Orthotic Therapy: A Podiatrist’s Guide

Orthotic Therapy for the People of Belconnen, Canberra and Surrounds

 

What are custom foot orthotics?

Foot orthoses are commonly referred to as orthotics. Custom prescription orthotics are shoe inserts that alter the functioning of the body’s structures (including nerves and muscles) to improve stability and function and reduce pain. Everyone’s feet are different in shape, size, function, strength, and are used in different ways depending on who you are. Custom orthotics are made and fitted to suit your diagnosis, pain location, footwear, lifestyle, activity, and medical history. This means one person’s orthotics may not be suitable for another.

 

What do orthotics do?

The main aim of wearing orthotics is to offload and control excessive forces from a stressed and painful area. In doing this, they help to reduce pain and deformity, increase comfort, and aid in making gait more efficient. There has been little to no evidence in research that shows orthotics are capable of splinting or holding the foot in a corrected position and as such do not ‘re-align’ the skeleton. However, many feel a sense of improved alignment when wearing their orthotics.

Of course, there are instances where custom foot orthoses are used to accommodate the foot as it is. In this case an orthotic would primarily provide comfort and prevent wounds or ulcerations. These devices could be used in those who are diabetic or have lost most of their protective fat pads under the feet.

 

 

 

 

Who can benefit from orthotics?

Orthotics are a very useful tool in managing pain and discomfort for conditions such as:

– Plantar heel pain including plantar fasciitis, tarsal tunnel syndrome

– Achilles pain

– Arch pain

– Chronic ankle instability

– Shin pain including medial tibial stress syndrome, muscle-tendon injuries or strains

– Forefoot pain including neuritis or neuroma, bursitis, plantar plate dysfunction

– Big toe joint conditions including bunions, turf toe, hallux limitus

– Prevention of callous and corn formation

– Children’s lower limb conditions

 

Orthotics may not be a compulsory requirement in the treatment of your condition. Other treatments can be utilised to reduce pain and improve function. These include:

– Progressive strengthening and stretching exercise program

– Shockwave therapy

– Gait re-training

– Foot and ankle mobilisation

– Dry needling

– Strapping or taping

– Change in footwear

There are also multiple orthotic options available to fit everyone’s circumstances.

 

 

 

How orthotics are made and customised for each individual?

To ensure a successful outcome with orthotics, your podiatrist will start by assessing the biomechanics and musculoskeletal function of your feet and legs. A thorough history of your lifestyle, medical conditions, activity, pain, and footwear will also be taken. A visual gait analysis is performed to observe how the lower limbs function and move while walking or running. We utilise PODOSmart motion analysis insoles placed into walking shoes which provides useful information on biomechanical patterns that may not be fully observed with a visual analysis.

Based on your lower limb and foot function a customised prescription will be followed to design a pair of orthotics. An impression of both feet is taken, and the podiatrist designs your orthotics through advanced software. The podiatrist chooses specific features of the orthotics to the centimetre including contours, densities, lengths, heights, depths, materials, colours, and any extra features you may need. The designs are then sent off to a milling site to be manufactured by a computerised machine.

If the orthotics require adjustment, your podiatrists can modify them in-house. Orthotics are fitted to your foot and shoes to ensure they are comfortable and are adequately supporting your foot.

 

 

 

How long should I wear orthotics for?

Orthoses may be prescribed for short term or lifelong use. Ideally you would wear them 80% of weightbearing time but it depends on person to person.

Our feet and legs are dynamic structures and always adapting. Ideally, orthotics should be reviewed every 6 to 12 months to ensure they are still suitable for your activity levels or any changes in your lower limb.

 

What are orthotics are made out of?

Customised orthoses come in a variety of materials and densities including soft & hard plastic, 3D printed nylon plastic and carbon fibre. Top covers provide additional cushioning. Weight, wearing time, activity levels, age and medical conditions determine the shelf life of top covers and orthoses. Top covers will wear quicker than the orthotic shell and can be replaced without replacing the shell. Customised foot orthoses can last 3-8 years before replacement.

 

 

 

What are the different types of orthotics?

Over the counter / pre-made

Off the shelf devices that allow for minor adjustments. These devices are normally made from less durable materials and have a short life span but are useful in conditions needing temporary support. Because they are modelled from a ‘generic’ foot type, they may not have the stiffness, shape, or characteristics (contour, corrective ability) your foot needs. They can be full or half length.

Heat mouldable

Prefabricated devices are heated to moulding temperature to capture the shape of the foot. They are slightly more adjustable and have a longer life span compared to pre-made devices. Multiple adjustments can be made. These are normally full-length devices.

Prescription / custom

3D scans are taken of your feet and the devices are individualised to your needs using a computerised milling machine. Customised prescription orthotics have a long shelf life and are available in a variety of materials including soft and hard EVA, semi-flexible polypropylene, and rigid carbon fibre. They can be altered more easily to fit a wide variety of shoes.

Joeys/Precast

Similar to custom foot orthotics, but tracings of the feet are taken instead of a scan. This reduces costs and is a great solution for growing children who need a similar level of support to customised orthotics.

Orthotics come in all shapes and sizes. They can be full length to replace the existing innersole in the shoe or half-length / shell length to allow for more room in the toe box.

 

 

 

 

For Any Queries Regarding Orthotics, Get in Touch with New Step Podiatry Today

New Step Podiatry is here to assist you with whatever foot, ankle and leg issues that you may be experiencing. We have years of experience treating those in Belconnen, Canberra and surrounding areas, and will always put your health and comfort as our top priority. For any questions, give us a call on 02 6198 4818 or easily book an appointment online to see the Podiatrists at our clinic.

 

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