch and the lateral arch so that we can get the arch engaged. First of all, we want to get the forefoot contracted first, so we are going to use a couple of tapes on the feet (four pieces to be precise).

This is to get the fore to the mid foot corrected. We start by putting these neuromuscular tapes on to the foot. They adhere to the skin with hypoallergenic glue and the glue also does not cover the tape completely to allow the foot to breathe. When we squeeze the foot we’re making the foot stronger and tighter, bringing the transverse arch together. And then we can anchor it in place like this.

This tape can be used on the toe if there is a bunion, or it can be used underneath the ball of the foot to help pull the fat pad back down underneath the bones. This is particularly good when somebody has pain underneath the ball of their foot here. Now, that is the forefoot held in place so that the metatarsals through here can come together.

Now what we want to do though, is to engage the medial arch and the middle of the foot arch here. So, how do we do that?  We’re going to use one of these shaped pads called ‘Foot Arch Formation.’ First of all, we are going to apply it by peeling back the paper on to just the forefoot. Over the top of these pads here right up under the toes. Then we’re going to remove the rest of the paper and we ask the patient to point their toes down like this. Then, we stick it to the outside of the foot and bring each tab up the back of the foot like this. 

Now, we have the arch pointed at its highest position and the last thing we do is really lift and pull. As you can this person has a fantastic transverse arch, excellent lateral arch and magnificent medial arch when before the foot was flat. So this holds the foot in the place to help the ligaments contract.

The next step we would do when the patients wearing this every day for 2-6 weeks, is they would also wear an orthotic or insole that helps to lift the foot, keep the arch up, and keep the transverse arch up as well to give structural support and this addresses the bones, this addresses the ligaments. 

I’ll just show you one more time on the other angle of the foot. We anchor it to the first metatarsal, squeeze the foot laterally like this to make the transverse arch pick up, and then we’re going to use the other twin pad on to the side of the foot and squeeze the foot to hold it together. Then, we’re going to use the anchor tape to help those two like this on to the side of the foot – this engages the transverse arch which is really important, especially for cyclists. And now we’re going to use another anchor pad to bring that fat pad back down to where we want it to be. There we go, perfect! Now what we’re going to do is just use the next pad as I showed you before, up underneath here to engage the medial and middle arch as well. So one more time we peel the paper away and stick it underneath the toes like this. Then we can take the rest of the paper away. We stick it to the outside first like this and then we bring all the other tapes around the back of the foot. And then from the top here you can see the arch now is already beginning to form and now we’re really going to pull this arch right up like this. So, this flat foot has quite an incredibly high arch now and is very powerful when it is all held together. They would wear this all day every day from morning until evening. At night time, remove it so that they have no sweat buildup on the foot and let the fresh air get to the foot. 

To use the EMS devices, we just peel off the backing here and you can put it along the inside of the foot to work the arch or you can put that across the foot here to work this part of the foot. So for now, we’re going to put it across the mid foot, then switch the device on. We can increase the intensity of the electro-muscle stimulator by pressing the plus (+) button. We’re going to keep on increasing it until the foot starts to move. You can see the foot beginning to contract. So, the foot is contracting and pulling downwards because it is making this muscle here contract. That will hold it like this for 20-30 seconds and then it will release then contract again. 

So, you can see that this simple sticky patch is more than strong enough. It is not even at its maximum effect on this area here. If we want to switch the machine off, we press the minus (-) button. Now the machine goes off and the toes goes back to being relaxed. Therefore, no electro-muscle stimulation happening. 

If we want it to use on the inside of the foot, we remove the sticky gel and put it on the inside of the arch muscle here, then switch it on. Now, we’re going to increase the intensity. Here, we have level 9, and we can make it go to 10 to contract the big toe. This really works on the muscles of the feet and send signals to the brain to tell the foot to wake these muscles up as well. You can also help by contracting your foot as well and helping to scrunch the arch muscle to get even more out of this. I am going to switch it off now just to relax the foot again. 

Now, we’re going to move to a stronger machine because some extreme flat feet do not have enough muscle for this level to work on. So, we would use a much stronger electro-muscle stimulator device, but we would check that in the clinic which one you would need, and we stick it on the insides of the foot on the arch. This is to make the arch muscle work. Then, we switch the machine on. We already have it entered at a specific program that we want to use at channel 1, and we’re going to increase the intensity on channel 1 until we see the toe beginning to move.

It’s making the muscle (tick, tick, tick, tick) and move almost like doing sit ups on this muscle here. You can even see the muscle moving along the inside of the skin here as it really contracts the muscle and helps to build arch. This is at level 23, it depends on the level the intensity that the patient needs. Everybody’s different, the weaker the muscle, the higher the intensity needs to be. And you would leave this for 30 minutes to let the muscle stimulation program work. And then we switch it off by pressing that button.

If we want to use it in a different position, we just remove the little bit of gel sticker that’s on the foot and place it on a different area on the foot. This gel sticks well to the foot and can be tickly when we remove it. 

So, say we want to work on the transverse arch across the foot we can use it in this position as well. It is already set to everything that we want it to be, and we’re going to increase and see how fast these muscles will start to contract and work. Now, we see the toes begin to twitch. We increase the intensity and now we’re really beginning to see these two toe twitch. The first one is beginning to twitch as well. So that’s the intensity, now all the muscles are beginning to work and that works the muscles across the foot here. You can increase the intensity depending on what feels comfortable for you and what doesn’t feel comfortable. For this person, this is a nice and strong pulse.

[Showing the Tri-Step System box]. So, the Tri-Step System lifts arches. But just like braces for the teeth and adjusting the braces, we also adjust the height of these orthotics as we go along with it. So we start off minimal, then medium-strong, finally very strong, and then go back to medium-strong again. These are the collection of tapes that are all in here, there’s a full batch in here that last 2 weeks for both feet. And these are the electro-muscle stimulators that I have been talking about. 

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