How's your wheel alignment?

If our tyres were wearing unevenly again and again, wouldn’t we be looking for an alignment problem?

Have you ever noticed that one foot seems flatter than the other?

When you see a heath professional for back pain, do they remark how your ‘pelvis is rotated’ or ‘out’?

Does the treatment only give short term relief before the pain is back again?

Sometimes, the answer to these questions, (except for the wear on your car’s tyresJ) is that you have a difference in leg length or your the alignment of your pelvis is abnormal.

Maybe you've had an injury which has resulted in one leg bone being shorter than the other. Alternatively, if the pelvic misalignment is more than mild, it may be caused by a structural back condition called scolosis.  With total hip and knee replacements the outcome is often a shortening of one leg. This can be significant when combined with how your body adapted before the surgery and how it then adapts again after surgery.

We all have slight differences in the length of our structures. Most people have one foot bigger than the other, but if the difference is more than the body can easily compensate for, it can cause changes in how the body works as a whole. These changes lead to adaptations in your body, resulting in high forces being generated on tissues which become inflammed and painful.

How can you know?

Health professionals working in back care have great skill in analysing the dysfunction in your back at the time of treatment. Some will also take an X-Ray to assess joint structure and alignment to gain a better understanding, especially if your concern is long standing.

But if the condition seems to always reoccur, then there is often something else involved. It may be that the muscles in your ‘core’ are not strong enough, your bed is very poor and lacks proper support or be due to something you do repeatedly, such as standing or walking. If the pelvis is misaligned or you have a diffence in leg length, each step is going to place a little more pressure on one side than the other, forcing the joints and muscles to compensate, 4,000 times a day for each leg!

At Total Care Podiatry, we analyse these misalignments after you have seen your back health professional to make sure you are as straight as possible.

We then measure any misalignments with:


  • Plantar Pressure analysis to measure the amount and timing of pressure underneath your feet in walking and standing. We use our pressure plate to note asymmetry between the pressure on one side to the pressure on the other. We then use different heel lifts to see what side and what height give you the most balanced position. While this will improve your balance it doesn’t explain why it’s happened. If the difference is in the length of your bones an X-Ray will show the amount of difference. If it is not a difference in bone length, we need to measure further.

Pelvic Assessment.JPG

  • A digital pelvic inclinometer (DPI). This eqiupment has only been available in Austraila since early 2015 and has been shown by research to be very accurate. Using the DPI we can better understand why the differnce is there and how much is from your pelvis, leg and foot and the compensations and adaptations that have occurred over time.
  • Treadmill analysis. To see how your body functions with the correction of a heel lift, we have you comfortably walking on our state of the art treadmill,(that has an inbuilt plantar pressure plate). This allows us to examine how your pelvis functions dynamically. We also note symmetry in your stride, and as your body moves up and down with each step, by assessing the differences using the plantar pressure data.

Making sure we have it right

The body's mechanics are sometimes tricky, so after the heel lift height is decided we ask you to wear it (at all times in all footwear) for 7-10 days and journal the effect and report in if there are any concerns. We then review your progress after 2-3 weeks and discuss the best way of implementing the heel lift so you can wear it in all of your footwear.

We also advise your back health professional on our treatment and ask them to monitor it at your next treatments. Working closely with them, we aim to give you the very best chance of having a long lasting solution to greater mobilty.

WARNING: This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.