Patient Education

Custom Orthotic Devices

Description

You know you can get prescriptions for eyeglasses, high cholesterol, and allergies, but you may not be aware that you can get prescriptions for shoe inserts as well. These specially crafted devices, commonly known as orthotics or orthoses, are designed specifically for your foot, and are created to correct for problems in the way you walk, the way your foot is shaped, or provide additional support for weak areas of your feet. They may also be used to accommodate areas of your foot that are unusually prominent.

Basically, orthotics affect the way your foot interacts with the ground when you walk (or stand or do jumping jacks), making being on your feet much more comfortable. When you have foot problems, your podiatrist may use orthotics as a more conservative alternative to surgery. In many cases (although by no means all), they can help eliminate pain and discomfort while you walk, making it possible for you to forgo surgical treatment entirely. Orthotics generally work best when paired with other treatments, such as physical therapy and medication.

When you go in to see your podiatrist about a foot problem, and he or she suggests orthotics as a possible treatment method, you’ll probably have to have a model made of your foot in order for the orthotics to be suited to your specific needs. If time travel were possible, some famous sculptor like Michelangelo might be hired to create an exact replica of your foot. Unfortunately, scientists have not yet made time travel possible, (It’s time to get on that, scientists!), so your podiatrist will likely make a model of your foot using other methods. One such method (and possibly the coolest) is scanning your foot using an optical or mechanical scanner. The information is input into a computer, which constructs a 3D model of your foot digitally. Alternatively, your podiatrist may opt for the slightly less techy but still effective foam method: basically, you step into a box full of foam, which then takes on the shape of your foot. Your foot may also be modeled using the application of plaster (kind of like those art projects you did in elementary school, but in, let’s face it, a rather more useful form).

Accommodative or Soft Orthotics

Orthotics generally come in two different varieties: accommodative (aka “soft orthotics”) and functional (aka “rigid orthotics”). Accommodative orthotics are generally constructed of more flexible material, such as foam, leather, cork, or rubber (marshmallows, although soft, are generally not durable enough to work well in orthotics). As the name suggests, accommodative orthotics are there to accommodate your feet: they help relieve pressure on painful or prominent spots, absorb some of the force of the steps you take, and in general make things nice, soft and cushiony. They’re used a lot for diabetic (or other) patients who have developed painful ulcers on their feet, calluses, or those who are arthritic or who have serious foot deformities.

Soft orthotics tend to be fairly easy to break in, since the materials from which they’re made form themselves readily to your foot shape. Unfortunately, that same flexibility also makes them wear out rather quickly, so they may need more frequent replacement than rigid orthotics. They also tend to be a bit more bulky than rigid orthotics, so you may not be able to wear them with all shoe types.

Functional or Rigid Orthotics

Functional orthotics tend to be made of less flexible materials, such as rigid or semi-rigid plastics, or even graphite. (Surprise! It’s not just for pencils and golf clubs!) They’re designed to help improve the operation of the foot by correcting for irregular foot function, and may also be used to treat problems with other parts of your personal walking mechanism, such as your ankles, legs, knees and hips. Functional orthotics may also be used in the same way as accommodative orthotics: providing accommodation for painful parts of the foot.

Rigid orthotics tend to be, no surprise, rigid in nature, so getting used to wearing them may be a bit more difficult than with the soft variety. However, once you’re used to them, they tend to be a lot more durable, requiring fewer replacements or adjustments than their cushier cousins. They also tend to be on the thin side, so slipping them into a wide variety of shoes shouldn’t be too difficult.

Orthotics for Children and Athletes

Using specializes shoe inserts can be of particular benefit to children, whose feet may need to be corrected early on, and athletes, who may have special needs for those spectacular athletic moves.

Children with foot deformities may need to use orthotics in order to get as much foot function as possible as they grow. Generally, when a foot deformity is recognized (often flat feet or toes that abnormally point inward or outward), orthotics should be introduced pretty soon after the child begins toddling around (and getting into pots and pans and in general making a great deal of mischief). The child should be fitted for new orthotics when he or she has grown two shoe sizes (which may seem to occur about once a week during growth spurts).

In general, athletes tend to work best with semi-rigid orthotics. These provide both cushioning and structural support for the athletic foot, allowing it to move without pain according to the demands of the athlete’s particular sport.