Custom Orthotics and Modified Inserts

Unlike many practitioners, I routinely fabricate full-length custom orthotics from soft, lightweight materials. This has the advantage of providing personal service, and the ability to make timely adjustments while being cost effective.

I also modify over-the-counter inserts to address a variety of foot problems. When a custom orthotic is unnecessary or if cost is a major issue, this is an effective approach.

Since I am doing the work, I am able to charge less for the services, and whatever I fabricate will be ready to use in a day or two; frequently overnight.

I generally construct full length orthotics using a variety of tough foam materials. These materials provide correction and support without the uncomfortable feel of a hard plastic device.

How Functional Orthotics Work

A functional orthotic is a shaped device which acts as an interface between the inside of the shoe and the plantar surface of the foot. This orthothic is a platform to change stance and gait. It may have significant influence on the motion of the rear foot as to the timing of that motion and amount of motion allowed. The orthotic influences how weight is distributed as each phase of the weight bearing gait cycle proceeds from heal contact to toe off.

Flat Feet

The most common use of a functional orthotic is to reduce extra pronation or, in other words, the inward motion demonstrated by a flexible flat foot. Walking and running on hard surfaces may generate fatigue. Examples of problems associated with excess pronation and internal rotation of the leg are foot fatigue, tendinitis of the deceleration tendons acting on the inside of the foot, plantar fasciitis, shin splints, and medial  knee pain. These problems are often successfully treated with a functional orthotic device that limits excess pronation.

The construction of the shoe holding the orthotic  is also a significant factor. Some shoes will diminish while others enhance the influence the functional orthotic.

There is variation in how patients respond to an orthotic or other gait changing devises. In many instances, adjustments are required to accomplish the perceived bio-mechanical task as well as to address the patient’s sense of comfort.

Foot fatigue: Everybody Says: ‘When Your Feet Hurt, You Hurt All Over’.

Not everyone’s foot is shaped just the same. Folks with absolutely flat feet that don’t change shape much or those who have feet that start out with an arch but the arch is lost when they stand commonly experience problems described as foot fatigue. This may be felt in the arch or the rear part of the foot. Foot fatigue also encompasses secondary strain to involved joints, the surrounding soft tissues, and the tendons affecting them.

The symptoms of pain and fatigue can usually be improved significantly by the addition of a Functional Orthopedic or Modified Over-the-Counter Insert to the shoe. This will serve to shift the weight from the inside of the foot to a more neutral position in the middle. This change allows for the skeleton to more efficiently support body weight rather than straining soft tissue structures and placing the joints in a painful position where they are constantly at the end of their range of motion, and, an appropriate shoe makes any insert work better.

Foot Beds and Modified Over-The-Counter Inserts

Custom molded orthotics are not always necessary for reasons having to do with the specific foot problem being addressed, or because the relative higher cost of a custom orthotic is an issue.

I frequently modify the underside of a quality ( meaning…one constructed from materials that will hold up to the wear and tear of hard daily use..they are not expensive )  replacement innersole to  1. shift the position of the foot during stance and gait much like a custom orthotic does. 2. to protect problem areas, such as callouses or ulcer sites from focused weight bearing.

Why Modified Inserts Work

Callouses form when friction and pressure is focused over prominent bone. By isolating these lesions and reducing the forces of friction and pressure the callouses will not develop, at best….or will take much longer to form.  Therefore, if I shave a patient’s callous on the ball of their foot and the patient wears an appropriate shoe and modified insert, that area will remain relatively pain free between appointments. Simple to do.

Contact us to make an appointment at 508-771-7272 to discuss custom orthotics.