Orthotics: a useful tool in any Podiatrists arsenal.

Orthotics: a useful tool in any Podiatrists arsenal.

“An orthotic should be reserved for troublesome feet, not for foot function.”

This is not how we usually talk about orthotics, but it should be.

Discussion often revolves around alignment, correction of flat feet, or even supporting high arches. Orthotics have been around for years, early on (a long time ago) they were made of some really interesting materials, luckily we have moved away from anything too thick or rigid and moved toward friendlier materials the foot can tolerate.

As Podiatrists we love talking about orthotics, we love using orthotics, they are terrific in the treatment for many foot and ankle injuries, we can even use them for knee pain. A lot of the time in the clinic we fail to incorporate other treatment options in with orthotic therapy, or we don’t educate our clients well enough about orthotics to have a good understanding of their use. This is our greatest concern, because using an orthotic can be the difference between someone being able to run and walk and being inactive.

What is an orthotic?

An orthotic is a device we use in a shoe which sits under the foot. The device is shaped around the contours of the foot to fit snuggly and aid its function.

The main aim of any orthotic should be to help an injury. Whether that be an injury from running or walking, or from something more structural which has been developing over the years, an example of this may be joint Osteoarthritis.

If we look back at some of our earlier blogs, we discuss how injury can be caused. This revolves around tissue stress and overload.

An orthotic, when designed properly should look at how it can alter the stress on a tissue which is injured, whether that is bone, tendon, joint or muscle. By aiding in the reduction of stress, plus using other treatment modalities such as strengthening, stretching and load management we can efficiently care and resolve a foot and ankle injury.

What is an orthotic made of?

Orthotics can be made of many different materials, the most common forms we see are flexible plastics, 3D printed or heat moulded or EVA which is a soft but dense foam.

The material used should represent the client’s needs, this may revolve around the type of shoes worn, whether it needs to be slim line or can fit into anything. A softer EVA may be used if there are pressure areas of the foot which need to be accommodated to prevent irritation.

What should my orthotic feel like?

The usual process when you receive your orthotic should involve education on the best way to adapt to your new device.

Your orthotic should feel comfortable, however given we are introducing a foreign device into your shoe it needs to be a slow introduction to prevent any irritation.

So back to the first comment made on orthotics. An orthotic should be reserved for troublesome feet, not for foot function.

This is true, don’t get an orthotic if you are not clinically indicated for it, in most cases it won’t improve performance. However, if it is aimed at reducing pain, function will naturally improve which will lead to performance improvements.

Will you need to wear an orthotic for the rest of your life?

The simple answer to this is not necessarily. An orthotic is usually implemented to offload a damaged structure, if this structure can be rehabilitated and strengthened to where it was prior to injury, then theoretically the orthotic can be removed. There are of course many things to consider before taking out your orthotic, which of course will be covered when you see a Podiatrist.