Orthotics can be made to fit nearly any shoe type. When purchasing orthotics, keep the shoe gear you will be using in mind. Multiple pairs are also an option. Orthotics can be designed for specific sports. Any orthotic can be made full length or half length depending on individual needs.

Orthotic Tips

• Wear shoes that work well with your orthotics.
• Bring your orthotics with you whenever you purchase a new pair of shoes.
• Wear socks or stockings similar to those that you plan on wearing when you shop for new shoes.
• Return as directed for follow-up evaluation of the functioning of your orthotics. This is important for making certain that your feet and orthotics are functioning properly together.

Why do I need orthotics?
Everyone's foot structure is different. Just as each individual's eyesight, personality, and medical problems are unique to that person, so is his foot structure unique. The foot is composed of 26 bones, 107 ligaments, numerous tendons, and 19 muscles originating in the leg and the foot. The way these bones, muscles, and tendons work together determines the balance and alignment of the foot. This, together with your weight, the type of work you do, the amount of time you are on your feet, and the type of surface you stand on all day, not to mention the type of shoes you wear, also contributes to the delicate balance and alignment of your feet. A perfectly balanced and aligned foot is extremely rare.
Practically all foot problems are directly or indirectly related to foot malalignments. If you are experiencing any foot pains, deformities, fatigue, cramps, etc., you probably have an imbalance in your feet. Orthotics are designed to correct or rebalance that abnormality. Just as glasses or contact lenses help to correct your eyesight, orthotics help re-balance your foot structure to reduce abnormal stresses or abnormal areas of weight bearing in your feet that lead to discomfort and that can cause more serious problems as time passes.

What do orthotics look like?
Orthotics look much like arch supports. There are many types that can be prescribed: some are rigid, some soft and flexible. The doctor will decide which type you need depending on the problems you are having. In all cases, the devices fit in closed shoes and can be transferred from one pair of shoes to another.

How long do I have to wear orthotics?
Depending on your problem, orthotics should be worn the majority of the time you are on your feet, if possible.  This is not to say that you must wear orthotics when you want to dress up on occasion with shoes that are not compatible with the devices.

What type of shoes are compatible with orthotics?
Most closed shoes with a heel height of 1-1/2" or less. Orthotics are less useful in high-heeled shoes and slip out of sandals. Obviously, they can't be worn when you are barefoot

Can orthotics be used for sports activities, i.e., running, aerobics, etc.?
Definitely! In fact, many professional and amateur athletes treated in this practice would be unable to perform without their orthotics.

Do orthotics ever have to be replaced? Can they break?
If you are an adult, it is not likely that your orthotic prescription will have to be changed. Occasionally your foot structure may change over a period of time and a new prescription may be necessary, but this is rare. In children, new prescriptions may be necessary, and orthotics need to be changed after two to four years of use, and possibly sooner if the child has a growth spurt. Orthotics generally do not break.  Most of our orthotics are made out of a new high-tech material called Carboline which is non-breakable. Occasionally, they may need to be refurbished when the corner or heel post wear thin.

What is involved in having orthotics made?
A biomechanical evaluation with objective measurements of the joint movements in your feet, ankles, knees, and hips are used to prescribe orthotics to fit your individual foot. Occasionally certain muscle groups may also be tested, along with posture, stance and gait analysis.  This examination, along with angular measurements of the bones of the foot seen in your x-rays or cast are used to determine a prescription for your orthotics. A plaster cast is then taken of each foot to get an exact impression of the foot in the "neutral" position. This is the position the foot should be in to be perfectly balanced. These casts, along with the prescription, are then mailed to an orthotic laboratory that actually constructs the orthotics through 27 different manufacturing steps to get the final finished product, which is then mailed back to our offices. The day your orthotics arrive, you will be notified so you may come in and have the orthotics dispensed, along with instructions for wearing. The "turn around time" is usually two weeks.

Rigid Orthotics
The so-called rigid orthotic device, designed to control function, may be made of a firm material such as plastic or carbon fiber and is used primarily for walking or dress shoes. It is generally fabricated from a plaster of paris mold of the individual foot. The finished device normally extends along the sole of the heel to the ball or toes of the foot. It is worn mostly in closed shoes with a heel height under two inches. Because of the nature of the materials involved, very little alteration in shoe size is necessary.
Rigid orthotics are chiefly designed to control motion in two major foot joints, which lie directly below the ankle joint. These devices are long lasting, do not change shape, and are usually difficult to break. Strains, aches, and pains in the legs, thighs, and lower back may be due to abnormal function of the foot, or a slight difference in the length of the legs. In such cases, orthotics may improve or eliminate these symptoms, which may seem only remotely connected to foot function.

Soft Orthotics
The second, or soft, orthotic device helps to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. It is usually constructed of soft, compressible materials, and may be molded by the action of the foot in walking or fashioned over a plaster impression of the foot. Also worn against the sole of the foot, it usually extends from the heel past the ball of the foot to include the toes.
The advantage of any soft orthotic device is that it may be easily adjusted to changing weight-bearing forces. The disadvantage is that it must be periodically replaced or refurbished. It is particularly effective for arthritic and grossly deformed feet where there is a loss of protective fatty tissue on the side of the foot. It is also widely used in the care of the diabetic foot. Because it is compressible, the soft orthotic is usually bulkier and may well require extra room in shoes or prescription footwear.

Semirigid Orthotics
The third type of orthotic device (semirigid) provides for dynamic balance of the foot while walking or participating in sports. This orthotic is not a crutch, but an aid to the athlete. Each sport has its own demands and each sport orthotic needs to be constructed appropriately with the sport and the athlete taken into consideration. This functional dynamic orthotic helps guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently. The classic, semirigid orthotic is constructed of layers of soft material, reinforced with more rigid materials.

Orthotics for Children
Orthotic devices are effective in the treatment of children with foot deformities. Most podiatric physicians recommend that children with such deformities be placed in orthotics soon after they start walking, to stabilize the foot. The devices can be placed directly into a standard shoe or an athletic shoe.
Usually, the orthotics need to be replaced when the child's foot has grown two sizes. Different types of orthotics may be needed as the child's foot develops and changes shape.
The length of time a child needs orthotics varies considerably, depending on the seriousness of the deformity and how soon correction is addressed.

Other Types of Orthotics
Various other orthotics may be used for multidirectional sports or edge-control sports by casting the foot within the ski boot, ice skate boot, or inline skate boot. Combinations of semiflexible material and soft material to accommodate painful areas are utilized for specific problems.
Research has shown that back problems frequently can be traced to a foot imbalance. It's important for your podiatric physician to evaluate the lower extremity as a whole to provide for appropriate orthotic control for foot problems.

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(content courtesy of APMA)