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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Bunions

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A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

  • Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
  • Removal of corns and calluses on the foot.
  • Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
  • Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
  • Exercises to maintain joint mobility and prevent stiffness or arthritis.
  • Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.


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