What exactly is an 'orthotic'?
An 'orthotic' is a device designed to restore your natural foot function. Many 'biomechanical' (walking) complaints such as heel pain, knee pain and lower back pain are caused by poor foot function. Orthotics re-align the foot and ankle bones to their neutral position, thereby restoring natural foot function. In turn this helps alleviate problems in other parts of the body.
In addition, orthotics give a more even weight distribution, taking pressure of sore spots (e.g. the ball of the foot, corns in between toes, bunions etc) and they provide some shock absorption.
Orthotics
There are many types of orthotics available today, ranging from off the shelf, the type to fit your shoe size, right up to a fully bespoke pair.
We have chosen to feature Orthotics4U having worked for many years with the Doctor in the USA who designed them They are an excellent orthotic providing great support and durability and being made of very thin Black Nylon are comfortable and easy to fit into foot wear.
As with all our products, we have worn Orthotics4U ourselves and speak about them not only from a medical knowledge but with personal experience.
If your have more severe or specific problems, Orthotics4U will give you some relief, but you may need to consider a more in-depth approach.
A full lower limb biomechanical assessment will tell us exactly where your problems are and where you have any restrictions in movement.
In our Practice we allow up to 1 ½ hours for an assessment and we take about 70 different measurements and conduct a video gait analysis. This allows us to understand your feet and lower limbs.
Once we have all the facts and have looked at your foot wear, we can advise on the most appropriate orthotic whether it be fully bespoke, semi bespoke or off the shelf orthotics.
The fully bespoke option will give you the best result as these are made specifically for your feet, with an individual prescription. Fully bespoke orthotics are made by taking a cast of your foot. At our Practice, we use a 3D optical laser scanner from the USA. which was the first one of its type to be used in the UK. Unlike casting in plaster of paris, the Laser Scanner is quick, clean and very precise. We have used a laser scanner since August 2000, achieving a very high success rate.
The scan is then e-mailed to the Lab together with a 2 page prescription form which will have been completed to ensure that your orthotics provide you with the correct control for your feet. There are many modifications that can be made to the shell of the orthotics to improve function and these will be included in your prescription where appropriate. At our Practice we keep up to date with the latest prescription techniques and this helps us achieve our excellent success rate.
There are different types of bespoke orthotics available dependant on the problem and whether you play a particular sport, are a dancer, runner or a walker. (A list of the type of some of the sports and orthotics suitable for them are listed below)
The materials can also vary from very hard rigid shells for maximum control to softer materials for patients with Rheumatoid Arthritis or Diabetes. Each orthotic is specifically made to suit the individuals requirements and no two will be the same.
Getting used to orthotics is done by wearing them for one hour the first day and slowly building up to full wear. This usually only takes about a week and gives the best results as some muscle groups will not have been working correctly and they need to adjust. However it can take longer and much depends on the individual patient.
We often have the comment that our patients expect their rigid orthotics to be very uncomfortable especially to start with and they are amazed that it is the opposite and that they are in fact very supporting and comfortable.
Foot wear with orthotics is extremely important and there are certain types of shoes which just really don’t work well with fully functional orthotics. The best results are obtained with lace-up or fastening shoes. It is also very important to wear shoes that have not been worn down through incorrect gait patterns.
Semi Bespoke Orthotics are made to your shoe size and they can have a certain level of prescription in them which are again made at a laboratory. The most popular for adults is still a thin material and results are very good.
Children’s Orthotics vary considerably from holding the child’s feet into position using higher sided orthotics, special orthotics which stop the child from either in-toeing or out-toeing and orthotics to prevent over pronation. Again, foot wear is extremely important in achieving good results and full advice is given at the assessment.
Sports and Orthotics
The correct choice of foot wear for running is imperative as is the fit of the shoe. Ill fitting shoes can produce injuries such as blisters, black toe nails, corns, ingrown toenails and pressure irritation.
The most common problem runners have is over pronating (rolling the foot too far inwards and flattening the arch) and many shoes now have a degree of pronation control, which is helpful if your condition is not extreme. If orthotics are to be used in running shoes, the shoes should be neutral without any anti pronation control which will allow the orthotics to provide the exact level of control required.
Many runners have problems around the shin area, commonly called shin splints, and it is important to address these within an assessment to properly assess the cause in order to provide the right treatment.
Football boots are great for the sport, but not necessarily kind to feet. Because they have to be quite snug on the feet and have good traction, they don’t give much support in this multi directional sport. We usually recommend heel raises to help take the strain off the muscles in the back of the leg leading down to the Achilles tendon, particularly with children as they are growing when the muscles can be susceptible to strain.
Orthotics can be used very successfully in football boots as the orthotics used are made from extremely thin materials which don’t interfere with the fit of the boot.
A note about football socks… many footballers suffer with athletes foot type conditions, our Active Silver Socks can help to eliminate this problem
Tennis
This is another multidirectional sport which requires a lot of lunging onto the ball of the foot. Ill fitting shoes can again cause all sorts of skin and nail related problems. Orthotics for this sport will take into consideration the level of shock absorbency required and extra materials added to help with this. Orthotics for this and other racquet sports are usually full length and have extra control under the ball of the foot to ensure that the orthotics maintains the foot is a good position even at toe off.
Golf
Golf is a multidirectional sport which also requires the right handed player to be able to pronate (roll the foot inward and flatten the foot) through a large range during the end of the golf swing while the left foot needs to be stable. Orthotics need to take this into consideration but also be constructed to allow for the fact that the golfer walks quite a distance during the round.
Wearing our Active Silver Socks can also increase the comfort of your round of golf.
Downhill Skiing
Orthotics in ski boots work really well. They can help improve edging and turning. Even the skier who has mild pronation will find it difficult to edge as once the ski boot is on, it acts almost like a cast, keeping the joint which connects the foot and leg in a rigid position. In those with pronation problems, this leaves the foot balanced on the outside edge where the opposite movement is required in edging. By introducing an appropriately prescribed orthotic the skier can achieve better edging, more comfort and less likelihood of injury.
Wearing heavy duty Active Silver Socks instead of ski socks can help maintain comfort and the condition of your feet.
Walkers and Ramblers
There is a big difference in foot wear for walkers dependant on the terrain you are going to be walking over. Proper advice should be sought to achieve a good fit and choice.
If there are any underlying biomechanical problems symptoms may start when walking long distances. Uphill and downhill walking puts different strains on muscles and in particular can start up pain in the shins. Heel pain, ball of foot pain are also very common.
Orthotics can provide a stable platform to take away the pressures and working with the boot provides a greater degree of comfort. Wearing our heavy duty Active Silver Socks instead of normal socks can help maintain comfort and the condition of your feet.
Frequently asked questions about Orthotics:
Orthotics benefit people with foot pain or discomfort due to walking imbalance (biomechanical complaint). Imbalances such as Flat feet, heel pain, knee pain and shin pain are known to cause pain and discomfort.
Can you wear the orthotics during all daily activities?
- People who stand or walk all day will benefit from orthotics.
- If you suffer from pain during any form of sporting exercise then orthotics can reduce the pain associated with your condition.
- For overweight individuals, orthotics will help to counteract the extra stress being placed on the feet.
What specific conditions may be helped?
Below is a list of all the conditions that orthotics can help.
Achilles Tendonitis, Corns, Metatarsalgia, Sesamoiditis, Ankle Sprains, Flat Feet, Neuroma, Tendonitis, Arch Pain,
Heel Pain, Pronation, Top of the foot pain, Bunions, Knee Pain, Shin Pain, Toe Pain
Imbalance in your feet can alter the bony structure of your feet and lower legs, foot orthotics may eliminate posture problems and foot and leg pain.
Do I need a doctor's prescription to order custom orthotics?
No. Orthotics are available in foot care stores and via internet sites. Custom orthotics are orthotics that are especially molded to your feet. These need to be made by a podiatrist and will be very expensive.
Why do I need orthotics?
Imbalances of the bones of the feet can result in abnormal foot motion (over pronation). This can impair foot function which can result in abnormal rotation of the legs and sometimes affects the knees, hips or back. If we combine these tremendous forces with the need for precise balance, we can see how small structural changes in the foot can make significant differences. Orthotics help to improve those structural changes.
If I use orthotics, will I become dependent on them?
No. Orthotics simply allow the muscles, tendons and bones of the feet and lower legs to function at their highest potential.
It depends on what type of orthotics you have. Normally top covers of bespoke orthotics will need replacing about every 12 months. The shell will normally last about 5 years and any external postings will need to be replaced when they compress. This all depends on what Biomechanical problems you have and how hard you work your orthotics. Other types of orthotics will have varying degrees of life depending on the materials used to make them.
Your lower limbs need time to become accustomed to their new position. We normally advise wearing them for one hour the first day and increasing the wear time by one hour each day until you are wearing them full time. If any problems are experienced take the orthotics out of your footwear and resume the next day with the wear time you were comfortable with. You can then start to increase the wear time again until you are wearing them full time.
Back to top
|
