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When It Comes to Orthotics, First Impressions Count

Posted on 19 March 2015
When It Comes to Orthotics, First Impressions Count

The term orthotics comes from the Greek word ``ortho`` which means `straighten`. Thus an orthotic will straighten or align a foot deformity.

Orthotics are fitted to the patient`s foot and, when worn in shoes, will redistribute the patient`s weight on the foot so that their gait is more balanced and abnormal motions are controlled. This will allow the patient to function more comfortably.

Orthotics are made out of many different types of materials of varying flexibility (soft, semi-soft or rigid), thicknesses and shock absorbing abilities. Podiatrists take into account the age and weight of the patient, the activity the orthotic is to be used for and the shoe type it is worn in. It is not uncommon for a patient to have two pairs of orthotics, one pair for athletic shoes and the other for fashionable shoes. The athletic orthotic is bulkier, broader and more cushioned. It is better suited for wearing when exercising. The thinner orthotic, usually the newer graphite material is better suited for inserting into tighter fitting dress shoes.

The type of medical problems that can be eased by the use of orthotics are numerous, but must occur as a result of a foot that has a weaker arch (flatter foot) causing the foot to pronate or roll in onto the arch. This type of motion can lead to arch pain, shin splints, plantar fasciitis, knee, hip and lower back pain to name a few.

The impression taking technique, like the foundation of a house, is most important to achieving a positive orthotic result. The preferred method and the one that I use at Toronto SEMI is to take a plaster NONWEIGHT BEARING cast of the patient's feet. This will give the exact position before it has collapsed. Avoid foam box impressions as they collapse the arch somewhat and it is more difficult to achieve the neutral position. Don`t be fooled by the high tech illusion of the computerized gait analysis. This looks state-of-the-art but again the arch is collapsed on weight-bearing.

No one in the health profession sees more feet than a podiatrist and therefore no one is better trained to treat them. Many other professionals, as well as retailers are `selling` orthotics. Know to ask the right questions, including what impression technique is used. The practitioner prescribing orthotics must possess the following qualities:

  1.     The practitioner must have a detailed understanding of the fabrication of foot orthotics from start to finish and must understand how errors in the cast can affect the shape and function of the orthotic.
  2.     The practitioner must be able to treat the patient as an entirety, not just the feet.
  3.     Finally, and most importantly, the practitioner must understand the biomechanics of the lower extremity and how to adjust or modify the orthotic after it is dispensed.

Orthotics, although not covered by OHIP, are usually covered by most extended health care plans. Know the restrictions of your plan. Some may only pay when a plaster cast is taken. Other plans may only cover the cost of the treatment if it is provided by a podiatrist.

If you have a specific question you would like answered, speak to one of your health care professionals at Toronto SEMI.

Tags: Lower body


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