#CustomOrthotics Archives | Dubai Podiatry Centre

03/Oct/2026

Hard skin under one big toe is more than the other and it’s splitting like paper cuts.

When hard skin keeps coming back, look at why the skin is protecting itself

A common complaint we hear from patients is:

“I constantly get hard skin underneath my big toe. It splits and feels like little paper cuts. I use foot cream, file it and have the callus removed during pedicures, but it always comes back.”

When callus repeatedly develops in exactly the same place, simply removing the hard skin may not address the reason it is forming.

Callus is often the skin’s response to repeated pressure, shear and friction. The location and pattern of the callus can therefore provide useful clues about how forces are travelling through the foot.

A patient with painful, splitting callus

In this particular case, the patient had recurring hard skin underneath her big toe which frequently split, producing a painful sensation similar to paper cuts.

She had tried creams, regular filing and intensive callus removal at pedicure salons, but the problem continued to return.

She also had areas of callus beneath the ball of the foot, particularly underneath the second metatarsal head, as well as callus and a corn around the fifth metatarsal head.

She had also noticed that her feet seemed to be becoming broader.

What was particularly interesting was the difference between her two feet.

The left foot had only a relatively mild amount of hard skin underneath the big toe and forefoot.

The right foot showed considerably more.

Right and left foot soles showing uneven calluses and hard skin beneath the big toes, more pronounced on the right foot

Why was one foot worse than the other?

When we see a significant difference between the right and left feet, we don’t just examine the skin.

We look higher up the body.

In this patient’s assessment, we identified a leg-length discrepancy associated with pelvic asymmetry. Her right side demonstrated a pelvic tilt and altered lower-limb position, with the right foot abducting as she walked.

Instead of progressing straight over the big toe, she was repeatedly rolling across the side of it.

This created increased pressure and shear around the plantar and side of the big toe and first metatarsal region.

The skin was therefore repeatedly being subjected to mechanical stress in the same location.

Removing the callus could make the skin temporarily smoother, but it did not remove the forces that were causing it to develop.

The callus in the middle of the foot told us something different

Not every area of callus on this patient’s foot had the same mechanical explanation.

She also had callus underneath the second metatarsal head and around the fifth metatarsal head.

During her examination, this corresponded with changes in the shape and loading of her forefoot and a reduction in the normal transverse arch across the front of the foot.

As the forefoot spreads and its loading pattern changes, individual metatarsal heads can become more prominent beneath the foot.

The second metatarsal head is a particularly common area of increased plantar pressure.

Between the metatarsal bones and the ground lies an important layer of specialised fibrofatty tissue that helps cushion the foot.

When excessive pressure and shear repeatedly occur over a prominent metatarsal head, the skin may respond by producing additional keratin.

This is what we recognise as callus.

A more concentrated area of pressure can produce a corn.

Callus isn’t necessarily the problem. It can be a clue.

This is an important distinction.

Callus is not simply “dead skin that needs to be removed”

Its distribution can act almost like a map of pressure across the foot.

A podiatrist will therefore look at questions such as:

Is the callus symmetrical between the two feet?
Is it underneath a particular metatarsal head?
Is it underneath or along one side of the big toe?
Is there a corn in the centre of the callus?
Has the forefoot become broader?
Is one arch lower than the other?
Does one foot pronate more than the other?
Is one leg functionally or structurally longer?
Is there pelvic asymmetry?
Is the patient’s walking pattern creating excessive pressure or shear?

The position of the callus can help us understand what may be happening mechanically above it.

Why do some calluses crack and feel like paper cuts?

When callus becomes thick, it is less flexible than normal skin.

Every time the toe bends, twists or pushes against the ground, that thickened skin is subjected to movement and shear.

Eventually tiny fissures can develop.

These cracks can feel surprisingly painful, sometimes exactly like a paper cut.

Applying moisturiser may improve the flexibility and condition of the skin, and careful reduction of excessive callus can provide considerable relief.

However, if abnormal pressure and shear remain, the skin may continue to rebuild the callus.

That is why some patients find themselves in a cycle:

Callus forms → callus is filed or removed → skin feels better → the same mechanical forces continue → callus returns

What about people with diabetes or neuropathy?

This is particularly important in patients who have reduced sensation in their feet.

A person with neuropathy may not feel excessive pressure, rubbing, a blister or a developing wound normally.

Callus can itself be an important warning sign of repetitive high pressure, and in a neuropathic foot, areas beneath callus may be at increased risk of tissue breakdown and ulceration.

For this reason, recurrent callus in a person with diabetes, neuropathy or reduced circulation should not simply be aggressively filed or treated with corn-removing acids without appropriate professional assessment.

Why we examine the whole body

At Dubai Podiatry Centre, when we see a recurrent pattern of callus, particularly when one foot is significantly worse than the other, we don’t only look at the piece of hard skin.

We assess the biomechanics producing the pressure.

This can include examining:

Pelvis → hips → knees → ankles → subtalar joints → arches → forefoot → toes

Human bodies are naturally asymmetrical. Small differences are extremely common and do not necessarily cause problems.

It is when that asymmetry produces excessive or repetitive loading that symptoms can begin to appear.

In this patient’s case, the difference between the right and left callus patterns was an important clue.

Why the right and left orthotics may be different

If biomechanical assessment indicates that orthotic therapy is appropriate, the objective is not simply to put identical arch supports underneath both feet.

The two sides of the body may require different corrections.

For example, one orthotic may require a different thickness, inclination or degree of support from the other. The medial arch support may differ, and the forefoot or transverse arch may require different accommodation or correction.

The prescription is based on the individual patient’s examination.

The aim is to redistribute plantar pressure and improve lower-limb and foot mechanics so that the skin is no longer repeatedly exposed to the same excessive forces.

How long does it take for the callus to stop returning?

Skin does not necessarily change immediately when biomechanics are altered.

Even after the source of excessive pressure has been reduced, the skin may continue producing protective keratin for some time.

In clinical practice, we may see the callus pattern gradually reduce over the following months as pressure and shear are better controlled. For some patients, noticeable changes may occur over approximately four to six months, although this varies considerably according to the individual, their footwear, activity, skin condition and underlying biomechanics.

The important point is that we are not simply asking:

“How do we remove this hard skin?”

We are asking:

“Why does this particular piece of skin keep needing to protect itself?”

Once we understand that, we can work on the underlying mechanical cause as well as treating the skin itself.

The takeaway

Recurring callus can be more than a cosmetic problem.

Its location, shape and whether it is symmetrical between the two feet can provide valuable information about pressure, friction, foot structure and walking mechanics.

If the same callus keeps returning despite creams, filing and pedicures, it may be time to stop treating only the surface and investigate what is happening underneath it.

Dubai Podiatry Centre
Looking beyond the callus to understand why it formed.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

A big toenail that becomes white, lifted or separated along one side is often assumed to have a fungal infection. However, not every separated toenail is fungal.

In some patients, the underlying problem is mechanical and begins much further up the foot, at the alignment of the subtalar joint and ankle.

What causes the nail to separate?

When the foot pronates excessively, the subtalar joint and ankle lean inwards and the hallux, or big toe, can begin to internally rotate.

At the same time, the soft tissues and fibrofatty padding beneath the hallux are displaced laterally, towards the second toe.

Instead of remaining directly underneath the big toe, these tissues repeatedly move and press against the structures beneath and around the nail plate during standing and walking.

With thousands of steps each day, this repetitive movement can create an up-and-down and side-to-side mechanical force beneath the nail.

Over time, the nail plate can gradually be pulled away from the nail bed underneath. This produces a characteristic curved or U-shaped area of separation, particularly along the lateral border of the hallux nail.

This type of nail separation is known as onycholysis, but importantly, onycholysis describes the separation itself. It does not tell us what caused it.

An interesting left-versus-right comparison

This photographic example of the toes and feet provides an excellent example because the severity of the nail changes is different between the two feet.

On the left foot, the ankle/subtalar joint pronates approximately 30 degrees, and the lateral separation of the hallux nail plate is considerably greater.

On the right foot, the subtalar joint pronates approximately 12 degrees, and the lateral nail separation is noticeably less extensive.

The asymmetry is clinically interesting because the foot demonstrating the greater degree of pronation also demonstrates the greater degree of nail separation.

Rather than examining the toenail in isolation, we therefore need to examine what is happening to the whole foot, ankle and hallux during weight-bearing and walking.

Why can this be mistaken for fungal nail disease?

When air gets underneath a separated nail plate, the nail can appear white, yellowish or opaque. Debris may also accumulate beneath the separated portion.

Visually, this can resemble a fungal toenail.

However, treating a mechanically separated nail with antifungal treatment alone does not correct the forces repeatedly acting upon the nail.

Where fungal infection is suspected, appropriate clinical assessment and, when indicated, laboratory testing can help distinguish fungal nail disease from other causes of nail dystrophy and onycholysis.

The relationship with ankle alignment

In our clinical observations at Dubai Podiatry Centre, we frequently begin to see secondary foot and nail changes as subtalar joint pronation increases.

When inward deviation becomes more pronounced, mechanical stress upon the hallux can increase. With greater degrees of pronation, we may see progressively wider and deeper lateral nail separation together with increasing rotation or displacement of the hallux.

At very significant degrees of pronation, other structural changes, including hallux valgus, may also coexist.

These degree measurements should not be interpreted as universal diagnostic thresholds. Every patient is assessed individually because foot structure, joint mobility, footwear, activity, gait and other medical or dermatological factors can also influence the appearance of the toenail.

Treatment must address the cause, not simply the nail

If the separation is predominantly mechanical, our objective is to reduce the abnormal forces acting upon the hallux long enough for a healthier nail to grow forward while remaining attached to the nail bed.

Depending upon the individual assessment, treatment may include:

Corrective orthotics designed to improve subtalar joint alignment and reduce excessive pronation
Toe socks to encourage the toes to remain separated and in a more neutral position
Silicone toe liners or separators between the toes where appropriate to assist alignment
Footwear with an accommodating toe box, including suitable barefoot-style footwear where clinically appropriate, so that the toes are not compressed or displaced by the shoe

The important principle is consistency.

If a corrective device is worn for only one hour each day but the foot spends the remaining weight-bearing hours returning to its previous position, the mechanical forces responsible for the problem continue.

The objective is to maintain improved foot and toe alignment for as much of the patient’s weight-bearing day as reasonably possible.

How long does the nail take to recover?

Toenails grow slowly.

The recovery period therefore depends partly upon how far backwards the existing separation extends. The damaged portion cannot simply be pushed back onto the nail bed. Instead, we need to reduce the causative mechanical stress and allow healthier nail to gradually grow forward.

For some patients, visible improvement may occur over several months. A mechanically separated area may require approximately four to six months or longer to grow forward sufficiently, depending upon the depth of separation, individual nail-growth rate and how effectively the underlying mechanical problem is controlled.

Look beyond the toenail

A separated toenail does not always mean a fungal toenail.

Sometimes the toenail is simply showing us the end result of a biomechanical problem occurring elsewhere in the foot.

By examining the nail together with the hallux position, plantar soft tissues, subtalar joint, ankle alignment, gait and footwear, we can investigate why the nail is separating rather than treating its appearance alone.

Michelle Duffy Champlin
B.Sc. (Podiatry), M.Ch.S., S.R.Ch. (UK)
Chief Podiatrist
Dubai Podiatry Centre

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

When we think about the arches of our feet, most people immediately picture the large arch running along the inside of the foot.

But there is another, much smaller arch at the front of the foot that we pay very close attention to during a biomechanical assessment at Dubai Podiatry Centre.

It is called the transverse arch.

What is the transverse arch?

The front part of your foot is called the forefoot. It includes the toes and the metatarsal bones, which are the long bones immediately behind your toes.

Across the forefoot, just behind the toes where they connect with the foot, is the transverse arch.

Rather than running from the heel towards the toes like the more familiar medial arch, the transverse arch runs across the foot from side to side.

It is a relatively small arch, but biomechanically it can be extremely important.

What happens when the transverse arch starts to drop?

Over time, the forefoot can begin to spread and the transverse arch can become lowered.

We sometimes describe this to patients as the metatarsal bones beginning to “avalanche” forwards and downwards.

Although this change is occurring in a relatively small area at the front of the foot, it can influence the way the rest of the foot functions.

The metatarsal bones do not work independently from the remainder of the foot. They form part of the interconnected structure of the foot and contribute to its stability and function during standing and walking.

As the forefoot begins to change position, we may also see changes occurring through the larger medial arch, the midfoot and eventually the mechanics around the ankle.

This is why we never look at the transverse arch in isolation.

Are you beginning to look hunched forwards?

One of the observations that can prompt us to investigate the forefoot is a change in a person’s stature.

Sometimes a patient, or their family, will say that they are beginning to “look hunchbacked” or that they appear to be leaning forwards.

The head may be sitting further forwards, the shoulders may appear more rounded and the person can develop an increasingly stooped appearance.

There are, of course, many different reasons why somebody may develop a forward head position or stooped posture. It should never automatically be assumed that it is coming from the feet.

However, it is one of the physical signs that makes us look more carefully at the person’s overall biomechanics.

We look at the person from the side and assess their stature. We look at the position of the head and shoulders. We observe how they stand and walk.

Then we investigate what is happening underneath them.

In particular, we examine the sole of the foot and the forefoot to see what has happened to the transverse arch.

If that small arch has dropped and the metatarsal bones have moved forwards and downwards, it may be contributing to a chain of biomechanical changes occurring further up the body.

Your feet form the foundation of your posture

The feet provide the foundation for the body when we stand and walk.

Changes in that foundation can sometimes contribute to compensations further up the biomechanical chain.

This is why a person’s posture can give us clues about what we should investigate in their feet.

A forward head, rounded shoulders, a stooped stance or a tendency to shuffle when walking does not diagnose a foot problem. However, these observations can be a reason to include the feet in the assessment rather than concentrating only on the upper body.

Sometimes the clue is visible at the shoulders and head, while part of the biomechanical problem may be much further down, at the sole of the foot.

Why we look for problems early

One of the reasons we pay such close attention to the transverse arch is that it can give us an opportunity to identify biomechanical changes relatively early.

If the transverse arch has started to lower but the remainder of the foot is still relatively well controlled, treatment can be much simpler.

Where appropriate, a custom corrective orthotic can be designed to support and lift the transverse arch and improve the mechanical stability of the forefoot.

The objective is not simply to put something soft underneath a painful area. It is to address the position and function of the forefoot as part of the mechanics of the entire foot.

What if the whole foot has already started to collapse?

More advanced biomechanical changes can also be managed. It simply requires a different approach.

If changes have progressed through the forefoot, midfoot and ankle, attempting to correct everything at once may not be appropriate or comfortable.

Instead, orthotic therapy may need to be carried out step by step and stage by stage.

We may initially need to address the forefoot and transverse arch. As the foot adapts, we can reassess the midfoot, medial arch, rearfoot, heel and ankle mechanics.

This process naturally takes longer than treating an early biomechanical change.

A small arch can give us a big clue

The transverse arch is a relatively small structure, but it can tell us a great deal about what is happening throughout the foot.

This is why we don’t assess feet simply by asking, “Where does it hurt?”

We look at the toes, forefoot, midfoot, heel and ankle. We look at how you stand. We look at the position of your shoulders and head. We watch how you walk.

If somebody tells you that you are beginning to look more hunched over, or you notice that your head is increasingly sitting forwards and your shoulders are becoming rounded, there can be many possible explanations.

But don’t forget to look down.

A biomechanical assessment of the feet, and particularly that small transverse arch underneath the forefoot, may provide another important piece of the puzzle.

The earlier we identify a change in foot biomechanics, the easier it may be to manage before it progresses further.

Dubai Podiatry Centre
Biomechanical Foot Assessment and Custom Orthotic Therapy

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Flat feet in children are common, but parents may become concerned when a child’s feet or ankles roll inward while standing or walking. This inward movement is known as overpronation and may affect foot posture, ankle stability, balance and walking comfort.

At Dubai Podiatry Centre, our podiatrists assess children’s flat feet and walking patterns to determine whether additional support, such as custom-made orthotics, may be beneficial.

What Are Flat Feet in Children?

Flat feet occur when the arches of the feet appear lowered or make increased contact with the ground. In some children, the heels and ankles may also lean inward, causing the feet to overpronate.

Although flat feet do not always cause problems, a podiatry assessment may be recommended if your child experiences:

Foot, heel, ankle or knee pain
Tired or aching legs
Frequent tripping or poor balance
Difficulty walking or participating in sports
Uneven or excessive shoe wear
Ankles that visibly roll inward
Changes in posture or walking pattern

Recognising these signs early allows the child’s foot posture, movement and support requirements to be professionally evaluated.

How Overpronation Can Affect Foot Alignment

When a child’s feet overpronate, the heels and ankles lean inward instead of remaining in a more neutral position. This may change how pressure is distributed across the feet and influence the alignment of the lower limbs.

The comparison image demonstrates the rear view of pronating feet and the improved neutral alignment achieved while standing on corrective orthotics. The orthotics provide support beneath the feet and help stabilise the heels and ankles.

Custom Orthotics for Children’s Flat Feet

Custom orthotics are individually made to match the shape, posture and biomechanical needs of each child’s feet. Unlike standard insoles, they are created following a professional foot and walking assessment.

Corrective orthotics may help to:

Support the arches of the feet
Reduce excessive inward rolling
Stabilise the heels and ankles
Improve foot and lower-limb alignment
Distribute pressure more evenly
Support balance and walking comfort
Reduce strain on the feet and legs

Every child’s feet are different, which is why orthotics should be designed according to their individual assessment rather than selected as a one-size-fits-all solution.

Children’s Biomechanical Foot Assessment in Dubai

At Dubai Podiatry Centre, a children’s biomechanical assessment examines foot posture, ankle alignment, lower-limb movement and walking pattern. The podiatrist will determine whether custom orthotics are appropriate and explain the recommended treatment plan.

Regular reviews may also be advised to monitor the child’s progress, comfort and changing needs as they grow.

Book a Children’s Flat Feet Assessment in Dubai

If your child’s feet roll inward or you have concerns about flat feet, foot pain, balance or walking, professional assessment can help identify their individual support requirements.

Book a children’s flat feet and overpronation assessment with Dubai Podiatry Centre on Sheikh Zayed Road. Our podiatrists provide personalised foot assessments and custom orthotics for children in Dubai.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Flat feet can affect more than just the feet. When the arches collapse excessively during standing or walking, the feet may roll inwards—a movement known as overpronation. This can alter the position of the heels and affect the alignment of the ankles, knees and hips.

Over time, poor foot alignment may place additional strain on the muscles, tendons and joints throughout the lower limbs.

Signs and Symptoms of Flat Feet

Not everyone with flat feet requires treatment. However, adults and children whose flat feet cause pain or affect their mobility may experience:

Tired or aching feet
Heel, arch or ankle pain
Knee or hip discomfort
Reduced walking endurance
Difficulty standing for long periods
Uneven shoe wear
Changes in walking pattern

A professional foot and gait assessment can help determine whether flat feet or overpronation are contributing to these symptoms.

Corrective Orthotics for Flat Feet

Not all insoles provide the same type of support. Cushioned insoles are primarily designed to improve comfort and redistribute pressure. Corrective orthotics are designed to control excessive foot movement, support the position of the heels and improve lower-limb alignment.

When clinically appropriate, custom-made corrective orthotics may help reduce excessive strain on the feet and legs, improve stability and make standing, walking and daily activities more comfortable.

Children’s and adults’ feet have different requirements. For this reason, corrective orthotics should be individually prescribed following a detailed assessment rather than selected as a one-size-fits-all solution.

Biomechanical Assessment at Dubai Podiatry Centre

At Dubai Podiatry Centre, flat feet treatment begins with a comprehensive biomechanical assessment. Our podiatrist evaluates:

Foot posture and arch position
Heel and ankle alignment
Walking pattern and gait
Muscle function
Joint movement
Lower-limb biomechanics

The assessment helps identify how the feet are functioning and whether custom-made corrective orthotics are suitable for you or your child.

Book a biomechanical assessment at Dubai Podiatry Centre to learn more about flat feet, overpronation and corrective orthotic treatment.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Choosing the right shoes is especially important for children who wear custom foot orthotics. Orthotic-friendly shoes should provide enough space for the devices while keeping the feet secure, comfortable and properly supported throughout the day.

At Dubai Podiatry Centre, we help parents choose suitable children’s footwear for custom orthotics, flat feet, overpronation and other foot conditions.

Why Are Orthotic-Friendly Shoes Important?

Custom orthotics are designed to support a child’s feet, improve foot function and distribute pressure more evenly. However, the orthotics must fit correctly inside the shoes to work as intended.

Shoes that are too narrow, shallow, soft or unstable may cause the orthotics to move, lift the heel or create pressure and discomfort. The best shoes for kids wearing orthotics should securely accommodate the devices without restricting the feet.

What to Look for in Children’s Shoes for Orthotics

When shopping for supportive kids’ shoes, look for the following features:

Removable Insoles

Shoes with removable insoles create additional space for custom orthotics. The original insoles should normally be removed before inserting the orthotic devices.

A Wide Toe Box

A wide, rounded toe box allows the toes to move naturally without rubbing or being compressed. This is particularly important as children’s feet continue to grow.

Adequate Width and Depth

The shoes must be deep and wide enough to accommodate the orthotics without making the fit too tight or pushing the feet upwards.

A Firm Heel Counter

A supportive heel counter helps hold the heel securely and reduces unwanted movement inside the shoe. This can provide additional stability for children with flat feet or overpronation.

Adjustable Fastenings

Laces, straps or adjustable closures help keep the feet and orthotics securely positioned. They also allow the fit to be adjusted as needed.

A Supportive Sole

Choose shoes with a stable sole that bends naturally near the toes rather than twisting or folding easily through the middle.

Lightweight and Durable Materials

Children need footwear that is comfortable for daily movement while being strong enough for school, sports and everyday activities.

Shoes for Children With Flat Feet and Overpronation

Children with flat feet or overpronation may require extra support to improve stability and reduce excessive inward rolling of the feet. Combining professionally prescribed custom orthotics with appropriately fitted supportive shoes can improve walking comfort and help the orthotics work effectively.

Every child’s feet are different. The best shoe is not simply the most expensive or popular option—it is the shoe that fits the child’s feet and orthotics correctly.

Tips for Finding the Correct Fit

Always take your child’s orthotics when shopping for new shoes. Insert the devices and ask your child to walk in the shoes before making a decision.

Check that:

The orthotics sit flat and securely inside the shoes.
The heels do not slip while walking.
The toes have enough room to move comfortably.
There are no areas of rubbing or pressure.
The shoes feel secure without being tight.
Your child can walk naturally and comfortably.

Do not automatically buy a larger shoe size to create space for the orthotics. A shoe that is too large may allow the feet and orthotics to move excessively. Instead, choose footwear with the correct width, depth and internal shape.

Expert Footwear Advice in Dubai

If your child has flat feet, overpronation, foot discomfort or difficulty finding shoes that fit their orthotics, a professional foot assessment can help.

Watch our video to discover the best supportive shoes for kids wearing orthotics, recommended by Michelle Duffy Champlin, a podiatrist at Dubai Podiatry Centre.

Contact Dubai Podiatry Centre to arrange a children’s foot assessment and receive professional advice about custom orthotics and supportive footwear in Dubai.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

A patient recently attended Dubai Podiatry Centre with an interesting story that led to a much wider discussion about menopause, movement, muscle strength and the importance of keeping our bodies active as we age.

She had completed menopause and described how, during the previous year, she had gained weight and noticed a significant change in her muscle tone and the way her body felt. She felt that she had lost some of the strength, firmness and resilience that she previously had.

More recently, however, she had become very proactive about her health. Under professional guidance, she had been exploring treatments aimed at supporting her health after menopause, while also paying closer attention to her vitamin D and calcium intake. Most importantly from our perspective, she had started walking every morning and was feeling considerably better.

She also mentioned feeling particularly motivated after listening to Mel Robbins’ podcast discussions about longevity and maintaining strength and health as we get older.

This prompted a fascinating conversation in the clinic about something we often discuss with our patients:

When it comes to movement, we really do have to use it or lose it.

Think of Your Fascia Like a Springy Spider’s Web

Fascia is the connective tissue network that runs throughout the body, surrounding and connecting muscles, bones and other structures.

I often describe it to patients as being a little like a three-dimensional spider’s web running throughout the body.

When we are young and active, our bodies tend to have a wonderful natural springiness. We run, skip, jump, change direction, climb stairs and step over obstacles without giving these movements much thought.

As we get older, particularly if our activity levels reduce, we can gradually stop performing many of these movements.

We may still walk, but perhaps we no longer skip.

We may climb stairs, but rarely jump.

We may exercise, but always in straight, predictable movements.

Gradually, we can lose some of our strength, agility, balance and natural rebound.

The answer is not necessarily extreme exercise. It is about continuing to give our bodies a variety of movements.

Walking and Our “Second Heart”

One of the best forms of exercise remains one of the simplest: walking.

The calf muscles are sometimes referred to as our “second heart” because their contractions help pump venous blood from the lower legs back towards the heart.

Every time we walk and activate our calf muscles, we are helping this natural pumping mechanism.

Regular walking is therefore wonderful for maintaining calf muscle activity, circulation, cardiovascular fitness, mobility and general wellbeing.

But walking does not have to be the only movement we practise.

Bring Back a Little Agility

I am delighted to see movements similar to traditional step aerobics becoming popular again.

Step exercises require us to lift our feet, judge the height of a step, transfer our weight, turn, coordinate our legs and maintain our balance.

These are valuable skills.

As we age, maintaining the ability to change direction, step sideways, lift our feet over an obstacle and react to an irregular surface becomes increasingly important.

Simple activities can include:

Walking regularly
Stepping up and down from a low exercise step
Side stepping
Gentle direction changes
Appropriate strength exercises
Balance exercises
Practising safely stepping over small obstacles
Maintaining the ability to get up and down from the floor

The exercises chosen should, of course, be appropriate for the individual’s health, balance, strength and medical history.

But What Happens When Walking Hurts?

Our patient’s motivation was excellent, but there was another part of the story.

She was experiencing plantar fascia discomfort as well as lower back and shoulder blade pain, particularly on one side.

Her chiropractor had also identified significant asymmetry and felt that her alignment could be contributing to her symptoms when walking.

This is an important point.

We frequently encourage patients to walk more, but if somebody is significantly mechanically misaligned, repeatedly walking with that imbalance can sometimes continue to aggravate certain tissues.

We therefore assessed her using our 3D scanning system.

The scan demonstrated an apparent leg length discrepancy of approximately 3.1 cm, with the left side measuring longer. For somebody approximately 5 feet 4 inches tall, this represented a considerable asymmetry.

Rather than simply treating the painful plantar fascia, we needed to look at what was happening throughout the body.

The Feet Can Affect What Happens Above Them

The feet are the foundation of the body when we stand and walk.

If one side functions differently from the other, compensation can occur through the legs, pelvis and higher into the body.

I sometimes describe this as a Z-shaped compensation pattern.

The body does not necessarily remain neatly vertical when trying to accommodate an imbalance. Soft tissues tighten, joints adapt and the pelvis and upper body may compensate in different directions.

For this patient, we therefore made the left and right orthotics quite differently.

The angles and thicknesses were individually designed to improve her overall alignment rather than simply giving her two identical insoles.

An Immediate Change From 3.1 cm to 1.3 cm

We then repeated her 3D assessment while she was standing on her new orthotics.

The apparent leg length discrepancy reduced immediately from approximately 3.1 cm to 1.3 cm.

That was an excellent initial change.

Importantly, however, our aim was not to make both sides completely equal on the first day.

The body has been compensating for its existing position for a long time. Muscles, fascia and other soft tissues have adapted to that position too.

Changing everything immediately can therefore be too much.

Instead, we make an initial correction and allow the body time to adapt.

Why We Review Again After 6–12 Weeks

We will review this patient again after approximately 6–12 weeks.

During this period, the muscles and soft tissues have time to respond to the altered skeletal alignment.

An apparent leg length discrepancy can sometimes look greater during the initial assessment because the measurement is influenced not only by the bones themselves but also by rotation and compensation occurring throughout the body.

As these compensatory patterns reduce, the apparent discrepancy may also change.

At the review appointment, we can repeat the assessment and adjust the orthotics according to how her body has responded.

This gradual approach allows us to work with the body rather than trying to force an immediate correction.

Healthy Ageing Starts From the Ground Up

One of the most positive things about this patient’s story was her motivation.

She wanted to walk.

She wanted to become stronger.

She wanted to maintain her mobility and enjoy her body as she moved into the next stage of her life.

That is exactly what we want to encourage.

Menopause and ageing can bring changes in muscle mass, bone health and body composition, but becoming older should not mean accepting that we can no longer move freely.

Walk.

Maintain your strength.

Challenge your balance.

Practise changing direction.

Lift your feet.

Use stairs and steps when appropriate.

And, if you used to skip, perhaps don’t completely forget how to skip.

Our bodies are designed for movement.

Use your movement, maintain your strength, and look after the foundations carrying you through life: your feet.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Have you ever wondered how custom-made corrective orthotics can transform the way you stand and walk? Watch our before-and-after video to see the remarkable improvement in foot alignment after wearing custom orthotics designed specifically to correct overpronation and flat feet.

When the feet lean inward excessively, they can cause poor body alignment, placing extra pressure on the ankles, knees, hips, and lower back. This imbalance often contributes to heel pain, plantar fasciitis, arch pain, ankle instability, knee pain, corns, calluses, and foot fatigue. Without proper support, these problems can worsen over time and affect everyday mobility.

At Dubai Podiatry Centre, our experienced podiatrists perform a comprehensive biomechanical assessment, gait analysis, and foot impression to accurately diagnose the cause of your foot pain. Using these findings, we design custom-made corrective orthotics that help restore proper foot posture, improve balance, reduce excessive pressure, and support natural walking mechanics.

This before-and-after transformation highlights how corrective orthotics can improve foot positioning, enhance stability, and promote healthier movement. By supporting the feet in a more neutral position, custom orthotics help reduce strain throughout the body and improve overall comfort during walking, standing, and daily activities.

If you suffer from flat feet, overpronation, heel pain, plantar fasciitis, foot pain, ankle pain, knee pain, arch pain, or recurring corns and calluses, a professional biomechanical assessment may be the first step towards lasting relief.

Book an appointment with Dubai Podiatry Centre to discover how custom corrective orthotics can improve your foot alignment, relieve pain, and help you move with greater confidence.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Are you experiencing foot pain, heel pain, arch pain, knee pain, or lower back pain? The underlying cause may be the way your feet are aligned. Flat feet (pes planus), overpronation (feet rolling inward), and supination (feet rolling outward) can affect your entire body, leading to discomfort, poor posture, and inefficient walking.

At Dubai Podiatry Centre, our experienced podiatrists specialize in diagnosing and treating flat feet, overpronation, and other biomechanical foot problems using advanced assessment techniques and custom-made orthotics.

Common Symptoms of Flat Feet and Overpronation

Poor foot alignment can contribute to:

Flat feet (fallen arches)
Heel pain
Plantar fasciitis
Arch pain
Corns and calluses
Bunions
Ankle instability
Knee pain
Hip pain
Lower back pain
Foot fatigue
Difficulty walking or standing for long periods
Sports and running injuries

Comprehensive Biomechanical Assessment

At Dubai Podiatry Centre, we perform a detailed biomechanical assessment to identify the cause of your symptoms. Your assessment may include:

Foot posture evaluation
Gait analysis (walking assessment)
Digital foot impressions
Foot alignment assessment
Lower limb biomechanics evaluation
Custom orthotic assessment

This allows us to accurately diagnose the source of your pain and recommend the most effective treatment.

How Custom Orthotics Help Flat Feet

Our custom orthotics (medical shoe insoles) are individually designed to support your feet and restore proper alignment. They can help:

Correct overpronation and excessive foot rolling
Support flat feet and fallen arches
Improve foot posture and body alignment
Redistribute pressure across the feet
Reduce heel, arch, knee, hip, and back pain
Improve walking, standing, and athletic performance
Prevent further foot and lower limb injuries

Unlike over-the-counter insoles, custom orthotics are made specifically for your feet, providing targeted support and long-term comfort.

Watch the Video

Watch our video to see how custom orthotics can immediately improve foot alignment by correcting excessive inward or outward foot movement. Proper foot support can reduce pain, improve balance, and help you move more comfortably every day.

If you have flat feet, overpronation, heel pain, or recurring foot discomfort, book a biomechanical assessment with the specialists at Dubai Podiatry Centre. Our expert podiatrists will determine whether custom orthotics are the right solution to improve your foot health and overall mobility.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Dubai Podiatry Centre

03/Oct/2026

Plantar fasciitis is one of the most common causes of heel pain. People typically notice it when they take their first steps out of bed in the morning or when they stand after sitting for a prolonged period. The pain often eases after walking for a few minutes, only to return again after periods of rest.

What is the plantar fascia?

The plantar fascia is a strong band of connective tissue that runs from the heel bone (calcaneus) to the base of the toes. Its primary function is to help support the arch of the foot.

When you walk, run or land from a jump, the plantar fascia becomes tensioned, helping the arch maintain its shape and absorb forces. Without this support, the bones of the midfoot would be subjected to much greater mechanical stress.

A healthy plantar fascia is not designed to remain under constant tension. Instead, it should be relatively relaxed at rest and become taut only when required during movement and weight-bearing activities.

Why does plantar fasciitis develop?

The term plantar fasciitis literally means inflammation associated with the plantar fascia. Although the pain is felt in the heel, the discomfort is usually concentrated where the plantar fascia attaches to the heel bone.

Rather than viewing plantar fasciitis as simply an isolated heel problem, it is often more helpful to consider why the plantar fascia has become overloaded in the first place.

In many people, the ligaments and muscles of the foot provide enough stability to support the arch without excessive strain on the plantar fascia. However, if the alignment of the foot changes, the plantar fascia may remain under tension for much longer than it was designed to.

One of the most common contributing factors is excessive pronation of the foot and ankle. As the foot rolls inward, the plantar fascia may become progressively tensioned throughout standing and walking instead of only during the phases when it is normally required.

An easy way to understand the problem

Imagine holding a single strand of long hair with a heavy weight attached to the end.

The hair itself is not painful.

The pain would occur where the hair is anchored into the scalp because that attachment point is constantly being pulled.

Once the weight is removed, the strain at the attachment point disappears.

The plantar fascia behaves in a similar way. The discomfort usually develops where the fascia attaches into the heel bone rather than within the fascia itself. If excessive tension continues day after day, this attachment site can become irritated and painful.

Why is the pain worse in the morning?

Many people notice that the first few steps in the morning are the most painful.

After sleeping or sitting for a prolonged period, blood flow and tissue fluid movement slow down. When the foot is suddenly loaded, the already irritated attachment of the plantar fascia is placed under tension again, producing the characteristic sharp heel pain.

As you begin walking, the calf muscles act as a pump, improving circulation through the lower leg and foot. This often reduces discomfort temporarily, which explains why many people feel better after several minutes of walking.

Treating the cause—not just the symptoms

While heel cushions, supportive insoles and stretching programmes may provide symptom relief for some individuals, long-term improvement depends on identifying and correcting the mechanical cause of the overload.

If excessive pronation or another alignment abnormality is placing unnecessary tension on the plantar fascia, simply adding cushioning beneath the heel may not adequately address the underlying problem.

A corrective orthotic is designed to improve foot and ankle alignment rather than simply support the arch. Because every person walks differently, the correction required for the left foot is often different from that required for the right foot. The amount of correction should therefore be individually prescribed.

As the abnormal strain on the plantar fascia is reduced over time, the attachment at the heel is given the opportunity to recover, allowing symptoms to gradually settle while also addressing the underlying biomechanical problem that contributed to the condition.

The key message

Plantar fasciitis should not simply be viewed as inflammation of the heel. In many cases, it is the result of an underlying mechanical imbalance that places excessive and prolonged tension on the plantar fascia where it attaches to the heel bone.

Successful long-term treatment focuses on identifying the biomechanical cause, correcting the alignment of the foot and ankle, and reducing the abnormal forces responsible for the condition. By addressing the underlying mechanics rather than simply cushioning the symptoms, many patients can achieve lasting relief and reduce the likelihood of recurrence.

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024

Older Posts