What Is An Orthotic?

Custom orthotics are like prescription eyeglasses for the feet.   Just like glasses or contact lenses change the angles by which light reaches your eyes, orthotics change the way that forces from the ground work when they reach your feet.

Functional and Accommodative Orthotics

There are two types of orthotics, functional and accommodative.  The foot is made up of 28 bones.  As you can imagine, there are many joints between these bones, not to mention between the foot and the lower leg, lower leg and thigh, and all the way up to the back.

Functional orthotics

A functional orthotic controls how these bones function in relation to each other and any abnormal motion.  They may be used to treat foot pain caused by abnormal motion.  Functional orthotics are usually crafted of a semi-rigid material such as plastic or graphite.

Functional orthotics can be used to treat various conditions often treated by surgery or various exercises.  Using the analogy of the eye, orthotics would be like getting glasses, instead of having Lasik surgery or squinting.  It is often easier and more effective, therefore, to be treated with custom orthotics.

Some conditions where functional orthotics are needed include plantar fasciitis, osteoarthritis, tarsal coalitions, neuromas, metatarsalgia, hallux limitus, Achilles tendinitis, flat foot or pronation, pes cavus, chronic ankle sprains, leg length discrepancy, shin splints or tendinitis.

Accommodative orthotics

An accommodative orthotic, on the other hand, is softer and meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, painful calluses on the bottom of the foot, and other uncomfortable conditions.  They work to take weight off a prominence such as a bone spur, ulcer, callus, etc.  Some conditions where accommodative orthotics are needed include Charcot foot, diabetes, peripheral neuropathy.

Orthotics can also be a combination of these two.

Orthotics can also be custom prescription, or over-the-counter.  The difference between over-the-counter inserts and custom orthotics is like reading glasses purchased at the store and eyeglasses prescribed by an eye doctor.  Dr. Hoy will go over with you based on your condition, which types can work for you and which types will not.

What are Shoe Inserts? 

You’ve seen them at the grocery store and at the mall. You’ve probably even seen them on TV and online. Shoe inserts are any kind of non-prescription foot support designed to be worn inside a shoe. Pre-packaged, mass produced, arch supports are shoe inserts. So are the “custom-made” insoles and foot supports that you can order online or at retail stores. Unless the device has been prescribed by a doctor and crafted for your specific foot, it’s a shoe insert, not a custom orthotic device—despite what the ads might say.

Shoe inserts can be very helpful for a variety of foot ailments, including flat arches and foot and leg pain. They can cushion your feet, provide comfort, and support your arches, but they can’t correct biomechanical foot problems or cure long-standing foot issues.

The most common types of shoe inserts are:

  • Arch supports: Some people have high arches. Others have low arches or flat feet. Arch supports generally have a “bumped-up” appearance and are designed to support the foot’s natural arch.
  • Insoles: Insoles slip into your shoe to provide extra cushioning and support. Insoles are often made of gel, foam, or plastic.  
  • Heel liners: Heel liners, sometimes called heel pads or heel cups, provide extra cushioning in the heel region. They may be especially useful for patients who have foot pain caused by age-related thinning of the heels’ natural fat pads.
  • Foot cushions: Do your shoes rub against your heel or your toes? Foot cushions come in many different shapes and sizes and can be used as a barrier between you and your shoe.

Choosing an Over-the-Counter Shoe Insert

Selecting a shoe insert from the wide variety of devices on the market can be overwhelming. Here are some podiatrist-tested tips to help you find the insert that best meets your needs:

  • Consider your health. Do you have diabetes? Problems with circulation? An over-the-counter insert may not be your best bet. Diabetes and poor circulation increase your risk of foot ulcers and infections, so schedule an appointment with a podiatrist. He or she can help you select a solution that won’t cause additional health problems.
  • Think about the purpose. Are you planning to run a marathon, or do you just need a little arch support in your work shoes? Look for a product that fits your planned level of activity.
  • Bring your shoes. For the insert to be effective, it has to fit into your shoes. So bring your sneakers, dress shoes, or work boots—whatever you plan to wear with your insert. Look for an insert that will fit the contours of your shoe.
  • Try them on. If all possible, slip the insert into your shoe and try it out. Walk around a little. How does it feel? Don’t assume that feelings of pressure will go away with continued wear. (If you can’t try the inserts at the store, ask about the store’s return policy and hold on to your receipt.)

When to Visit the Podiatrist

If you are simply looking for extra cushioning or support, you may wish to try an over-the-counter shoe insert first. If you have serious pain or discomfort, however, schedule an appointment with Dr. Hoy. He will assess your overall health and look for any other contributing factors. Today’s podiatrists are specially trained to evaluate the biomechanics of the lower extremity.

Dr. Hoy will examine your feet and how you walk. He will listen carefully to your complaints and concerns and assess the movement and function of your lower extremities.

The information gathered during the exam will help Dr. Hoy determine if shoe inserts might be helpful or if you need prescription orthotics. If orthotics are needed, Dr. Hoy will make a cast of each foot. Those casts, as well as any measurements obtained by Dr. Hoy, are used to create a set of unique foot supports that will improve your foot movement and lead to more comfort and mobility. Dr. Hoy might also suggest additional treatments to improve the comfort and function of your feet.

In general, like glasses, orthotics will not magically reverse the condition, but correct it.  Once the glasses are taken out, you can’t see well.  Once the orthotics are taken out, the foot problem may return.

“I am a diabetic, so keeping my feet in good shape is top priority. A set of custom-fitted orthotic inserts and periodic followup foot care by a caring and thorough physician and his fine staff has helped a lot.” -Thomas S.