Podiatry and Biomechanics: The “Game Changer” in Pain Prevention

Our Medical Director, Jorge Orduña, tells us today in his podcast Pirates of Pain how biomechanics has become a key factor in preventing minor aches and pains from turning into disabling chronic pain. In this episode, Dr. Orduña welcomes back Elena Francisco, a specialist in podiatry and physiotherapy, to delve into how the analysis of the footprint and the choice of footwear can radically change the evolution of common pathologies such as plantar fasciitis or Morton’s neuroma.

Morton’s Neuroma and Fasciitis: Beyond Surgery

One of the key points of the talk is the approach to Morton’s neuroma, a stabbing pain in the forefoot that often ends up in the operating room prematurely. Elena explains that, in many cases, this problem is a defensive response of the body to excessive pressure or poor load management. Before surgery, biomechanics offers solutions to restore natural space to the bones of the foot, allowing the nerve to stop being compressed. The same is true for plantar fasciitis, which is often the “cry for help” of a fatigued structure because the rest of the leg musculature is not fulfilling its stabilizing function.

Barefoot” footwear and the myth of the ideal shoe

Is there such a thing as the perfect shoe? For Elena Francisco, the ideal shoe is the one that least interferes with the natural movement of the foot. She analyzes the trend of respectful or “barefoot” footwear (which seeks to simulate going barefoot) and its compatibility with customized insoles. The key is not to buy the most expensive shoe on the market, but to perform a dynamic analysis to determine what each specific foot needs. For athletes, especially runners, this analysis is vital to push back their physical limits and reduce the risk of overuse injuries.

The connection between the foot and the spine: Hernias and dysmetrias

Dr. Orduña and Elena analyze striking cases where the origin of low back pain or recurrent disc herniation was not in the back, but in an undiagnosed dysmetry (difference in leg length). An imbalance of just a few millimeters at the base can generate excessive friction in the vertebral discs or the hip. Early detection of these factors makes it possible to treat the mechanical cause of the problem, in many cases avoiding second surgeries or spinal fixations with screws.

Interdisciplinarity: The patient in the center

The conversation underscores an urgent need in the healthcare system: real communication between professionals. A patient should not “wander” from one doctor to another; the pain specialist, the physiotherapist and the podiatrist must work in unison. Elena stresses that often a pain is so intense that it prevents a correct biomechanical analysis, so the first step should be the control of the symptom by the pain doctor in order to subsequently correct the mechanics that caused it.

Entrepreneurship in health: Ethics and education

In closing, Elena Francisco shares her experience of 16 years at the head of her clinics, stressing that professional success comes from hyperspecialization and the humility to refer the patient when the problem is not within their competence. She encourages future podiatrists to train deeply in biomechanics, a growing field that not only treats those who already suffer, but also optimizes the health of those who want to age with mobility and without pain.

Taking care of the foundation of our body is ultimately taking care of the whole building. If your aches and pains don’t go away with medication, the answer may lie in the way your feet interact with the world.