TCS devices are worn in the shoe to change the way the foot functions. Rather than pushing up under the arch the way a traditional arch support does, they are designed to control the position of the heel bone and the subtalar joint, the joint just below the ankle that lets the heel tilt in and out. Dr. Marzano uses them for patients whose foot pain is tied to how the foot moves when they stand and walk.
The heel bone, or calcaneus, sits directly under the leg and takes the first impact of every step. From there, weight passes forward through the arch to the ball of the foot and the toes. As the foot meets the ground it normally rolls inward a little, a motion called pronation, which helps absorb shock.
When that inward roll is excessive or poorly controlled, the arch can flatten more than it should, and soft tissues on the bottom of the foot, such as the plantar fascia, are strained with every step. Our guide to foot anatomy explains how the heel, arch and forefoot fit together.
As Dr. Marzano explains it, TCS devices gently reposition the heel bone underneath the leg. When the heel sits in the right position, the other bones of the foot settle into stable positions around it, and the foot can act as a firm lever that pushes the body forward when you walk, instead of collapsing inward.
That is why he is careful to distinguish them from traditional arch supports. An arch support works from underneath the arch; a TCS device works at the heel, where, in his view, the alignment of the rest of the foot is set.
Dr. Marzano may recommend TCS devices when faulty foot mechanics seem to be contributing to pain, for example:
With plantar fasciitis in particular, he uses them to help protect the healing fascia over the long term by limiting harmful inward rolling of the foot as you walk. Because foot mechanics differ from person to person, TCS devices are recommended after an evaluation, not as a one-size-fits-all product.
Before recommending TCS devices, Dr. Marzano evaluates your foot structure, alignment and the way you walk. They are designed to fit most athletic, walking, dress and work shoes, and with proper care they typically last several years, with periodic check-ins to make sure they are still working as intended.
They are often one part of a broader plan. Depending on the problem, Dr. Marzano may combine them with other treatments, such as MLS laser therapy or, for heel pain that has not settled, shockwave therapy.
Foot or heel pain that lasts more than a few weeks, keeps coming back, or changes the way you walk deserves an evaluation. Seek prompt care after a significant injury, if you cannot put weight on the foot, or if there is marked swelling, redness, warmth, numbness, tingling or fever.
People with diabetes, poor circulation or neuropathy should have new foot symptoms checked promptly, since reduced sensation can mask a developing problem. This article is educational and cannot determine the cause of an individual patient's pain.
Westchester Podiatric Medicine fits TCS devices in Scarsdale, New York, after a full evaluation of how your feet move. Learn more about TCS devices at our office and our plantar fasciitis treatment, or request an appointment.