Custom Foot Orthotics
Custom foot orthotics (orthoses) are specialized orthopedic devices designed to correct and treat various biomechanical foot disorders. They can be rigid or soft in design, depending on the unique requirements of the foot. Foot orthotics can prevent and alleviate many of the common foot complications that cause discomfort in otherwise healthy people.
You may need custom foot orthotics if:
- The bottoms of your feet hurt when you walk or run
- You have chronic heel, knee or lower back pain
- Your shins hurt
- You frequently sprain your ankle
- Your toes are not straight
- Your feet point inward or excessively outward when you walk
- One side of the sole of your shoe wears out faster than the other
Your feet should not hurt. Pain is the body’s way of warning you something is wrong. If you ignore your pain, the condition causing it could become worse.
We can assess your feet and recommend the best course of action. This may include a comprehensive Gait Analysis using MotionMetrix, Foot Mobilization Therapy (FMT) and Soft Tissue Release (STR). If you require foot orthotics, we can supply you with customized foot orthotics to alleviate your pain, and we always recommend foot and lower limb exercises to help achieve long-lasting results.
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How is a custom foot orthotic made?
Following assessment and diagnosis, we make a plaster cast of the patient’s foot. This is called a “negative impression.” This is usually done in a non-weight-bearing position to allow for accurate correction of the foot alignment without ground reaction force. The cast is sent to a certified laboratory with our prescription for recommended modifications. At the lab, a positive cast is made using state-of-the-art technology to achieve a mold which reflects the true corrected alignment of the foot. Using our recommendations for corrections, the lab technicians custom-mold an orthotic that incorporates the necessary adjustments. This will provide the patient with the support, stability, cushioning, and alignment necessary to keep the patient’s feet, ankles, and lower body comfortable, healthy, and pain-free.
How does an orthotic work?
To explain how orthotics function, it’s important to understand the mechanics of gait which is highly complex . With each step, the vertical axis of the heel ideally should land almost perpendicular to the ground, with a slight inclination of only a few degrees toward the outside of the heel. From there, the weight is distributed progressively toward the lateral (outside) side of the foot. As the little (or fifth) toe starts to touch the ground, the arch of the foot should flatten slightly, shifting the body’s weight toward the medial (inside) side of the foot. The heel should then start to lift off the ground, shifting the weight to the medial forefoot, principally the ball of the foot and the first toe joint.
This coordinated motion occurs in much less time that it takes to describe. It is, nevertheless, a complex process in which many things can go wrong. If a structural problem is present, the foot can for instance, collapse under the body’s weight. Runners in particular exert much greater forces on their feet than those generated by simple walking. This can lead to more severe injuries, such as sprained ankles, shin splints, and even fractures.
Over time, stresses on the feet can deform them. One of the foot’s main functions is to absorb shock as the body’s weight shifts with each step. It does this through a complex process in which the arch of the foot flattens slightly. This absorbs and distributes the weight throughout the entire foot.
There are two problems that can occur in this mechanism.
- The arch does not flatten appropriately. This typically occurs in a person with a high arch, called a “cavus foot.” Instead of absorbing and spreading shock throughout the entire foot, the weight of the body falls only on the heel and the bases of the toes. This increases stress on the foot, especially the heel. Furthermore, because the weight is not absorbed well in the foot, it radiates up the leg to other joints. Over time, this can cause pain in the knees, hips and lower back. To correct or improve this condition, foot orthotics may be required to help realign the foot and bring the ground into even contact with the rest of the foot. Sometimes manual foot mobilization therapy can be an effective way of improving joint range of motion in the feet, thus allowing for significantly improved foot function – sometimes negating the need for foot orthotics. If orthotics are required, they can be designed in such a way as too allow the entire foot to be supported through the gait cycle. If required, extra cushioning can be built into the foot orthotic to further reduce forces on the foot.
- The arch flattens too much. This is known as a “pes planus,” or “flat foot.” In such cases, the weight distribution on the foot is too far on the medial side. A flat foot is unstable and cannot maintain a proper arch. Over time, the weight of the body on an unstable foot will cause the bones of the foot to become misaligned. This can lead to the development bunions, hammertoes, and other foot deformities, as well as knee and lower back pain. To address this problem, foot exercises and possibly foot orthotics designed to correct alignment may be prescribed to distribute the forces more effectively.