imbalance, improve and encourage fluid exchange, reduce fibrous tissue, and mobilise and adjust joint positions. In conjunction, a suitable rehabilitation plan is necessary to restore full range of movement, muscular strength, balance and proprioception. The patient should perform weight-bearing closed-chain exercises while wearing foot orthoses in order to ensure that correct limb and pelvic alignment is maintained throughout. Emphasis should be placed on simple but specific exercises for restoring core and pelvic stability, eg. hard-surface single-leg balancing, progressing to a soft surface. If necessary, electrotherapy modalities can be used to assist in pain control and tissue repair.

References 1. Padiar N. Foot orthotics: their role in injury management. sportEX Medicine 2001;8:6–8 2. Razeghi M, Batt M. Foot type classification: a critical review of current methods. Journal of Gait and Posture 2002;15:282–291 3. Quinn G. Foot posture, biomechanics and orthotic selection workshop. Cheshire July 2007 4. Cornwall MW. Common pathomechanics of the foot. Journal of Athletic Therapy Today 2000;5:10–16

5. Root M, Orien WP, Weed JH. Clinical biomechanics. In: Normal and abnormal function of the foot. Clinical Biomechanics Corp. 1977. ISBN 6. Bolgla L, Keskula D. A biomechanical approach to evaluating and treating lower leg dysfunction. Journal of Athletic Therapy Today 2003;8:6–12 7. Vasyli lower limb biomechanics workshop: rear foot mechanics. Manchester, September 2005 8. Norris C. Sports injuries: diagnosis and management, 3rd edn. Butterworth Heinemann 2004. ISBN 0750652233 9. Fleet T, Edge D, Catterall K. Prevention of hamstring injuries in a professional football club: using a multidiscipline sports medicine team approach. sportEX Dynamics 2008;15:10–14 10. Zelle BA, Gruen GS, Brown S, George S. Sacroiliac joint dysfunction: evaluation

and management. Clinical Journal of Pain 2005;21:446–455 11. Prather H. Sacroiliac joint pain: practical management. Clinical Journal of Sports Medicine 2003;13:252–255 12. Dananberg JH. Gait style as an etiology to chronic postural pain: part 1. Journal of the American Podiatric Medical Association 1993;83:433–441 13. Dananberg JH. Gait style as an etiology to chronic postural pain: part 2. Journal of the American Podiatric Medical Association 1993;83:615–624 14. Dananberg JH, Guiliano M. Chronic low-back pain and its response to custom- made foot orthotics. Journal of the American Podiatric Medical Association 1999;89:109–117 15. Patel K, Patel S. Who owns low back pain? sportEX Dynamics 2007;13:19–22.

THE AUTHOR

Nick Dinsdale originally trained as a sports masseur and later qualified as an osteopath before completing a BSc (Hons) in sports therapy, gaining a first class degree. Over the years Nick has worked as team masseur to the GB and England

cycling teams, covering both domestic and overseas events. Nick has been a keen athlete, competing in running and cycling events at all levels, culminating in winning the national cyclo-cross series. Nick is a part-time tutor at the Northern Institute of Massage (NIM). Specialist workshops include: i) Electrotherapy, ii) Lower limb biomechanics and orthotic prescription. Nick is a visiting lecturer at Teesside University and has carried out consultancy work for the University of Central Lancashire.

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