Custom Functional Orthotics
Functional orthotics are shoe inserts that are used to correct an irregular walking pattern. They are used to treat a variety of foot and ankle issues, including heel pain (plantar fasciitis), shin splints, metatarsal pain, painful calluses and the diabetic foot. They perform functions that make standing, walking, and running more comfortable and efficient, by altering slightly the angles at which the foot strikes a walking or running surface.
Orthotics differ from commercially made devices, such as cushioned heel cups or insoles for shoes. These are sold over-the-counter in drug stores. A custom made functional orthotic, however, is a device made specifically to meet an individual's needs. Doctors of podiatric medicine often fabricate orthotics as a conservative treatment for many foot and ankle problems. They are also often used as a method of control after certain types of foot surgery to maintain the correction achieved via surgery. We have found their use is a highly successful, practical approach to treatment.
Orthotics come in various forms and are constructed of various materials. All are used for improving foot function and minimizing stress forces that could ultimately cause foot and ankle pain or deformity. It is important to differentiate the difference between a functional orthotic and an arch support. A functional orthotic is made when a foot and ankle physician takes a plaster mold of the foot and ankle. The position of the foot during the casting process is determined after the doctor has made a detailed and thorough medical analysis of the foot and ankle. This is a critical point. It involves much more than pressing your foot into a foam box, standing on a "gait plate", or any other means of obtaining a foot imprint. The plaster impression is then sent with specific instructions, often with x-rays, to a lab for fabrication. The finished functional orthotic is then put into the patient's shoe and assists in keeping the foot properly aligned. It actually alters the function of the foot and ankle. It is much more than a padded arch support.
Foot orthotics fall into three broad categories: those that primarily attempt to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.
The rigid orthotic device, designed to control function, may be made of a firm material such as plastic or carbon fiber, and is used primarily for walking or dress shoes. The finished product extends along the sole of the heel to the ball of the foot. It is mostly worn in closed shoes with a heel height of less than two inches. Because of the materials involved, very little alteration in shoe size is required.
Rigid orthotics are designed to control motion in two major foot joints, which are directly below the ankle joint. These devices last a long time, do not change shape, and are hard to break. Aches, and pains in the legs, lower back and thighs may be due to abnormal function of the foot, or a slight difference in the legs length. In these cases, orthotics may improve or eliminate these symptoms.
Soft Orthotics help to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. They are usually made of soft, compressible materials, and may be molded by the action of the foot in walking, or fashioned over a plaster impression of the foot. Also worn against the sole of the foot, it usually extends from the heel past the ball of the foot to include the toes.
The advantage of any soft orthotic device is that it is easily adjusted to changing weight-bearing forces. The disadvantage is that it must be periodically replaced. It works particularly well for arthritic and grossly deformed feet where there is a loss of protective fatty tissue on the side of the foot. It is also widely used in the care of the diabetic foot. Because it is compressible, the soft orthotic is usually bulkier and may require more room in shoes, or even prescription footwear.
The semirigid orthotic allows for dynamic balance of the foot while walking or participating in sports. This orthotic can be an invaluable aid to the athlete. Each sport has its own demand and each sport orthotic needs to be made correctly with the sport and the athlete in mind. This dynamic orthotic helps guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently. The classic, semi rigid orthotic is constructed of layers of soft material, reinforced with rigid materials.
Orthotics for Children
Orthotic devices are often used in the treatment of children with foot deformities, and are very effective. Most podiatric physicians recommend that children with these deformities, particularly flat feet, be placed in orthotics not long after they begin to walk in order to stabilize the foot. The devices can be put directly into a standard shoe, or an athletic shoe. Usually, the orthotics need to be replaced about once a year as the child continues to grow.
Dr. Katz and Amin have been successfully treating many painful foot and ankle conditions with custom functional orthotics for over 25 years. While not everybody will obtain relief with orthotics, the vast majority of patients have been able to return to their desired activities painfree. If you suffer from foot, ankle or knee pain, we invite you to come in to see for yourself what over 10,000 of our patients have experienced.