What is an Orthotic?
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:
- Those that primarily attempt to change foot function, known as functional Foot Orthotics
- Those that are mainly protective or accommodative in nature, and
- Those that combine functional control with accommodation for comfort.
Foot & Ankle Surgery · Nerve Specialist · Podiatry
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Corrective and Prescription Shoes
As always, you can contact our office to answer any questions or concerns.
Proper footwear is an important part of an overall treatment program for people with diabetes, even at the earliest stages of the disease. If there is any evidence of neuropathy, wearing the right footwear is crucial.
As a general rule, people with diabetes should choose shoes that:
- Accommodate, stabilize, and support deformities, such as Charcot Foot, loss of fatty tissue, hammertoes, and amputations. Many deformities need to be stabilized to relieve pain and avoid further damage. In addition, some deformities may need to be controlled or supported to decrease further progression of the deformity.
- Limit motion of joints. Limiting the motion of certain joints in the foot can decrease inflammation, relieve pain, and result in a more stable and functional foot.
- Reduce shock and shear. A reduction in the overall amount of vertical pressure, or shock, on the bottom of the foot is desirable, as well as a reduction of horizontal movement of the foot within the shoe, or shear.
- Relieve areas of excessive pressure. Any area where there is excessive pressure on the foot can lead to skin breakdown or ulcers. Footwear should help to relieve these high pressure areas, and therefore reduce the occurrence of related problems.
Prescription Footwear
Many diabetics need special prescription footwear. The various types include:
- Custom-made shoes. When extremely severe deformities are present, a custom-made shoe can be constructed from a cast or model of the patient's foot. With extensive modifications of in-depth shoes, even the most severe deformities can usually be accommodated.
- External shoe modifications. In these cases, the outside of the shoe is modified in some way, such as adjusting the shape of the sole or adding shock-absorbing or stabilizing materials.
- Healing shoes. Immediately following surgery or ulcer treatment, special shoes may be necessary before a regular shoe can be worn. These include custom sandals (open toe), heat-moldable healing shoes (closed toe), and post-operative shoes.
- In-depth shoes. An in-depth shoe is the basis for most footwear prescriptions. It is generally an oxford-type or athletic shoe with an additional 1/4-inch to 1/2-inch of depth throughout the shoe. This extra volume accommodates inserts, or orthotics, as well as deformities commonly associated with a diabetic foot. In-depth shoes are usually designed to be light in weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot.
- Orthoses or shoe inserts. Also known as orthotics, an orthosis is a removable insole which provides pressure relief and shock absorption. Both pre-made and custom-made orthotics or shoe inserts are commonly recommended for patients with diabetes, including a special total contact orthosis, which is made from a model of the patient's foot and offers a high level of comfort and pressure relief.
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