Custom-Made Orthotics

orthotics

A Patient’s Guide to Foot Orthoses

A foot orthotics is an orthopaedic device that is designed to support, to absorb shock, to correct a deformity, to relieve pressure or to improve the function of the foot or of the whole body in conjunction with the lower extremity (the lower extremity includes the foot, ankle, leg, knee, thigh and hip). A prescription foot orthotics is more commonly known by the public as a “foot orthotic”.

One of the most common conditions that may require orthotic therapy is abnormal pronation of the foot.

Pronation is a natural foot motion that aids the body to absorb shock and adapt to terrain changes. Foot pronation is observed as the arch coming down and the foot splaying somewhat outward as the foot hits the ground. Abnormal pronation indicates the foot is pronating excessively or when it should not be. Over-pronation is, therefore, a concern because it can cause foot problems such as tendonitis and arthritis, as well as knee and back pain.

In all cases, the ultimate goal of orthotic therapy is to reduce pain and inflammation in the anatomical structures affected by the aforementioned complications.

There are two types of orthotics that can be prescribed depending on their pathology, accommodative and functional foot orthotics.

Both types are designed to reduce pain in the foot and lower extremity so that normal activities can be resumed pain free. However, accommodative and functional foot orthotics are generally made using different materials and may not look or feel the same. Both types of foot orthotics are nearly always prescribed as a pair to permit more natural function of both feet (this is similar to correcting both the left and right wheels of a car realigned in a front end alignment). They are fabricated from a three dimensional model of the foot which can be produced by either taking a plaster mold of the foot, stepping into a box of compressible foam, or scanning the foot with a mechanical or optical scanner.

Accommodative orthotics are designed to support and protect the feet that have deformities which cannot be corrected.

They may also be fabricated in an attempt to restrict irregular function of the foot. Since the primary objective of an accommodative orthotic is to alleviate pain and pressure rather than control motion, they are commonly more flexible and soft than functional foot orthotics. Some examples of foot pathologies that accommodative orthotics are indicated for include diabetic foot ulcerations, painful callouses (hard skin that develops due to excessive pressure), and aching bones on the bottom of the foot.

Where abnormal foot and lower extremity function exist, functional orthotics are used to correct them.

Foot complications such as toe joint pain, arch pain, ankle pain and heel pain are regularly remedied with functional foot orthotics. Moreover, these types of orthotics are not confined to the treatment of foot pathologies strictly. Since atypical foot function causes irregularities in leg, knee and hip function, functional foot orthotics are therefore also widely utilized in the treatment of knee and back pain. Unlike the accommodative variety, functional foot orthotics may be made of flexible, semi-rigid or rigid materials and can effortlessly fit into most shoes.

Therefore it is important to know your foot type, biomechanical and gait abnormalities in order to choose the correct foot orthotics to suit your needs and lifestyle. A foot specialist (chiropodist) who is regulated by the College Of Ontario will prescribe and perform an assessment to determine what type of orthotic is required to correct or accommodate an abnormal foot function.

Although, there is an abundance of over the counter orthotics, there is very little evidence to support their efficacy. To be optimally effective in the treatment of common foot pathologies a custom – made orthotic appropriately selected by a chiropodist will assure positive results.