Foot Orthotics and Shoes

Are you experiencing foot pain?

If that answer is yes, then there are multiple ways your health care provider will suggest or prescribe certain items in order to get you back on the path of recovery.  Based on the severity of the problem, the patient will be prescribed various tools that provide alignment, support, and cushioning in order to address symptoms.

Conservative treatment of foot and ankle pain includes Foot orthotics, OTC orthotics, OTC inserts, and shoes. The appropriate course of action the patient will be determined by your treating physician.

Common Foot problems where orthotics and inserts can be beneficial:

• Plantar Fasciitis
• Morton’s Neuroma
• Hallux Rigidus & Limitus
• Achilles Tendinitis
• Posterior Tibial Tendinitis
• Chronic Ankle Sprains
• Metatarsalgia(fore foot pain)
• Peroneal Tendonitis
• Arthritis(various types)
• Neuropathy
• Post surgical discomfort
• Plantar Fibroma
• Leg Length Discrepancy

Foot Mechanics:

First it’s important to understand some basic functions of the foot and ankle and how it applies to everyday life.  Feet are rather complicated of course, so it is suggested to take some extra time to understand your specific condition.

You can divide the foot into two main functions, Pronation and Supination

Pronation:

The foot is designed to adapt to uneven terrain while reducing impact it creates on the body.  The medial or inside arch of the foot is the mobile adapter, it’s also the suspension for your body, it allows for the foot to find stability with the ground while reducing impact forces.

Supination:

The outside or pinky toe side of your foot is known as the rigid lever. The outside of the foot allows you to make contact with the ground when entering a step or landing on your heel.  Supination also creates leverage for the foot to propel a person forward at the end of a step or “toe off.”

Overview:

Both Pronation and supination are normal motions of the foot and ankle. Where problems arise is when the foot might over pronate (flat feet) or over supinate (high Arches) creating stresses on the various tendons, ligaments and bone structure.

Orthotic and Insole Overview:

Custom Orthotics: A custom foot orthotic is comprised of supportive or accommodative materials that are formed to a cast of the patient’s feet.  Orthotic composition will be based on addressing patients’ needs such as foot deformities, areas of pain, the level of activity, and the shoe requirements of the patient.  A more supportive or functional orthotic will be made with stiffer materials where an accommodative orthotic is more flexible or has a softer feel.

Materials:

There’s a wide assortment of materials used in foot orthotic construction such as various types of polymers, carbon fiber, EVA, medical grade cork, and 3D printed filaments.   Layers of cushion are added as well such as urethane, leather, neoprene, suede and types of foam.

Overview:

The goal of a functional custom orthotic is to provide control over range of motion of the foot.  The design of the device is to improve how the foot balances while walking, standing, or running. An accommodative orthotic would be designed to reduce pain at a given location on the foot whether it’s a bony prominence or an area of concern that would be prone to skin breakdown or ulceration.

Insurance coverage for custom foot orthotics can vary, it is suggested that you check with your insurance provider to see if you’re covered for such items.

OTC Orthotics and OTC Inserts:

OTC options come in many shapes and sizes in order to accommodate various types of footwear and foot shapes.  OTC inserts are designed to work with a large percentage of the population and are effective at treating more mild discomfort. However, keep in mind these inserts are made to fit on an average which means they do not necessarily work for everyone.   Also with OTC options being quite affordable they will have to be replaced more often than custom.

Patients with mild to moderate discomfort, budget concerns, or just looking for extra support, OTC inserts can be an effective solution at an affordable price. (Link to ROC Shop)?

Shoes:

Shoes can be often overlooked when deciding how to reduce a person’s pain.  Shoes should be viewed as the foundation for support and alignment.  Investing in a quality pair of shoes involves visiting a professional shoe fitter to have your feet measured, needs discussed, and trying various models that will suit your needs.

When deciding on a new pair of shoes, there are multiple factors to consider.

• First is activity, such as walking, running, hiking, or work related scenarios such as non-slip soles, steel toe, etc.
• Second is pairing the appropriate shape of shoe with the person’s foot shape. For example shoes are made to accommodate various types of feet such as high arches or flat feet with various features to provide support for that given foot shape.
• Our feet will change over time; these changes can be a result of age, prior injury, or high impact activities. Having your feet professionally measured will allow the fitter to determine the proper length and width of shoe which can create quite a positive result one’s comfort.
• It’s important to remember that there’s no standard to shoe size.  You’ll find that a particular brand or model will fit shorter or longer than other shoes of the same size. Same can be said for width, one brand’s wide might fit like the medium width of different brand.

Pairing Shoes with orthotics:

When adding an orthotic or insert to a shoe can create certain fit issues.  Foot orthotics are made to suit the patient’s needs, so you might find that you have to purchase a shoe with a space allowance to comfortably fit the device along with your feet.  Your orthotic fitter will guide you through this process.

Final Overview:

Orthotics, insoles, and shoes are an effective means of providing conservative treatment of the foot and ankle. Many patients experience an improvement in quality of life and less painful feet. Feel free to ask the treating Physician about what options will apply to you.  The Clinician will assist in connecting you with the ROC’s Certified Pedorthists for orthotic consult.

The Foot and Ankle Center at the ROC offers a full circle approach to foot and ankle care. We have multiple experts in their field from Orthopedic Surgeons, Nurse Practitioners, Certified Pedorthists, Casting Technicians, and skin and nail care specialists.