Custom orthotics are designed to gently realign the bones of the foot in a
more adventurous position for running, walking and standing. Many types of foot pain are associated with over pronation. Over pronation occurs when the foot is allowed to flatten, this allows a cascade of disadvantageous events to occur. Sit in a chair rotate your knee inward and outward- notice your how your foot flattens and arches. This is called the windlass mechanism. These rotations are transferred up the legs into the hips and into the back as your arch collapses and arches when you walk or run.
Custom orthotics work to control these motions and ultimately balance them as people carry on with their everyday lives. They are not like the “custom orthotics” people buy at the Good Feet Store, those are generic arch supports fit to a “normal foot.” Custom orthotics are constructed from a mold of your foot in a CORRECTED position. This CORRECTED position is called the neutral position. Podiatrist identify this position as we move your foot through its pronation/supination range of motion, when the bones in your foot align perfectly, we know your foot is in its neutral position. This is the most important step in prescribing orthotics- therefore should be done by a Podiatrist.
Other balancing features are often incorporated in orthotics to match the position of the forefoot (ball of the foot) to the rearfoot. Occasionally, some people have anomalies in their bone or ligament structure which will require additional modifications to the custom orthotics to assure a proper fit and a properly functioning foot.
Your foot and custom orthotics are much like an elongated tripod. The heel is one leg of the tripod and the inside and outside of the ball of the foot make up the other two legs of the tripod. In order to balance the foot properly and accommodate for any anomalies, custom orthotics balance each leg of the tripod in an ideal position.
How to Wear Custom Orthotics
There are some tricks to getting the most our of your orthotics, follow these basic steps to maximize your orthotics.
- Always place your orthotics on the midsole of the shoe- this is the platform under the foam, neoprene, or leather insole, then place your insole on top of your custom orthotic if you do not have a top cover for your orthotics. If you do have a full length top cover built into your custom orthotic, remove the insole altogether.
- When buying new shoes, make sure your shoes have removable insoles- some companies insist on gluing them in- if they do- do not buy their shoes for orthotic wear.
- Buy shoes that have a rigid midsole, shoes that can easily be bent in any direction do not offer solid platform for your orthotics.
- Evaluate your shoes regularly, the materials used to construct shoes break down over time. When the materials break down they can change the way custom orthotics support your feet, making the orthotics seem uncomfortable.
- Make sure your custom functional orthotics are designed for the shoes you will be wearing. They can be constructed for narrower dress shoes, running shoes, walking shoes, ski boots, or even some sandals. It is important your orthotics are fit to the shoes you wear or will be wearing on a daily basis. The materials, width, heel cups and posts may be different based on the shoes you wear. You don’t take your reading glasses to watch a baseball game and you should not take your dress orthotics to the gym. In some cases it is necessary to get different pairs of orthotics to fit different pairs of shoes you wear.
- Break your orthotics in, I normally tell my patients to wear them 1 hour the first day and increase the time by 1 hour per day, at the end of a week you are at nearly a complete day. This is the case for most patients, however, as you practice podiatry or any medicine for that matter you quickly realize people have different tolerances. Some are able to wear them all day from the start while others may need 10 days to acclimate to their new custom orthotics. Don’t over do it with new orthotics!!!
- Let your feet get use to the new custom orthotics.
Dr. Terry Oehler DPM