Poor biomechanics can be debilitating for patients. It can cause chronic pain, which can significantly affect a patient’s quality of life. Podiatrists can change a patient’s life quality by altering their biomechanics to function more efficiently. Over-the-counter or custom orthotics are effective, common treatments.
Over-the-counter (OTC) orthotics can be a quick fix for a minor issue or an intermediary step when transitioning a patient into custom orthotics. Generally, patients who are of light to normal weight, have minimal deformity, a relatively neutral arch, and have a job that requires light weight-bearing benefit the most from OTC orthotics. These orthotics tend to be less expensive, softer, and fit in most shoe-types. There are some excellent choices in OTC orthotics and can offer choices that are similar in nature to custom devices. There are limitations to OTC orthotics. They are not a replacement for custom orthotics, as they do not address specific pathologies that may be present in a patient’s foot. If a patient has a severe deformity or has a heavy weight-bearing job, they would benefit more from a custom orthotic. However, when used appropriately, an OTC orthotic can drastically aid patient outcomes.
Custom orthotics, on the other hand, can be specifically designed for the needs of each patient, as well as individual feet. They can be used to manage specific deformities or gait abnormalities, such as: bunions, tendonitis or tendon dysfunction, arthritis, or plantar fasciitis. In general, the design of the orthotic is to accommodate these issues as well as allow the foot to function in a more neutral and proper position.
To develop the orthotic, the Podiatrist captures an image of the foot as accurately as possible. There are many ways to do this: plaster casting, foam box molding, pressure scanning, and 3-dimensional camera modeling. Customizations occur and vary based on each patient’s needs. The material the orthotic is made of is chosen by the Podiatrist based on exam and can range from flexible and soft to super rigid. The material needs to be supportive for the foot as well as comfortable enough to wear. Once the device is made, they usually require a break in period. This can take 2 - 4 weeks to become comfortable. Generally, a follow up appointment is scheduled to make sure the orthotic is managing the issues appropriately. In some cases, adjustments may be needed initially and in the future to best treat each patient.
Custom orthotics are a great treatment option for many podiatric conditions and can alleviate pain not only in the feet and ankles but also can help hip, knee and back pain by helping alignment issues in the lower extremities.