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.
 
 

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Our team of specialists and staff believe that informed patients are better equipped to make decisions regarding their health and well being. For your personal use, we have created an extensive patient library covering an array of educational topics. Browse through these diagnoses and treatments to learn more about topics of interest to you. Or, for a more comprehensive search of our entire Web site, enter your term(s) in the search bar provided.

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A callus, also known as hyperkeratosis, is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. Although many consider them a skin problem, they are indicative of a problem with the bone.

Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot). Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.

Calluses can be treated with over-the-counter callus removers, which use strong acids to peel this excess skin away after repeated application. Be careful using these products as they can cause chemical burns when misapplied or used in excess. Alternatively, treat calluses as follows: Begin by soaking the foot or feet in warm soapy water and gently rubbing away any dead skin that loosens. Next, use a pumice stone or emery board to file away the thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Nonmedicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) are available in stores and can relieve pain caused by calluses. However, use caution removing pads or moleskins to avoid tearing the skin.

If you need assistance relieving calluses, please contact our office. We can trim and apply comfortable padding to the painful areas. In more severe cases, we may prescribe medication to relieve inflammation, or inject cortisone into the underlying bursal sac to rapidly reduce pain and swelling.

A plantar callus forms on the bottom of the heel over time where one metatarsal bone is longer or lower than the others. This structure causes the one metatarsal to hit the ground first and with more force than it is equipped to handle. As a result, the skin under this bone thickens. In most cases, plantar calluses can be treated without surgery. In some recurring cases, however, a surgical procedure, called an osteotomy, is performed to relieve the pressure on the bone.

A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a "dropped metatarsal," which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form. A dropped metatarsal can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time.

You can prevent calluses by:

  • Switching to better-fitting shoes or using an orthotic device to correct an underlying cause.
  • Buying socks with double-thick toes and heels or nylon hose with woven cotton soles on the bottom of the foot.

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