What is an Orthotic?

An ORTHOTIC is a foot-supporting device also known as a custom insole. Foot Orthotics support, correct and accommodate the 26 bones, 2 sesamoid bones, tendons, ligaments, and plantar fascia band in each foot. 

Foot Orthotics allow the muscles, tendons and bones of the feet  through open and closed chain joint migration, up through the legs, hip and lower back, to function at their optimal potential for our body weight, structure, walking pattern and life styles. 

When appropriately prescribed and more importantly, appropriately manufactured, Foot Orthotics can decrease pain and discomfort in the foot, ankles, knees, hips and back. Foot Orthotics increase our stability, prevent further progression of bony deformities, soft tissue pain, burning and numbness and help to improve our overall quality of life in our activities of daily living (ADLs).

Remember, foot pain is not normal and should not be ignored. The pain in our feet often is associated with other pains in our lower limbs all due to the poor inherent biomechanics of our foot.

With a foot orthotic supporting the three main arches of the foot the muscles and tendons are able to work within their intended range of motions (ROMs) and we do not run the risk of causing injury or furthering one.
 

Benefits of Orthotics

Custom Foot Orthotics help in providing relief for painful foot problems or an injury, especially for those who must walk, or stand excessively on the job or in every day activities.

The mechanical properties  of the Custom Foot Orthotic help to maintain the normal positioning of the bones in the foot, the joints in the ankle and knees leading up to the hips and lower back. The muscles and ligaments holding these bones in their intended anatomical positions are prevented from over stretching and becoming lax over time.

With enough functional correction from a Custom Foot Orthotic, the foot structure can be aligned to give more propulsion, making walking, running and even cycling more efficient biomechanically.

Along with aligning the foot structure, the Custom Foot Orthotic reduces muscular fatigue and helps to promote more efficient muscle performance thus enhancing performance during the gait cycle.

Below is an example of a foot without the corrective support of an orthotic and then another example of the same foot with a Custom Made Foot Orthotic from POL correcting and supporting the foot. Notice the difference a well made Custom Foot Orthotic makes!

 

The Structure and Function of an Orthotic

Foot Orthotics are constructed from various materials consisting of plastics, foam, rubbers, and cork composites that are utilized for their mechanical properties.

The main similarity of all Foot Orthotics is the principle of their structure. The core is comprised of a plastic material more commonly referred to as the shell. External support structures on the underside of the shell material are utilized for balance and support inside the footwear; these are commonly referred to as extrinsic posts. Soft padding is placed on the underside and the topside to absorb compression forces when walking and running, this includes the top covers, underlay materials and arch fills.
All of these materials have the goal of improving foot function and minimizing the stress forces that cause foot deformity and pain.

Dependent on the reason for the prescription of Foot Orthotics, all of the above mentioned materials can be utilized in many combinations to achieve three broad categories of Foot Orthotics:

  1. Those that primarily attempt to change foot function, known as functional Foot Orthotics
  2. Those that are mainly protective or accommodative in nature, and
  3. Those that combine functional control with accommodation for comfort.
 
 

Foot & Ankle Surgery · Nerve Specialist · Podiatry

 

 

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Foot and ankle problems usually fall into the following categories:

  • Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
  • Arthritic foot problems, which typically involve one or more joint.
  • Congenital foot problems, which occur at birth and are generally inherited.
  • Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
  • Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
  • Traumatic foot problems, which are associated with foot and ankle injuries.

The top foot problems are:

  • Bunions - misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem.
  • Hammertoe - a condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Selecting shoes and socks that do not cramp the toes will alleviate aggravation.
  • Heel spurs - growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel can later calcify to form a spur. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced.
  • Ingrown nails - toenails whose corners or sides dig painfully into the skin. Ingrown toenails are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity and poor foot structure. Women are much more likely to have ingrown toenails than men. Ingrown nails can be prevented by trimming toenails straight across, selecting proper shoe style and size - not too tapered or shallow - and paying special attention to foot pain.
  • Neuromas - enlarged benign growths of nerves, most commonly between the third and fourth toes. They are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Treatments include orthoses (shoe inserts) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.
  • Plantar fasciitis (heel pain) - usually caused by an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
  • Sesamoiditis - inflammation or rupture of the two small bones (sesamoids) under the first metatarsal bones. Proper shoe selection and orthoses can help.
  • Shin splints - pain to either side of the leg bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching and corrective orthoses (shoe inserts) for pronation can help prevent shin splints.
  • Stress fractures - incomplete cracks in bone caused by overuse. With complete rest, stress fractures heal quickly. Extra padding in shoes helps prevent the condition. Stress fractures left untreated may become complete fractures, which require casting and immobilization.

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Podiatrist - Chicago, Lee R. Stein, DPM, FACFAS, 2623 North Halsted, Chicago IL, 60614 773-477-3668