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Orthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe orthotics that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotics are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription foot orthoses can since they are not custom made to fit an individual's unique foot structure.
Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.
Semi-rigid orthotics provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials. Semi-rigid orthotics are often prescribed for children to treat flatfoot and in-toeing or out-toeing disorders. These orthotics are also used to help athletes mitigate pain while they train and compete.
Frequently Asked Questions:
What is the difference between an over the counter insert and a custom molded orthotic?
An insert is usually over the counter and prefabricated. These can be compared to buying reading glasses at the store. Some people do well with OTC inserts like Powersteps and their condition improves. Custom orthotics are like getting prescription eye wear. The orthotics are used to treat a specific condition and corrections are made based on a biomechanical exam. A 3 dimensional picture is taken of the foot with a cast or a digital image and sent to a lab for fabrication and sent back to the office for dispensing to the patient.
How long do custom molded orthotics last?
Generally 3-5 years. Sometimes the top covers may need to be replaced if they become cracked or worn. For children it may be 1-2 years depending on growth.
How long do over the counter inserts last?
We recommend replacing over the counter inserts every 6-12 months.
What kind of shoes can I wear my orthotics in?
We recommend you wear the orthotics in the shoes you wear the most often and do the most activity in. Sneakers, mocassin and lace up style shoes work best. Several women's shoes now come with removable foot beds to accomodate orthotics. It is a good idea to bring in your shoes when you are getting casted and when the orthotics are dispensed. No orthotic will work in all shoes.
How often should I been seen after I get orthotics?
Initially, the patient is seen one month after the orthotics are dispensed then every one to two years for follow up. Occasionally orthotics may need to be adjusted after they are dispensed. Most often this can be done in the office.
Conditions treated with orthotics:
- Plantar Fasciitis or Heel Pain
- Hallux Limitus
- Posterior Tibial Tendonitis
- Peroneal Tendonitis
- High Arches
- Flat Feet
- Tarsal Tunnel
- After Surgery to Maintain a Correction or Prevent Future Problems
Recommended Break in Period for Orthotics
Like new eyes glasses or contacs, orthotics should be broken in gradually. After they are dispensed wear them for one hour the first day, two hours the next day, four hours the following day, increasing the time over the next 2 weeks until the orthotics can be worn comfortably for 8 hours. Avoid exercising in the orthotics until they are comfortable. If the orthotics squeak talcum powder can be added to the shoes with the orthotics.
What make a good orthotic?
- Orthotics work best when you know what you are treating, tarsal tunnel, posterior tibial tendonitis, hallux limitus etc. The orthotic should address the pathology not the activity. They are not a cure all and sometimes surgery is indicated.
- The patient is scanned or casted in neutral subtalar joint with the midtarsal joint locked and the first metatarsal phalangeal joint plantarflexed.
- The orthotic should control the rearfoot and conform to the arch.
- The material is appropriate for the patient's weight and age.
- The shoe is deep and wide enough to accomodate the orthotic and the orthotic is appopriate for the shoe.