Hattie MacMillan

At TBL, we are fortunate to have some of the leading sports podiatrists, physiotherapists, biomechanists and sports scientists in the country.

To provide our patients the very best advice, our clinical team come together once a week to review complex cases and provide a holistic view of patient management based on our individual practitioners experience and expertise.

This ensures the most complex cases we see benefit from the insight of a range of practitioners. This provides our patients the very best outcome.

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Wishing everybody a Happy Easter, may the Easter Bunny visit you and your family 🐰 🍫

Part 4 of 4 on how we use gait analysis data for patient treatment - Using 3D gait analysis to design appropriate foot & ankle surgery

We provide our patients with all the possible conservative options viable to them. In some situations we identify in the gait analysis that there is no function or control of a particular joint(s) and despite any best efforts in strength and conditioning or orthotic prescription, the function of your foot is unlikely to improve without surgery. In this case, we work with our team of surgeons to develop the most appropriate procedure for you. We can use the gait data as a baseline measurement to compare to in the rehab phase that occurs post-operatively. We also work with a lot of patients who see us as an initial patient after they have had surgery or had a complex traumatic event where surgery may not be possible or indicated. And as much as we have discussed individual applications above, there is not a better or more suited patient for 3D gait analysis that one with a complex history of trauma or surgery that has caused a significant alteration he original function of the foot and ankle. In this situation, we can use the data to optimise the current situation and make the most out of the situation we are presented with.

Part 3 of 4 on how we use gait analysis data for patient treatment - Using 3D gait analysis to design custom orthotics

Custom foot orthotics are often used by podiatrists to improve pain and restore function in patients with complex foot and ankle injuries. They have also been shown to be effective in improving symptoms associated with knee and hip arthritis, anterior knee pain and low back pain. We take a 3D scan (pictured) that captures the unique geometry of your foot, and we can then use design modifications to apply forces to influence the function of the foot when you walk, run or jump. Yet, given standard analyses cannot measure force, without 3D gait data, there is no way to precisely understand what forces are applied to the foot and leg, where those forces are applied and how large they are. With the use of 3D gait analysis, we can measure the exact forces applied to your body. Now that we have a clear picture of the forces applied to the body, we can use orthotic design principles to target and manipulate the forces applied to the body.

Part 2 of 4 on how we use gait analysis data for patient treatment - Using 3D gait analysis to prescribe footwear

Footwear is so much more than a covering for our foot that needs to look good. By virtue of its location between the foot and the ground, it is a medium which needs to attenuate force and provide stability to the foot. Some examples of where we use specific footwear to treat complex foot and ankle problems include:

- Changing the materials of the midsole to improve comfort in patients who have a very high rate of force loading.

- Using specific rocker forefoot designs to improve function in patients with reduced joint motion as a result of arthritis or in those patients who have high propulsive forces causing problems such as neuromas or plantar plate injuries.

We have also developed an analytical processes to understand how the foot moves inside the shoe. This relies on holes cut in the shoe to allow gait analysis markers to be applied directly on the skin surface through the shoe upper. We have a range of lab shoes that allow us to better appreciate the function of the foot when wearing shoes. This is important when considering the need for / quantifying how foot orthotics work.

Part 1 of 4 on how we use gait analysis data for patient treatment - Using 3D gait analysis to design strength and conditioning programs.

The information we collect in a 3D gait analysis relating to the range of motion of a joint and the velocity of movement allows us to better select exercises to improve functional control of movement and to prescribe load to increase muscle strength.

So what do we do with this information? An example includes: Increasing quadriceps strength (and the ratio between quads and hamstrings) in patients who have high breaking forces. This is important in running and landing based movements. But it is also important in patients who suffer from conditions such as hip/knee arthritis or anterior knee pain where there is a high amount of load applied to the joint.

An additional benefit of 3D gait analysis technology is the ability to test a patient at baseline or the commencement of treatment and then re-test them after the initial treatment phase. This allows us to monitor how you progress overtime and ensures that we are achieving the functional outcomes with treatment that were intended.