This latest development in the world of physical therapy concerning barefoot training is not really a new concept. The approach has been revived from one of the world’s leading physiatrists, and a revolutionary in the field of physical therapy, Professor Vladimir Janda MD.
The intrinsic training approach to foot rehabilitation is nothing new. It was first used by Vladimir Janda and called “short foot“ training. Dr.Kalika learned this method directly from Professor Janda when he was living in Prague and studying at Charles University Hospital.
Your foot is a complex structure capable of supporting your body weight and providing stability while you stand, walk, run, jump and dance. It is easy to take your feet for granted, but when something goes wrong and you begin to experience foot pain, it can be debilitating, keeping you from getting things done and doing the things you love.
Because of the foot’s complexity and its role in providing stability, there are many things that can go wrong to interfere with foot function and cause pain. Many interventions for foot pain center around providing external support via the use of orthotic shoe inserts and braces. However, in order to relieve pain and restore function, the muscles of the foot must be treated and retrained to perform as originally designed.
The first step to resolving foot pain and addressing foot-related problems is accurate diagnosis. Identifying the specific tissues that are at the core of your pain, and determining what factors and forces contributed to your injury are key. Simply addressing the locus of pain is not enough. Pain is only a symptom of greater issues caused by any number of factors.
Some factors underlying foot problems include:
Faulty gait mechanics while walking or running
Postural misalignment that overloads certain areas of the foot
Muscle weakness or imbalance
Abuse from footwear and hard or uneven surfaces
Overuse from sports or exercise with inadequate recovery
Simply providing external support without attempting to get to the root cause of foot pain can lead to long-term problems that become harder to resolve.
At NYDNRehab, we use a multi-modal approach to diagnosing your foot-related problems. After an initial health history overview and clinical analysis, we may use any of a number of diagnostic tools to get a better picture of the problem.
Some diagnostic approaches at NYDNRehab include:
Dynamic real-time ultrasonography: This technology enables us to look beneath the surface of your foot, to view and quantify girth and function of intrinsic foot muscles . Dr. Kalika uses his own carefully researched methodology, which for the first time allows for quantification of intrinsic foot function utilizing dynamic ultrasonography, elastography and M-Mode. This new method, created by Dr Kalika and his colleague, is particularly useful in the diagnosis and treatment of foot conditions such as tibial stress syndrome; heel pain and plantar fasciitis; tibialis posterior tendinosis; peroneal tendinosis, arch pain; hallus valgus and hallus limitus; ankle pain; and achilles tendinosis.
Video gait analysis: The mechanical aspects of walking and running can become inefficient over time, causing you to move in ways that place excessive loads on the structures within your foot. By analyzing your gait, we can identify mechanical deficiencies and faulty movement patterns that affect your foot function.
Pressure analysis of the foot: Using force plate technology, we are able to detect inefficient loading of your foot during standing and walking, giving us insight into lower limb dysfunction.
Postural, structural and biomechanical assessment: The way you distribute your body weight as you stand and move can profoundly affect the force loads placed on your feet. When your body alignment is less than optimal, your feet work overtime to maintain stability.
Jumping video analysis: Using a force plate, we are able to analyze movement at the knee, hip, and ankle/foot complex during a bilateral jump.
Once we have accurately assessed and diagnosed your foot problem, we create a personalized treatment program aimed at fully restoring function, so you can stand, walk, run and move without pain. At NYDNRehab, we use state-of-the-art technologies that engage and involve our patients in their own treatment.
At NYDNR, we use a combination of treatment options that may include:
Foot intrinsics retraining
Foot intrinsics retraining by isolated electro stimulation
Manual foot manipulation
Foot-specific myofascial release
Lower kinetic chain exercises
ESWT (extracorporeal shockwave therapy)
Gait retraining with CAREN (Computer Assisted Rehabilitation Environment)
Our Treatment Approach
At NYDNRehab, we are dedicated to getting to the source of your foot pain and resolving it. Unlike some treatment approaches that rely on steroid injections and orthotic correction, we retrain your walking and running gait and restore the function of your foot so it can once again adapt to the ground forces imposed by walking, running and other physical activities. Our treatment is based on sophisticated diagnostic results, and is specific to the needs of the individual patient.