Orthotics are shoe inserts designed to correct the way the foot moves while standing, walking, running or playing a sport. Orthotics modify abnormal foot behavior during weight-bearing activities in order to alleviate pain and protect the feet from further damage. By providing support in areas where the foot is weak and by directing its movement, orthotics provide support while helping the foot to function more normally.

Orthotics can be made for children, adolescents or adults or any age. They may be rigid, to control movement; soft, to absorb shock, improve balance and ease pressure on sore spots; or semi-rigid, with dynamic layers of rigid and soft materials, to assist athletes. It is possible for orthotics to be designed for use in a variety of footwear including almost all types of shoes, skates and boots.

Reasons for Orthotics

Orthotics may be worn for a number of purposes. While they are often worn to relieve the discomfort of minor foot abnormalities, they may also be used as essential medical devices. Orthotics may be used to:

  • Relieve chronic foot, leg or low back pain
  • Relieve fatigue when standing or walking
  • Accommodate flat feet, bunions, or other foot problems
  • Provide support after a sprain or fracture

In addition to decreasing undue pressure on the feet, legs and back, orthotics prevent abnormal shoe wear which can be a cosmetic, as well as a financial, advantage.

Types of Orthotics

While orthotics are available over-the-counter to correct minor problems, the most effective orthotics are those that are custom-made. Custom orthotics are typically made by creating a cast of the feet out of plaster, compressible foam, or some other substance, but may also be created after an optical scan of the feet. They meet the specifications of the particular individual for whom they have been manufactured and are fashioned to support the heel, arch muscles, ligaments, tendons and bones of that particular patient's feet.

As a medical device, orthotics help to reduce fatigue, provide support, and gently reposition the feet to alleviate pain and prevent further damage. There are two basic categories of custom-made orthotics: accommodative and functional.

Accommodative Orthotics

Accommodative orthotics are used to treat painful or injured areas on the bottom of the feet, such as calluses, foot sores or ulcerations or plantar fasciitis. They are frequently used in young children with minor foot problems. These orthotics are designed to cushion or pad the feet and to relieve pressure on damaged areas. They can be made of a variety of flexible materials, such as cork, leather, plastic foam or rubber. While very successful in reducing discomfort, accommodative orthotics are somewhat bulkier and less durable than functional ones. They also require frequent adjustments in order to work properly.

Functional Orthotics

Functional orthotics are designed to correct foot deformities and provide support to deformed areas of the feet. As such, they are typically made of less flexible materials than accommodative orthotics, such as semi-rigid or rigid plastic or graphite. Functional orthotics have the advantage of being more durable than accommodative ones, and, because they are thin, are more likely to fit into standard-sized shoes. They are, however, less padded than accommodative orthotics and more difficult to adjust. Functional orthotics are commonly used to treat a variety of painful condition which may include:

  • Excessively high arches
  • Plantar fasciitis
  • Neuromas
  • Neuromuscular disorders
  • Bunion deformities
  • Leg-length discrepancies
  • Stiffness of the big toe (hallux limitus/rigidus)
  • Fallen arches (pes planus)

Functional orthotics used for more serious disorders may include leg braces which offer more extensive support for purposes of rehabilitation and protection.

For patients with serious disorders of the foot, ankle, knee, hip or back, orthotics can mean the difference between being practically immobile and leading a normal lifestyle.

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