What is Orthotics?
Orthotic: A support, brace, or splint used to support, align, prevent, or correct the function of movable parts of the body. Shoe inserts are orthotics that are intended to correct an abnormal or irregular walking pattern, by altering slightly the angles at which the foot strikes a walking or running surface. Other orthotics include neck braces, lumbosacral supports, knee braces, and wrist supports.
WHAT ARE ORTHOTICS?
Orthotics, also called orthoses, are devices that are worn to relieve pain associated with foot and ankle deformities and help prevent or delay surgery. Most people think of shoe inserts or arch supports when they hear the word orthotics, but they can include devices such as foot pads, shoe inserts, ankle braces, and similar items. Treatment often can begin with less expensive off-the-shelf orthotics and progress to custom orthotics if the symptoms and diagnosis require it.
Foot pads are the simplest devices. They can be placed on the bottom of the foot, or inside the shoe, but take up only a small area in the shoe. They are used to treat conditions that often cause pain at the front of the foot. Many styles, shapes and sizes are available, including circle or "doughnut" pads, bunion pads, and metatarsal pads.
Shoe inserts, also called inlays, insoles, foot beds, and arch supports, are placed into the shoe. These are used to treat a wide variety of problems, including arthritis and flat feet. They create a solid foundation for the body, decrease pain, and improve function and gait. There are many different kinds of inserts, from ones that are soft to ones that are very firm, and in different sizes or shapes. Other inserts need to be shaped to an individual's foot. Custom foot inserts may support, correct or prevent foot abnormalities or deformities. Many practitioners, including prosthetists, orthotists, and certified pedorthists, can make custom orthoses.
A period of adjustment is required for any new shoe inserts. The shoe inserts and the shoes are considered as a unit because the inserts occupy volume inside the shoe. This leaves less room for the foot. An appropriate period of breaking in should be allowed for a new insert. If it causes pain or pressure to the foot, the practitioner can make adjustments to improve the fit. Adjustment and proper fitting of the orthosis typically is included in the service provided.
Ankle braces are devices that the patient must put on before fitting into a shoe. They are used to treat a large variety of diseases like ankle arthritis, ankle instability, foot drop, and tendinitis. Depending on the type, severity, and location of the condition, some braces need to be custom made for the patient.
Shoes are important. They can improve the success of foot and ankle orthoses. The practitioner making the orthosis will ask that the shoes be brought to the office for planning and fitting. Not all shoe types will work properly with orthoses. This should be discussed with the practitioner before purchasing shoes.
Do orthotics work?
It depends on the problem. Orthotics can change the pressure on certain parts of the foot to relieve symptoms. This especially is true in diabetics and other individuals who are at risk for skin breakdown. Certain ankle braces are good at controlling motion and can help take pressure off of an arthritic joint. The result can be pain relief for patients who are unable or unwilling to undergo surgical correction.
What are orthotics and how do they benefit you?
Experiencing foot or heel pain? Considering buying orthotics to help relieve the pain? The first thing you should know is an orthotic is a shoe insert that supports the abnormal movement of a foot. Made of different materials and quality, not all orthotics are created equal. Understandably, people spend much time and money using the wrong orthotic.
When you experience foot pain, specifically in the arch of the foot, you likely thought you needed more cushion. A softer sole or more cushion feels great, but it doesn’t address the underlying issue causing the foot pain. This is where many people looking to buy orthotics make their mistake. Knowing which orthotic you need and using our bend test will save you from wasting money and living with more pain.
Orthotic manufacturers make their products to do one of two things:
To provide cushion and comfort. These orthotics are flimsy and made of memory foam. They are an added level of comfort compared to the insoles that come with your shoes. What these orthotic manufacturers don’t tell you is, memory foam orthotics are a short term fix.
To support the abnormal movement of a foot. Foot pain isn’t normal. When you’re experiencing foot pain, it’s due to an abnormality in your foot. These orthotics promote proper foot alignment and movement. Flimsy memory foam can’t do this, so manufacturers use a sturdier material that provides support and stability to keep your foot in place.
Orthotics are different. They are prescription medical devices that you wear inside your shoes to correct biomechanical foot issues such as problems with how you walk, stand, or run. They can also help with foot pain caused by medical conditions such as diabetes, plantar fasciitis, bursitis, and arthritis.
10 Common Foot Problems
FLAT FEET (also called pes planus or fallen arches) is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. An estimated 20–30% of the general population have an arch that simply never develops in one or both feet.
Flat feet
Synonyms
Pes planus, fallen arches
Flatfoot.
There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot. This association safeguards so that a majority of the forces incurred during weight bearing of the foot can be dissipated before the force reaches the long bones of the leg and thigh.[1]
In pes planus, the head of the talus bone is displaced medially and distal from the navicular. As a result, the Plantar calcaneonavicular ligament (spring ligament) and the tendon of the tibialis posterior muscle are stretched, so much so that the individual with pes planus loses the function of the medial longitudinal arch (MLA). If the MLA is absent or nonfunctional in both the seated and standing positions, the individual has “rigid” flatfoot. If the MLA is present and functional while the individual is sitting or standing up on their toes, but this arch disappears when assuming a foot-flat stance, the individual has “supple” flatfoot. This latter condition can be correctable with well-fitting arch supports.
OVERPRONATION As with the “normal pronation” sequence, the outside of the heel makes the initial ground contact. However, the foot rolls inward more than the ideal fifteen percent, which is called “overpronation.” This means the foot and ankle have problems stabilizing the body, and shock isn’t absorbed as efficiently. At the end of the gait cycle, the front of the foot pushes off the ground using mainly the big toe and second toe, which then must do all the work.
Preventing Overpronation Injuries
Overpronation causes extra stress and tightness to the muscles, so do a little extra stretching. Too much motion of the foot can cause calluses, bunions, runner’s knee, plantar fasciitis, and Achilles tendinitis.
SUPINATION
Underpronation (or supination) is the insufficient inward roll of the foot after landing. Again, the outside of the heel makes initial contact with the ground. But the inward movement of the foot occurs at less than fifteen percent (i.e., there is less rolling in than for those with normal or flat feet). Consequently, forces of impact are concentrated on a smaller area of the foot (the outside part), and are not distributed as efficiently. In the push-off phase, most of the work is done by the smaller toes on the outside of the foot.
This places extra stress on the foot, which can lead to iliotibial band syndrome, Achilles tendinitis, and plantar fasciitis. Underpronating will cause the outer edge of running shoes to wear sooner. To see if your shoes are unevenly worn, place them on a flat surface. If they tilt outward, supination is the culprit. Runners with high arches and tight Achilles tendons tend to be supinators.
Preventing Underpronation Injuries
Supinators should do extra stretching for the calves, hamstrings, quads, and iliotibial band.
HEEL SPURS
Occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping.
Risk factors for heel spurs include:
Walking gait abnormalities,which place excessive stress on the heel bone, ligaments, and nerves near the heel
Running or jogging, especially on hard surfaces
Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
Excess weight and obesity
A BUNION is a bony bump that forms on the joint at the base of your big toe. It forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. The skin over the bunion might be red and sore.
Wearing tight, narrow shoes might cause bunions or make them worse. Bunions also can develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis.Smaller bunions (bunionettes) can develop on the joint of your little toe.
Symptoms
The signs and symptoms of a bunion include:
A bulging bump on the outside of the base of your big toe
Swelling, redness or soreness around your big toe joint
Corns or calluses — these often develop where the first and second toes overlap
Persistent or intermittent pain
Restricted movement of your big toe if arthritis affects the toeCauses
There are many theories about how bunions develop, but the exact cause is unknown. Factors likely include:
Inherited foot type
Foot injuries
Deformities present at birth (congenital)
Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to bunion development.
Bunions might be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis.
Risk factors
These factors might increase your risk of bunions:
High heels. Wearing high heels forces your toes into the front of your shoes, often crowding your toes.
Ill-fitting shoes. People who wear shoes that are too tight, too narrow or too pointed are more susceptible to bunions.
Rheumatoid arthritis. Having this inflammatory condition can make you more susceptible to bunions.
Heredity. The tendency to develop bunions might be because of an inherited structural foot defect.
What are HAMMER TOES?
Hammer toes are common and painful deformities in the three middle toes where they appear to always be bent.
Causes of hammer toes include shoes that don’t fit properly, foot injuries, bunions, and rheumatoid arthritis.
Having toe joints sticking out can cause them to rub and a person may walk differently, risking other foot conditions, such as metatarsalgia.
Hammer toes can be a serious problem in people with diabetes or poor circulation.
Photo of side view of hammer toes
There are two types of hammer toes:
Flexible hammer toes. If the toe can still be moved at the joint, it's a flexible hammer toe. That's good, because this is an earlier, less-severe form of the problem. There may be several treatment options.
Rigid hammer toes. If the tendons in the toe become rigid, they press the joint out of alignment. At this stage, the toe can't be moved. This usually means surgery is required to correct the problem.
What causes hammer toes?
The muscles of each toe work in pairs. When the toe muscles get out of balance, a hammer toe can form. Muscle imbalance puts a lot of pressure on the toe's tendons and joints. This pressure forces the toe into a hammerhead shape.
How do the toe muscles get out of balance? There are three main reasons:
Your genes: you may have inherited a tendency to develop hammer toes because your foot is slightly unstable - such as a flat foot. But high-arched feet can also get hammer toes.
Arthritis
Injury to the toe: ill-fitting shoes are the main culprits of this cause. If shoes are too tight, too short, or too pointy, they push the toes out of balance. Pointy, high-heeled shoes put particularly severe pressure on the toes.
What are the symptoms of hammer toes?
A toe stuck in an upside-down "V" is probably a hammertoe. Some symptoms are:
Pain at the top of the bent toe when putting on a shoe
Corns forming on the top of the toe joint
The toe joint swelling and taking on an angry red colour
Difficulty in moving the toe joint - and pain when you try to
Pain on the ball of the foot under the bent toe
A CALLUSES area of skin which has become relatively thick and hard in response to repeated friction, pressure, or other irritation. Rubbing that is too frequent or forceful will cause blisters rather than allow calluses to form. Since repeated contact is required, calluses are most often found on feet because of frequent walking. Calluses are generally not harmful, but may sometimes lead to other problems, such as skin ulceration or infection.
MORTON'S NEUROMA is a painful foot condition that affects one of the nerves between the toes.
It's also known as Morton's metatarsalgia or interdigital neuroma.
In Morton's neuroma, a nerve in the foot becomes irritated and thickened, which can cause severe pain.
The condition can occur in one foot or both feet. It usually affects the nerve between the third and fourth toes, but sometimes the second and third toes are affected.
Morton's neuroma can occur at any age, but most often affects middle-aged women. This may be because women tend to wear tight or high-heeled shoes that can put pressure on the feet.
It's also increasingly seen in runners, possibly because of the increased pressure on the toes that occurs when running.
Symptoms of Morton's neuroma
You may initially experience a tingling sensation in the space between your toes, which gets worse over time. This eventually develops into a sharp shooting or burning pain in the ball of your foot or at the base of your toes. There may also be some numbness in your toes.
What is sciatica?
Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot.
What causes SCIATICA?
The most common cause of sciatica is a bulging or ruptured disc in the spine pressing against the nerve roots that lead to the sciatic nerve. But sciatica also can be a symptom of other conditions that affect the spine, such as narrowing of the spinal canal bone spurs (small, bony growths that form along joints) caused by arthritis, or nerve root compression caused by injury.
HIGH ARCH or Pes cavus (in medical terminology, also high instep, high arch, talipes cavus, cavoid foot, and supinated foot type) is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.
Why Wearing an Orthotics is Very Important?
A close look at the human foot reveals a marvel of design and efficiency. Each foot has more than 100 working parts. No less than 26 bones work with the foot's ligaments, muscles and tendons in two very small structures to support and balance the weight of the entire body. The force through a foot during normal walking is enormous. Walking puts up to 1.5 times one's bodyweight on the foot. On average, our feet log 1,000 miles per year. As shock absorbers, feet cushion up to one million pounds of pressure during one hour of strenuous exercise.
Foot pain is not normal and should not be ignored. The presence of foot problems can affect the proper functioning of other parts of the body, including the hip, knee and back.
Foot problems are often treated with shoe inserts called orthotics. Custom-made foot orthotics are medical devices inserted into the shoe to correct an abnormal or irregular walking pattern. They are prescribed to reduce pain, to provide support, to prevent foot deformity or keep it from getting worse, to provide better positioning, to relieve pressure on a certain area of the foot, and to improve the overall biomechanical function of the foot and lower extremity.
Orthotics work like shock absorbers, removing pressure and stress from painful areas in the foot and ankle. Orthotics also promote the proper alignment of the feet. They can restore balance, improve sports performance and even alleviate pain in the knee, hip and lower back. Research shows that back problems, the most common form of chronic pain, can often be traced to a foot imbalance.
Since foot orthotics alter the way a person walks, stands and absorbs shock from the ground, anyone wishing to use them should have a good reason. It is recommended that individuals considering orthotics consult a professional with the proper training and credentials, such as a podiatrist.
Custom foot orthotics prescribed by a doctor of podiatric medicine should not be confused with the prefabricated models found in shoe stores, ski and skate shops, pharmacies, sporting goods stores or mail order catalogues. There is a significant difference in quality and effectiveness. Anyone who provides orthotics as a sideline business may not have the proper training and qualifications.
Prefabricated orthotics, mass-produced to fit an "average" foot, may cost less, but usually do not properly correct the specific problems found in an individual's foot and may end up doing more harm than good. Many times, this type of foot orthotic can actually worsen a condition and create orthopedic problems elsewhere in the body. Those at particular risk are people with heel pain, achilles tendon pain, back or knee problems or those who have a high arch foot type or flat feet.
Exercise enthusiasts, who engage in high impact or high velocity sports often buy prefabricated foot orthotics to provide support or serve as shock absorbers. It is usually better to consult an Orthotist to find the most appropriate device for their needs. Orthotics are very sport specific and different sports require different orthotics (ski boots, golf shoes, cycling shoes, skates, tennis sneakers, hiking boots, etc.)
Custom-made orthotics can provide relief for many different types of foot pain including heel pain and plantar fasciitis; arch pain; pain caused by bunions, an injury or a sprain; pain caused by running, walking and sports; pain related to diabetes; and pain experienced by senior citizens whose feet change as they grow older. Foot orthotics do not actually correct foot or ankle problems, such as fallen arches. But orthotics can reposition the structures in the foot to optimize biomechanical function and reduce the chance of injury.
A close look at the human foot reveals a marvel of design and efficiency. Each foot has more than 100 working parts. No less than 26 bones work with the foot's ligaments, muscles and tendons in two very small structures to support and balance the weight of the entire body. The force through a foot during normal walking is enormous. Walking puts up to 1.5 times one's bodyweight on the foot. On average, our feet log 1,000 miles per year. As shock absorbers, feet cushion up to one million pounds of pressure during one hour of strenuous exercise.
Foot pain is not normal and should not be ignored. The presence of foot problems can affect the proper functioning of other parts of the body, including the hip, knee and back.
Foot problems are often treated with shoe inserts called orthotics. Custom-made foot orthotics are medical devices inserted into the shoe to correct an abnormal or irregular walking pattern. They are prescribed to reduce pain, to provide support, to prevent foot deformity or keep it from getting worse, to provide better positioning, to relieve pressure on a certain area of the foot, and to improve the overall biomechanical function of the foot and lower extremity.
Orthotics work like shock absorbers, removing pressure and stress from painful areas in the foot and ankle. Orthotics also promote the proper alignment of the feet. They can restore balance, improve sports performance and even alleviate pain in the knee, hip and lower back. Research shows that back problems, the most common form of chronic pain, can often be traced to a foot imbalance.
Since foot orthotics alter the way a person walks, stands and absorbs shock from the ground, anyone wishing to use them should have a good reason. It is recommended that individuals considering orthotics consult a professional with the proper training and credentials, such as a podiatrist.
Custom foot orthotics prescribed by a doctor of podiatric medicine should not be confused with the prefabricated models found in shoe stores, ski and skate shops, pharmacies, sporting goods stores or mail order catalogues. There is a significant difference in quality and effectiveness. Anyone who provides orthotics as a sideline business may not have the proper training and qualifications.
Prefabricated orthotics, mass-produced to fit an "average" foot, may cost less, but usually do not properly correct the specific problems found in an individual's foot and may end up doing more harm than good. Many times, this type of foot orthotic can actually worsen a condition and create orthopedic problems elsewhere in the body. Those at particular risk are people with heel pain, achilles tendon pain, back or knee problems or those who have a high arch foot type or flat feet.
Exercise enthusiasts, who engage in high impact or high velocity sports often buy prefabricated foot orthotics to provide support or serve as shock absorbers. It is usually better to consult an Orthotist to find the most appropriate device for their needs. Orthotics are very sport specific and different sports require different orthotics (ski boots, golf shoes, cycling shoes, skates, tennis sneakers, hiking boots, etc.)
Custom-made orthotics can provide relief for many different types of foot pain including heel pain and plantar fasciitis; arch pain; pain caused by bunions, an injury or a sprain; pain caused by running, walking and sports; pain related to diabetes; and pain experienced by senior citizens whose feet change as they grow older. Foot orthotics do not actually correct foot or ankle problems, such as fallen arches. But orthotics can reposition the structures in the foot to optimize biomechanical function and reduce the chance of injury.