Looking to get orthotics and don’t know where to start?
Want to know how orthotics from a Podiatrist are different from the ones at the chemist? And are they really worth the price?
Read on to learn what orthotics are, how they work and how they are used to treat foot conditions.
What is an orthotic?
Orthotics are a special shoe inserts that can be used to treat numerous foot conditions. There are many different types of orthotics, and they will vary in materials and features based on where you get yours.
History of orthotics
Orthotics have been successfully used for centuries as a treatment for foot pain and to improve comfort. The materials used and theory behind them has evolved and changed over time. Originally made with metal, they now use specialised plastics. The comfort and fit of orthotics has improved to provide the best solution for people that need to wear them.
Podiatrist and Orthotics
Podiatrists are experts in foot care with training in foot anatomy, biomechanics and prescribing orthotics for therapy. At our foot clinics, we assess all our patients looking at symptoms, their footwear, activity and recommend orthotic therapy options if needed.
How do orthotics work?
Our patients always ask us this question and feel that as Podiatrists, we should be able to answer it as best as possible. The goal of orthotic therapy is to reduce internal and external forces which are acting on specific parts of foot, to treat injury and reduce foot pain.
- Ground Reaction Force
Orthotics alter pressure coming from the ground to the foot (ground reaction force) when you stand, walk or run. By altering these forces, we can achieve better foot function and reduce any excessive forces that lead to foot injury.
- Orthotic Design
Depending on pathology and where your foot pain is located, different orthotic design with specific features can change location, magnitude and timing of force acting within the foot. These excessive forces inside the foot and ankle are the cause of nearly all mechanically related injuries that we treat on a daily basis.
- Neurofeedback
By wearing orthotics, we can help send back sensory feedback to your brain to prompt it to change its movement during gait. With these signals, your brain can send corrective movements to the foot and improve function, avoid pain and prevent injury.
Now that the Physics lesson is finished, read on to see how orthotics can help you with your foot pain.
If you are experiencing foot pain or discomfort, make an appointment with one of our Podiatrists to assess your feet.
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Conditions
Orthotics are used to treat numerous foot conditions.
Depending on which condition you have, the design and the features of the device will to help provide you with the best treatment outcome. Orthotics are never a standalone treatment. Your Podiatrist will recommend footwear changes, exercises and in some cases medication as well.
Here are some examples of foot conditions that can be treated with orthotics:
- Plantar fasciitis
- Bunions
- Knee pain
- Flat feet
- High arches
- Bursitis
- Neuroma
- Injuries
- Achilles tendinopathy
Different types of orthotics
Not all orthotics are made equal. Difference in materials and construction leads to variation in specialisation and ultimately price.
These are ones you would find in the pharmacy which fit according to shoe size. Many people can buy OTC orthotics and find them comfortable and able to relieve some of their foot pain. They tend to be a generic foot shape with some brands having specialised features such as “low arch” or “for high arches”. Remember, not everyone has the same foot and one-size-fits-all approach may not work for some people. Another downside to OTC orthotics is that they tend not to last long because of the materials used to make them.
This is where an orthotic is moulded to your foot. It allows more personalisation than an OTC orthotic and is more durable. They are handmade by your Podiatrist in a clinic. A silicon impression or foot mould is taken from the patients’ feet. This impression is later used to shape the warmed pieces of compressed materials that the orthotics/orthoses are made of. The patients’ feet are settled into these for a moment until the piece of warm orthotics have cooled down.
These are prescriptive foot orthotics where a Podiatrist incorporates patient-specific prescriptive elements into the design of the device. Typically, an impression of a foot is taken either by plaster or 3D scan, which is then reproduced in a lab. Then an orthotic is designed and made to fit your feet. They are 100% handmade by a specialist and involve complicated steps to manufacture.
we offer two orthotic solutions for our patients:
Custom Made Orthotics
Learn more about our custom orthotic process and range
EXPLORE
Custom Moulded Orthotics
Learn more about our SIDAS range
EXPLORE
Assessment
Orthotic therapy is a multi -step process. If you are considering getting orthotics from a foot doctor in Sydney, we will assess your relevant history, footwear and biomechanics. You can rest assured we will only recommend orthotics when necessary.
STEP 1: ASSESSMENT
A comprehensive foot assessment including footwear history and visual gait assessment.
STEP 2: ORTHOTIC SELECTION
Your podiatrist will recommend orthotic options according to your clinic needs. You will decide which option you would like to proceed with.
STEP 3: ORTHOTIC FITTING
Orthotics when ready will be fitted into your chosen footwear, and a six-week review appointment will be booked in.
STEP 4: REVIEW
The podiatrist will review how your orthotics are going and implement any modifications if required.
what shoes can i put my orthotics in?
Shoes are important when it comes to orthotic function. Wearing proper fitting orthotic-friendly shoes can help improve function of the your orthotics and avoid any potential fit issues. Your shoes should have:
- An enclosed heel with firm heel counter
- A firm midsole
- A wide midsole
- A removable footbed
- Enough depth and width for your feet
- Minimal heel height
Orthotic-friendly shoe design has come a long way in the last few years. You don’t have to worry about waeringyou no longer have to wear clunky, ugly shoes as previously in the past.
*Shoes from Bared Footwear
Dont know what shoes to put your orthotics in?
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evidence for orthotic therapy
There have been numerous studies on orthotic therapy and its role in treating foot and ankle conditions. Here are some summaries from recent studies done.
common myths
Orthotics are without their own controversies and myths. Here are some common myths and some answers from our Podiatrists.
Orthotics aren’t only for people with flat feet, they can be used for different foot types and conditions.
Orthotics are designed based on your needs. Depending on what is wrong, and what activity you are going to use them for, different materials are used. Some are hard, some are soft. But the goal of orthotic therapy is never to give you any pain but to treat your foot problem. If you feel pain or discomfort when wearing your orthotics, you should talk immediately to your podiatrist.
Orthotics do not immobilise your feet. As mentioned in our section on how orthotics work, they alter high forces acting in certain parts of your feet that lead to foot pain. You are constantly putting pressure on them when walking and standing, so as a result it’s hard to develop weakness in your feet. If you have pre-existing reduced strength in important muscles in your foot and legs, especially if they are important in highly demanding activities like running of professional dancing, we recommend working on strengthening those.
That’s incorrect. Shoes and orthotics have a close relationship, wearing inappropriate ill-fitting shoes can reduce the function and efficacy of your orthotics.
Not all OTC orthotics are the same. Some are highly specialised and durable and can be effective in treatment especially in children. However, sometimes they might not be therapeutic and you may require a custom made orthotic.
cost
Biomechanical Assessment
$200
Initial appointment
Medical history, patient history
Footwear assessment
Treatment plan
Orthotic recommendation
Private health insurance rebates
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Custom Made Orthotics
$720Total
Biomechanical Assessment: $200
3D foot scanning or plastering of feet: $60
1 pair of custom-made orthotics: $470
Orthotic fitting appointment: $50
12-month orthotic repair guarantee
30% discount on second pair
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Take advantage of our discounts and save money on multiple pairs of orthotics.
A good pair of orthotics is the best investment in your foot health.
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frequently asked questions
Yes, orthotics wear out. Materials and use will determine how quickly that happens. If you have a highly demanding activity that you feel will wear out your orthotics, make sure to talk to your podiatrist so they can recommend the correct orthotic for you.
At The Foot Hub this will depend on which orthotics you receive. Our Sidas orthotics are prescribed and made by our podiatrists on site. For custom made orthotics our podiatrists prescribe orthotics, but they are sent to a state-of-the-art orthotic lab for manufacture. At the lab, 3D technology and equipment recreate your foot casts from the scan. Orthotics are made by hand by high qualified orthotists following your orthotic prescription.
If your pair of Sketchers shoes have features recommended in the orthotic-friendly shoes section, then yes you can. But if the outsole is too soft and there is no firm heel counter, they won’t be ideal to put your orthotics in.
A bunion deformity is a structural condition. Orthotics can help reduce pain associated with bunions making weightbearing activities more comfortable.
No, Medicare does not cover costs for orthotics. If you are eligible for a chronic disease management plan, Medicare will rebate $58 per appointment.
We recommend a biomechanical assessment for a podiatrist to assess your feet and recommend which orthotics will work for you.
Orthotics will not change your foot structure. They will, however, support your flat foot when walking, running or standing for long periods of time. They also treat any conditions or foot pain that can arise from flat feet.
Orthotics can be used to treat different conditions like patellofemoral syndrome or various foot conditions that can lead to knee pain.
References
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- De Morais BC et al: The effect of foot orthoses on balance, foot pain and disability in elderly women with osteoporosis: a randomized clinical trial. Rheum, 52(3):515-22, 2013.
- Ferber,R. Benson, B. Changes in multi-segment foot biomechanics with a heat-mouldable semi-custom foot orthotic device. J Foot Ankle Res. 2011; 4: 18.
- Finestone A, Giladi M, Elad H, et al: Prevention of stress fractures using custom biomechanical shoe orthoses. Clin Orth Rel Research, 360:182-190, 1999.
- Gross MT, Mercer VS, Lin FC: Effects of foot orthoses on balance in older adults. J Ortho Sports Phys Ther, 42(7):649-657, 2012.
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- Hertel J, Denegar CR, et al: Effect of rearfoot orthotics on postural control in healthy subjects. J Sport Rehabil, 10:36-47, 2001.
- Kirby KA. The Ridiculous Marketing Claims of “Barefoot Science” Insoles, parts 1-4. [Facebook] (2016, Jul 10) https://www.facebook.com/search/top/?q=kevin%20a.%20kirby%20dpm%20orthotics&epa=SEARCH_BOX. [cited 2020 Feb 24]
- MacLean C, Davis IM, Hamill J: Influence of a custom foot intervention on lower extremity dynamics in healthy runners. Clin Biomech, 21:621-630, 2006.
- MacLean CL, Davis IS, Hamill J: Short- and long-term influences of a custom foot intervention on lower extremity dynamics. Clin J Sport Med, 18:338-343, 2008.
- Mills K et al: A randomised control trial of short-term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility. Br J Sports Med, 46:247-252, 2011.
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- Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Foot orthoses affect lower extremity kinematics and kinetics during running. Clin Biomech, 18:254-262, 2003a
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- Munteneau, S.et. al, Efficacy of customised foot orthoses in the treatment of Achilles tendinopathy: study protocol for a randomised trial. J Foot Ankle Res. 2009; 2: 27.
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- Nester CJ, Van Der Linden ML, Bowker P: Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait Posture, 17:180-187, 2003.
- Nigg BM, Stergiou P, Cole G, et al: Effect of shoe inserts on kinematics, center of pressure, and leg joint moments during running. Med. Sci. Sport Exerc., 35:314-319, 2003.
- Novick A, Kelley DL: Position and movement changes of the foot with orthotic intervention during loading response of gait. J. Sports Phys. Ther., 11:301-311, 1990.
- Pham T, et al: Laterally elevated wedged insoles in the treatment of medial knee OA: a two-year prospective randomized controlled study. Osteoarthritis Cartilage 12: 46-55, 2004.
- Postema K, Burm PE, Zande ME, Limbeek J: Primary metatarsalgia: the influence of a custom moulded insole and a rockerbar on plantar pressure. Pros Orth Int, 22:35-44, 1998.
- Powell M, Seid M, Szer IA: Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: A randomized trial. J Rheum, 32:943-950, 2005.
- Raspovic A, et al: Effect of customized insoles on vertical plantar pressures in sites of previous neuropathic ulceration in the diabetic foot. Foot, 10:133-138, 2000.
- Redmond A, Lumb PS, Landorf K: Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait. JAPMA, 90:441-449, 2000.
- Rome K, Brown CL: Randomized clinical trial into the impact of orthoses on balance parameters in excessively pronated feet. Clin Rehab, 18:624-630, 2004.
- Rubin R, Menz HB: Use of laterally wedged custom foot orthoses to reduce pain associated with medial knee osteoarthritis: A prelim. investigation. JAPMA, 95:347-352, 2005.
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- Scherer PR, Sanders J, Eldredge DE, Duffy SJ, Lee RY: Effect of functional foot orthoses on first metatarsophalangeal joint dorsiflexion in stance and gait. JAPMA, 96:474-281, 2006.
- Simkin A, Leichter I, Giladi M, et al: Combined effect of foot arch structure and an orthotic device on stress fractures. Foot Ankle, 10:25-29, 1989.
- Slattery M, Tinley P: The efficacy of functional foot orthoses in the control of pain and ankle joint disintegration in hemophilia. JAPMA, 91:240- 244, 2001.
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- Stackhouse CL, Davis IM, Hamill J: Orthotic intervention in forefoot and rearfoot strike running patterns. Clin Biomech, 19:64-70, 2004.
- Stacoff A, Reinschmidt C, Nigg BM, et al: Effects of foot orthoses on skeletal motion during running. Clin. Biomech. 15:54-56, 2000.
- Tomaro J, Burdett RG: The effects of foot orthotics on the EMG activity of selected leg muscles during gait. J Ortho Sp Phys Ther, 18:532-536, 1993.
- Walter JH, Ng G, Stoitz JJ: A patient satisfaction survey on prescription custom-molded foot orthoses. JAPMA, 94:363-367, 2004.
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- Woodburn J, Helliwell PS, Barker S: Changes in 3D joint kinematics support the continuous use of orthoses in the management of painful rearfoot deformity in rheumatoid arthritis. J Rheum, 30:2356-2364, 2003.
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Custom Made Orthotics
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