Improve Performance and Reduce Pain With a Sports Podiatrist.

Podiatrists, among other things, are specialists in the biomechanical assessment of feet. Biomechanics is the study of force and its control and distribution in the body. The foot is a complex collection of bones, ligaments, muscles, tendons, nerves and blood vessels, and podiatrists have spent a minimum of four years at the university level learning about the interaction between these structures, as well as how the foot relates to the alignment and function of the rest of the body.

Podiatrists have their 'Doctor of Podiatric Medicine' (DPM) degree, and are foot specialists, as this is the only area of the body they deal with. Podiatrists commonly use prescription orthotics to aid in the treatment and prevention of injuries, but also may perform surgery on the foot in certain circumstances.

What are Prescription Orthotics?

Prescription orthotics are custom made devices that are inserted into your shoes. They enhance your function by maintaining the anatomical angular relationships between the segments of the feet and legs.

Prescription orthotics control abnormal foot and leg motion, and are useful for preventing and treating injuries of the lower legs and feet. They also play a big role in managing many causes of low back pain.

Do Only Podiatrists Prescribe Orthotics?

Not at all; the prescription of orthotic devices is not regulated, so you do not need any special accreditation to prescribe orthotics. Because of this, many different practitioners and businesses make these devices.

There is a wide continuum of training, ranging from weekend courses all the way up to podiatrists with university degrees. Many shoe stores offer orthotics, as do many health care professionals, all with varying degrees of understanding of foot biomechanics.

The important thing to remember is, as with anything, the more training and experience a particular individual has, the better your treatment will be. Orthotics are no exception, and podiatrists are the most highly trained foot practitioners in the medical system.

Should I Get Prescription Orthotics Or Off the Shelf Orthotics?

Currently, there are four common methods used to make orthotic devices: off the shelf, force plate, foam box and plaster cast.

Off the Shelf Orthotics

These types of orthotics are prefabricated devices, typically store bought. Store bought orthotics can provide hit or miss pain relief because they are not specifically designed for your individual foot. Foot structure and function can vary tremendously from person to person, so this is the least desirable approach, much like one pair of glasses being used for many different people who have varying corrective eye prescriptions.

Force Plate Orthotics

Force plate involves walking on a pressure sensitive mat, which scans the foot intwo dimensions during weight bearing. The scan information is then usually used to modify prefabricated orthotic devices to fit your foot, so they are not quite custom made. The foot is a three dimensional structure, so using twodimensional information to modify a prefabricated device is less than ideal. Virtually anyone can use this method due to its simplicity, and this system requires minimal training and understanding of foot biomechanics to use it.

Foam Box Orthotics

The foam box method is used by many healthcare professionals (except podiatrists) to make orthotics. For foam box orthotics, the patient steps into a foam box, which takes a mould of the foot. The mould is then manufactured into a custom orthotic device. While this method is preferable to the prior two, it is still less than ideal in terms of accuracy, as much research into the topic confirms. The appeal of this method is it is relatively less messy and less costly than the next method.

Plaster Cast/3D Laser Scan Orthotics

The plaster cast method has repeatedly been proven to be the most accurate method used today. Much research supports the use of plaster cast orthotics. With this method, a plaster cast of your foot is taken while lying down, so that no weight is exerted on your feet during the process. Your feet are held in 'neutral position'(the foot position most ideal to be in) while the plaster dries. This enables the cast to most accurately represent your ideal foot position, and the orthotic is then manufactured from this plaster impression. A 3D laser scan maybe used in place of a plaster cast.

Why Does The Price Range Vary So Much For Orthotics?

The price of an orthotic, like anything else, is dependent on who makes them, and what method is used in the manufacturing process. The more educated and experienced your practitioner, the more they will charge, meaning podiatrist prescribed orthotics are usually more expensive than those made by other practitioners.

In addition, a truly custom device requires a series of angles be built into your orthotic to maximize control of your foot (your foot prescription), and your podiatrist will direct the manufacturing lab how to do this for your particular situation, much like a medical doctor directs a pharmacy with a prescription for medication. Adding angles to your orthotic increases the manufacturing cost. You can be sure that with less training, your practitioner is less likely to actually direct the manufacturing lab as to what angles to build into your devices, as this is an area requiring substantial levels of education and experience to fully understand.

Any prefabricated device will be less expensive (off the shelf and force plate technique) because these methods don't produce custom devices, and therefore are less expensive from a manufacturing standpoint. As it turns out, the manufacturing process for the plaster cast or 3D laser technique is on average a 20 step process, and, as such, is generally a more expensive, albeit much more accurate, method of manufacturing.

How Long Do Prescription Orthotics Need to be Worn?

Once prescription orthotics are prescribed to you, it is likely they will be worn for the rest of your life. Think of orthotics in the same way you think of eyeglasses. While orthotics are often used for rehabilitation from an injury, they are most often utilized to control abnormal foot and leg motion. Therefore, they will likely be worn forever.

Will a Foot Orthotic Improve My Athletic Performance?

Indirectly, yes. By contributing to injury prevention, prescription orthotics help to keep you training and competing, which in the end, can only help improve athletic performance. Orthotics also can improve the efficiency of power transfer from the foot to the legs. This is especially important in running, field and court sports, as well as cycling and figure skating.

Contact SEMI to connect with a top podiatrist in Toronto. Our sports podiatry team excels at treating and preventing foot injuries, as well as prescribing custom orthotics that improve your sports performance and general comfort.

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My thanks to you and your staff, because with the benefit of your expertise and care I was able to complete my first marathon in 4 hours, 22 minutes and 43.2 seconds. I came to you at the beginning...

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Sports & Exercise Medicine Institute

2 Sheppard Avenue E

Suite 601
Toronto, ON
M2N 5Y7

Phone: (416) 223-7364 (SEMI)
Fax: (416) 223-8048
Email: sheppard@semisportmed.com

Monday: 7 – 7
Tuesday: 7 – 7
Wednesday: 7 – 7
Thursday: 7 – 7
Friday: 7 – 5:30
Saturday: Open last Saturday of each month, (times vary) except long weekends, July and August
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(Not open long weekends nor Saturdays in July and August.)

40 St. Clair Avenue W

Suite 410
Toronto, ON
M4V 1M2

Phone: (416) 927-7364 (SEMI)
Fax: (647) 930-9536
Email: stclair@semisportmed.com
Monday: 7 – 7
Tuesday: 7 – 3
Wednesday: 7 – 3
Thursday: 7 – 3
Friday: 7 – 3
Saturday: Closed
Sunday: Closed

8150 Yonge Street, Suite 1
Thornhill, ON
L4J 1W5

Phone: (289) 459-7364
Fax: (905) 731-3336
Email: thornhill@semisportmed.com
Monday: 11 – 7
Tuesday: 9 – 5
Wednesday: 11 – 7
Thursday: 11 – 6
Friday: 9 – 2
Saturday: Closed
Sunday: Closed

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