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July 10, 2025
What is an Ankle Foot Orthotic (AFO)?
An ankle foot orthotic (AFO) is a medical-grade brace that supports the foot and ankle. It often extends partway up the calf. Unlike regular foot orthotics—which fit inside shoes to support the arch and heel. AFOs offer external stabilization of both the foot and ankle joints.
AFOs are commonly made of lightweight plastic or carbon fiber and may be custom-made or prefabricated. They assist walking, correct alignment, reduce pain, and help prevent further injury.
Who Needs an AFO?
Image from https://braceworks.ca/ and the Washington Post
AFO's received mainstream attention a few years ago when NFL quarterback Alex Smith returned to the football field after a catastrophic leg injury. The key to his return: an ankle foot orthotic. Due to a post-surgical infection, the nerve that helps flex the right foot was severed. This meant he couldn't lift his foot. So he got an AFO to help and made a brief comeback (with the help of an extensive rehab team).
So who exactly needs an AFO? Since AFOs are heftier than regular orthotics, they're typically recommended for patients with more complex conditions than those addressed by traditional foot orthotics. You might benefit from an AFO brace if you have:
Foot drop (difficulty lifting the front of the foot)
Cerebral palsy or neuromuscular disorders
Stroke-related gait issues
Multiple sclerosis (MS)
Post-surgical ankle instability
Tendon or ligament injuries
Severe arthritis affecting ankle mechanics
Ankle foot orthotics are most commonly indicated for neuromuscular disorders and foot drop.
AFOs v Regular Orthotics: What's the Difference?
FeatureRegular OrthoticsAnkle Foot Orthotics (AFOs)ScopeFoot support onlyFoot and ankle supportPlacementInside the shoe (underneath the foot)Worn underneath and around the foot, and around the ankleConditions TreatedArch pain, plantar fasciitis, overpronation, high arches, other biomechanical irregularitiesNeurological and structural gait disorders, severe instabilityCustomizationOften custom-fit or prefabOften custom-molded to leg shapeMobility SupportModerateHigh—can aid in walking and balance
While regular orthotics focus on redistributing pressure and correcting foot mechanics inside the shoe, AFOs provide external control for more complex biomechanical or neurological issues. Think of it as the difference between cushioning a sore spot and physically guiding your limb’s motion.
How Are AFOs Made and Fitted?
https://www.youtube.com/watch?v=nA_QklH7AWY
AFOs are usually prescribed by a foot specialist or chiropodist after a full assessment. The process may include:
Biomechanical Assessment
Gait analysis
Casting or 3D scanning
Custom fabrication
Fitting and adjustments
Some patients may only need short-term use post-injury or surgery, while others may rely on AFOs for long-term mobility support.
Final Thoughts
If you’ve been told you need more than just arch support or if your walking pattern has changed due to injury or illness, an ankle foot orthotic could be a game-changer. At our clinic, we assess your full biomechanics and work with you to find the right support—whether that’s a custom orthotic, AFO, or a combination of both.
March 6, 2023
Our gait, or the way we walk, is like our blueprint. It's unique to every individual. But there are commonalities.
Gait reveals a lot about us: gait tells us how we distribute our weight when we walk, the parts of our feet which may experience too much or too little pressure, and areas of compensation. These features factor into our biomechanics – the mechanics of our body's movement.
In this article, we'll talk about how a simple biomechanical analysis can help you say goodbye to foot and ankle pain and improve your foot and ankle function.
What's a biomechanical analysis?
Biomechanical analysis is a helpful tool for identifying and improving foot and ankle function. Biomechanical analysis can explain factors contributing to foot and ankle injuries or dysfunction, and develop interventions to improve function and reduce the risk of injury.
A biomechanical analysis also determines our gait and foot type. You may overpronate or supinate, which refers to how far inwards or outwards your ankle rolls when moving. An analysis can also provide details on your foot type: you may have high, medium, or low arches (flat feet).
There are three components to a typical biomechanical analysis.
Range of motion assessment: A chiropodist examines your range of motion in the major joints of the foot, ankle, hip and knee. They will check how everything in your body is aligned and the symmetry between your body's left and right sides. Generally, a higher range of motion is more ideal as it permits muscles and joints work together in unison equally.
Weight-bearing assessment: A chiropodist investigates how your muscles and joints distribute weight through different movements.
Gait analysis: A chiropodist carefully examines your gait to see how your feet, joints and muscles move when you walk. They will also examine how you distribute your body weight during each stage of your walking motion. Video analysis may be part of the gait analysis. Video gait analysis equipment records you from different angles while you walk on a treadmill and allows for slow-motion replays to pinpoint exact flaws or trends in your movement.
Once a biomechanical assessment is complete, a chiropodist can provide a treatment and prevention plan.
How do poor mechanics lead to foot conditions?
Abnormalities in your gait can lead to several foot and skin conditions due to uneven weight distribution. Over- or under-pronating (supination) creates a chain reaction in your feet and ankles every time you step by disrupting the proper distribution of weight and impact across your joints and muscles. Over time, specific muscle groups are over (or under) worked, which can cause irritation and, ultimately, pain and discomfort.
Common foot and ankle conditions that may stem from poor mechanics include:
Bone and heel spurs
Blisters
Bunions
Achilles tendonitis
Plantar fasciitis
Metatarsalgia
Morton's neuroma
Capsulitis
How can a biomechanical analysis help your feet and ankles?
Once a biomechanical analysis is complete, clinicians and researchers can use the information to develop interventions to improve foot and ankle function. Improvements may include:
Exercises to strengthen weak muscles
Stretching to improve flexibility.
Custom foot orthotics or footwear modifications to improve foot alignment. Orthotics are custom shoe inserts specific to your feet. Orthotics aim to correct or accommodate biomechanical abnormalities, foot deformities, and a variety of joint and muscle conditions (i.e., arthritis) to improve your gait and manage pain. They do this by redistributing the force and pressure placed on our muscles and joints when we move.
Overall, biomechanical analysis can be a valuable tool for improving foot and ankle function, thereby reducing the risk of injury. By identifying factors contributing to foot and ankle problems and developing targeted interventions, clinicians and researchers can help individuals maintain healthy, pain-free feet and ankles.
Who can benefit from a biomechanical analysis?
Many people can benefit from a biomechanical analysis to better understand their feet and how they move. A biomechanical analysis can be helpful for those looking to improve their physical performance or function, whether for sports, work, or everyday activities. In addition, those who spend a lot of time on their feet, patients with physical disabilities, and anyone who experiences foot and ankle pain can benefit from a biomechanical assessment.
September 25, 2020
Does your ankle crack or pop when you rotate it? You're not alone. Ankle cracking and ankle popping are quite common, and there's no immediate need to worry.
In fact, joint popping has a medical term. Crepitus is abnormal popping or crackling of a joint, which may be sometimes uncomfortable or painful. There are two variations to crepitus:
Bone crepitus: When two fragments of a fracture are moved against each other.
Joint crepitus: When the affected joint is passively moved with one hand, while the other hand is placed on the joint to feel the crepitus.
Why Does My Ankle Crack Every Time I Rotate It?
Ankle cracking or ankle popping can occur for two primary reasons
Tendons rubbing over a bone
Gas being released from the joint
A snapping sound in the ankle is most commonly caused by the tendon slipping over the bone. As you rotate your ankle, this triggers the snapping or clicking sound. Alternatively, an ankle may crack when rotated because as a force is exerted on the joint, bubbles of nitrogen in the synovial fluid burst. This can happen after long periods of sedentary, or if your muscles are tight.
Peroneal Subluxation / Dislocation
Ankle cracking and ankle popping may be due to the peroneal tendon rubbing over the joint. The peroneal tendons help support and stabilize the foot and ankle, and protects your lower leg from sprains. One peroneal tendon attaches to the outer part of the midfoot, while the other tendon runs under the foot and attaches near the inside of the arch. If either tendon is damaged, or slips out of place due to injury, it can rub on the bone cause cracking and popping. This cause is relatively uncommon, and seen mostly in athletes who severely sprain their ankles.
As you may know, cracking and popping is not exclusive to your ankles. In fact, many parts of your body can be 'cracked' in the traditional sense. Have you ever heard of the expression, "cracking your knuckles?" Understandably, knuckles, your hallux (toes), and neck joints can be easily cracked with minimal effort.
Is It Bad That My Ankles Crack?
A common claim to cracking your joints is that it causes arthritis. However, this argument is not backed by evidence. One study on joint cracking concludes that, "the evidence for the association of knuckle cracking and osteoarthritis comes mainly from observational studies that have failed to show an association."
The truth of the matter is that ankle popping or cracking is not necessarily a bad thing. However, if when your ankle cracks, pain and swelling occur, then you should seek advice from a medical professional. As Healthline recommends, strengthening your ankles with Ankle Exercises can help prevent injuries, like ankle sprains. Ankle exercise can also help strengthen the muscles and tendons that help stabilize your lower leg.
How Do You Get Rid of Cracks In Your Ankles?
Cracks in your ankle are typically not a cause for concern. If you're annoyed by the cracks, clicks, or pops, then there are some DIY treatment methods aimed at strengthening your ankles.
Ankle Exercises
Perform these ankle exercises to heklp prevent ankle popping or cracking:
Ankle circles
Calf raises
Single-legged balance
Draw the alphabet
Doing these in the morning will help loosen up your ankle and prevent stiffness, especially shortly after waking up. Incorporate these ankle exercises with the other Morning Foot Exercises you perform to start off your day.
Custom Foot Orthotics
If you have chronic ankle pain, Custom Foot Orthotics may be just what's needed. Orthotics are custom-built corrective shoe inserts that provide personalized support for your lower legs. These devices work to correct faulty foot mechanics and redistribute pressures along the bottom aspects of the foot.
As always, if you have any questions about or concerns with your feet, please don't hesitate to reach out to speak with one of our Licensed Chiropodists.
Is it OK to Crack Your Toes?
One of the most common joints in your body to crack is your hallux, the medical term for a person's big toe.
According to WebMD, "as a rule, painless cracking of joints is not harmful." But, if it's painful or if there is signs of discomfort, then there may be a greater underlying problem.
Your Leg Solutions Live Here!
Does your ankle bother you? Our team is trained to handle any and all your foot health concerns. From mild, to critical, we cover all aspects of the foot. Call us to ask about actionable steps towards your solution today.
Call us at 416-769-3338 or Book Your Assessment Today!
August 17, 2020
Did you know that of all major joints, the ankle is the most commonly injured? In fact, there are a variety of conditions that affect the ankle. Here are the 4 Most Common Ankle Injuries.
Ankle Sprain
Sprains rank number one among the most common ankle injuries. There are three primary forms of ankle sprains: inversion, eversion and high. Ankle Sprains occur when the ligaments overstretch and damage. Generally, sprains take 2-3 weeks to recover from, but you can continue to walk and be mobile if you have your ankle taped, and secured. Though ankle sprains are a very common sports injury, they can happen to anyone.
Inversion
An inversion sprain occurs when your ankle twists inwards.
Ankle rolls inwards
Most common form of ankle sprain
Eversion
An eversion sprain occurs when your ankle twists outwards. Eversion sprains impact the deltoid and medial ligaments of your ankle. Eversion sprains aren't as common as inversion sprains because of the ligaments' strength.
Ankle rolls outwards
Less common than inversion sprains
Accounts for 10-20% of sprains
High Ankle
A high angle sprain occurs when the foot twists outward due to the force. Here, we get a sprain of the syndesmotic ligaments which connect the tibia and fibula (shin bones).
Affects the high ankle
More common in sports (football, basketball, soccer) than in everyday life
To help prevent sprains, follow these Ankle Strengthening Exercises. Additionally, a Better Shoe Can Prevent Ankle Sprains. You'll want shoes with a good fit, strong treads, and orthotic inserts if necessary. We carry a full line of footwear in the clinic including Leading Shoe Brands that you can choose from.
Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome is a common foot condition that affects the ankle. It's a result of a damaged posterior tibial nerve, and is considered the ankle's version of carpal tunnel syndrome. Tarsal tunnel syndrome is the most common nerve entrapment of the ankle. The tarsal tunnel is a narrow space on the inside of the ankle next to the ankle bones. The tunnel is covered with a thick ligament that helps contain its inner workings – veins, arteries, tendons, and nerves. Notably, the tibial nerve runs through the tarsal tunnel.
Tarsal tunnel syndrome occurs when the tarsal tunnel compresses. Imagine you squeeze a casing of wires. The more pressure you exert, the more you put onto the fillings inside. In this case, these are the nerves, arteries, and tendons inside. Symptoms include sharp, shooting pain, pins and needles, or a burning sensation on the inside of your foot, close to where your foot meets your ankle. Some say that pain can be severe enough to cause a person to limp, and individuals may describe a Radiating Pain that cannot be localized to one spot.
Achilles Tendonitis
The Achilles is the longest tendon in the body, and can withhold extreme amounts of stress. The tendon connects the calf to the heel bone, and can become inflammed over time if overused. If this occurs, the injury is known as Achilles tendonitis. The most common symptom of Achilles Tendonitis is a mild ache or pain in the back of the lower-leg or above the heel, especially first thing in the morning and after exercise. The tendon can also be warm, swollen and irritated with certain ankle movements. This can cause pain in and around the ankle as well, as other joints and muscles attempt to compensate for the damage to the Achilles.
The following can cause Achilles tendonitis:
lack of conditioning in your lower leg muscles
excess strain on the Achilles tendon
bone spurs in the heel rub on the Achilles tendon
untreated flat feet lead to stress on the posterior tibial tendon
To treat, and prevent Achilles tendonitis, you can:
Strengthen and stretch your Achilles
Rest, or decrease activity
Invest in Custom Orthotics
Use Over-the-counter Insoles
Dorsal Spurs
A Bone Spur is a benign growth and occurs on all parts of the body including on the heel, ankle, and toes. Specific to the ankle area, a Dorsal Spur is a bone growth at the insertion of the Achilles tendon. Bone spurs develop as your body's response to trauma in the area. The body's defense mechanism begins to grow bone to help protect the area against further damage. So, as these deposits build up, there is less area for your body to move freely, which can cause seperate issues due to the underlying bone spur.
There are two sides to this: one is that the injury is quite common. Two is that although bone spurs are common, only 5% of people with a bone spur feel pain.
Dorsal spurs occur because:
Straining foot muscles and ligaments
Over-stretching the plantar fascia
Repeated tearing of the thin lining of the heel bone
Generally, you should not worry about dorsal spurs. But if you do suspect a dorsal spur, or any sort of other ankle pain over more than a short period of time, consult a foot expert for next steps.
Questions About Your Ankle(s)? We Can Help!
Do you have an ankle injury? We’re confident in our ability to help inform you and solve all types of common ankle injuries with the least amount of discomfort as possible. Don't hesitate: Call us to ask about a quick question and we’d be happy to point you in the right direction!
Call us at 416-769-3338 or Book Your Assessment Today!
September 4, 2019
Trail running? More like extreme running.
Trail runners run for hours on end pushing their body to the limit. They endure brutal terrain, harsh conditions, and they put their feet through the wringer.
When running at such extremes, it’s no wonder that injuries are common.
Below are six of the most common trail running injuries, and what you can do to prevent and treat each of the pains. These injuries are not exclusively for trail runners, but are common because of the nature of the sport leaving the average runner more susceptible to these ailments.
Metatarsalgia
Metatarsal pain is discomfort in the small bones within the ball of your foot. Metatarsalgia can start off as a small bruise, and slight discomfort, but can quickly escalate into a serious injury like a metatarsal fracture. It can occur due to narrow footwear or running shoes being tied improperly. It can also occur with excessive forefoot running, meaning when extra pressure is placed on the front of the foot when running.
Fortunately, most trail running shoes these days are built with a rock plate, a rigid piece of plastic within the midsole. The rock plate offers protection against sharp edges on the trail and is essential when running on more technical terrain when facing rocks, roots, and uneven surfaces.
Alternative forms of prevention and treatment include using a metatarsal pad, icing the affected area, and self-massage by rolling your foot over a ball. You can also try doing the towel-gripping exercise below. When in doubt, and you’re not sure whether the injury is serious, take an extra day or two off of running as a precautionary measure and cross-train in the pool or on the bike instead.
Achilles tendonitis
Trail running consists of a lot of ups and downs.
The undulating terrain is a lot different than say, road running. Constantly climbing and descending can add pressure on parts of your body like your Achilles tendon. When climbing or descending, stress is disproportionally allocated to your lower legs compared to running on flat land.
Achilles tendinitis can be a sharp or dull pain in the back of the heel and can extend into your lower calf. Because the Achilles is such an essential part of your running economy, addressing the symptoms early is important to prevent the tendinitis to be long-lasting.
When trail running, make sure to ease your way into it, and do not increase mileage too quickly. Doing a proper warm-up with calf raises and some stabilizing exercises can help prevent tendinitis and eliminates the period at the beginning of a run when you're running on stiff legs. It's also important to stretch your calves before and after a run - see the video demonstration below to see how. Cold muscles don’t fire properly, and they can lead to overcompensation, with that domino effect reaching your Achilles heel. If you have a history of Achilles tendonitis or ankle sprain/strains, then you may even want to also stretch mid-run as well to keep your calves loose - tight calves are a major contributing factor to developing Achilles' tendonitis.
Ankle Sprains
An ankle sprain is one of the most common trail running injuries. Because of the rugged terrain and unexpected obstacles that many trails present, all it takes is one wrong step to roll an ankle. When you sprain an ankle, you essentially over-stretch the ligaments or tear them in more serious cases, beyond their maximum. Immediate signs include swelling around the top of your foot or sides of the ankle, and tenderness.
To lessen the lasting impacts of an ankle sprain, follow the PEACE (Protect, Elevate, Avoid anti-inflammatories, and Ice) & LOVE (Load, Optimism, Vascularization and Exercise) protocol. This reduces swelling, and the pain to subside. Before resuming your running, it's best to get your ankle evaluated by professional to avoid aggravating the injury.
It's always good to do a proper warmup before trail running, and you can help prevent ankle sprains by working on mobility. Other ways of avoiding ankle sprains include planning your route ahead of time to account for mud and trail conditions, taking routes within your ability, and allowing adequate space between you and other runners as to not block your eyesight.
If you still experience pain after extended rest, or the pain is extreme immediately, contact a healthcare professional to rule out more serious injuries like a tear or rupture.
Blisters
Thanks to being out on the trains for hours on end, blisters are another common trail running foot injury.
Blisters can start small, like a hotspot somewhere on your foot, and get progressively worse if you don't address the chafing. Investing in proper running socks, and using some sort of anti-chafe cream like Vaseline can help prevent blisters in the first place. It's also important to make sure that your shoes and socks fit properly, as ill-fitting shoes and socks are a leading cause of blisters.
Another potential cause of blisters is worn-out footwear. Blistering around a pressure point on the foot is one of the first signs that your shoes need to be replaced.
If you feel a blister in the early stages, cover it with a band-aid or better yet, use medical paper tape.
In fact, as published in a recent study, it’s reported "that inexpensive paper tape, the kind available at most drugstores, when applied to blister-prone areas prior to exercise, successfully reduced the incidence of foot blisters in those areas. The tape commonly known as surgical tape is used for wound treatment. It is only mildly adhesive — an advantage because it doesn’t tear the blisters if they do occur.” Sometimes the simplest measure can be the most effective.
ITB Syndrome
Iliotibial band (IT) syndrome (ITB syndrome) is one of the most frustrating and common trail running injuries.
ITB syndrome can be described as an overuse injury of the connective tissues that are located on the outer thigh and knee.
Thanks to the repeated climbs and descents of trail running, your IT band is exposed to more impact. Additionally, the IT band is stressed the most at certain flexion angles, like when ascending, while your knees and IT band take additional stress when descending.
A warm-up with clamshells and stretching out your hip flexors pre-run can help with the pain and tightness. What you want to do here is activate and work the hip abductors, as muscle imbalances and weakness can be the source of the problem.
Another great option are heel lifts: Heel lifts provide near-instant relief for ITB syndrome as it limits stress on the knee. If you do try heel lifts, make sure you use them in conjunction with strengthening exercises for the hips and gluteal muscles to address the root cause of the ITB syndrome (i.e.: gait issues, running technique, hip misalignment, knee strain, etc.).
You don’t necessarily need complete rest from running, but you will need pain management and mileage reduction, if necessary. Investing in a proper foam roller and routinely working the band will help alleviate pain - just make sure that you don't roll over the actual IT band: New studies show that, instead, you want to foam-roll the gluteal and quadricep muscles, which are adjacent to the IT band. Stretching our your hip flexors can also help release your IT band.
Plantar Fasciitis
This pesky injury arises when you experience pain and inflammation within the tissue on the underside of your feet that connect your heel and toes. The pain can be anywhere from your heel to the ball of your feet and can be sharp or dull.
We recently wrote more about plantar fasciitis, remedies, and prevention methods on our blog, which you can read here.
May 29, 2018
Earlier this month, we began discussing the joys of summer walking in our fair city of Toronto. We spent so much time exploring debilitating foot conditions – such as Toenail Fungus – that we lost track of time and were only able to cover the Rosedale Ravine and High Park. We're lucky enough to live in a city within a park; might as well take advantage! These are some of the best places to walk in Toronto.
Being based in the west end of the city, we're pretty savvy concerning the walking paths out this way. In the previous edition, we discussed High Park and its seemingly infinite number of paths. Today we're going to talk about a walk that consists of one path and one path only: the West Toronto Rail Path.
West Toronto Rail Path
This revitalized, post-industrial hipster's paradise is a super fun – if somewhat short – stroll. It runs from Dundas pretty well up to Dupont and is well suited to dog walkers, cyclists and tourists alike. Businesses like Henderson's Brewery and the Drake Commissary make for great stops along the way, and the MOCA (Museum of Contemporary Art) is slated to open a space to the public in a huge building that sits along the path. Additionally, the mixture of industrial scenery and green art projects makes for a pretty neat contrast that your whole family will appreciate! Wearing supportive footwear can help prevent foot fatigue, blisters, and long term issues like plantar fasciitis, especially on longer walks. So strap on your walking shoes (preferably a pair with good arch support), and hit the rail path!
The Beaches Boardwalk
Just because our Toronto foot clinic is tucked away in the west end of the city, doesn't mean we don't occasionally venture over to the east end of the city for some of the best places to walk in Toronto. In fact, walking the Queen Street Strip just north of the beaches, it's hard not to think of this area as the sister strip to Bloor West Village with all the friendly folks and cute boutiques and cafés. If you've never taken the time to walk along the Beaches Boardwalk on a sunny day, you are truly missing out. It feels more like the ocean than Lake Ontario, you can grab some ice cream at Beaches and Cream and walk out onto the Ashbridges Peninsula to catch the sunset!
Trillium Park
This brand new park owned by the province of Ontario is right on the waterfront, just south of exhibition place. There's a fire pit, cycling and walking paths, lots of hills to gaze out on the lake or the skyline and, best of all, a public fire pit to warm you up on those chilly nights making it one of the best places to walk in Toronto. The park offers little shade for now, but the city's planted over a thousand trees that will transform the space in coming years! So grab your bike or a pair of Saucony's outfitted with custom orthotics and the heel-toe express for a ride through Trillium!
As of 2025, only the east end of the island is open due to ongoing construction, but it's still well worth the trip for the exercise, views, and fresh air!
We Can Help!
If you are suffering from an issue that requires the care of a foot specialist, contact us immediately and book a consultation; we'll get you fix up and ready to take a stroll. If you're looking for a corn removal specialist in Toronto or the GTA, for example, look no further: Feet First Clinic will get the job done with flying colours, at an affordable rate! Call us at 416-769-3338 or Click Above to Book Your Assessment Today!
