Patient Information

Common foot problems that respond to the use of orthotics:

Please note that most feet problems can be avoided with proper care of the feet. This includes proper footwear (Shoes that have high and wide toe boxes and deep heel cups) and foot orthotics.

1. Achille'sTendonitis: Inflammation of the Achilles' Tendon due to a shortened tendon or lack of stretching. Recommendation: An orthotic fitted with a heel cup for added support.

2. Calluses: The accumulation of dead skin cells, normally on the balls of the feet, that become hard and thick. This is normally as a result of wearing tight, and high heeled shoes, and the loss of fat pad. Recommendation: An orthotic, to help redistribute the patient's weight evenly.

3. Corns: The accumulation of dead skin cells on other areas of the foot than that of calluses. Namely, the tops, sides, and tips of the toes. Recommendation: Orthotics to help reduce ground shock.

4. Diabetic Neuropathy: The diabetic patient loses the ability to feel pain, due to numbness in hands and feet. Minor cuts, etc. can lead to ulcerations and even amputations if left untended. Recommendation: A diabetic orthotic, containing a plasizote top cover which accommodates pressure by conforming to the diabetic foot's heat and pressure.

5. Heel Spurs: this is an abnormal growth of the heel bone as a result of calcification where the plantar fascia pulls away from the heel. This is normally due to over-pronation. Recommendation: Orthotics with a heel spur pad along with shock absorbing footwear.

6. Metatarsalgia: Pain located on the balls of the foot. Recommendation: Orthotic which includes a metatarsal pad to relieve the pressure off the metatarsal heads.

7. Morton's Neuroma: The inflammation, pain, and swelling between the 3rd and 4th rays at the ball of the foot. Symptoms include numbness and cramping of the forefoot. Recommendation: A casual, sport, or dress orthotic with a metatarsal pad.

8. Morton's Toe: A condition where the 2nd toe is longer than the big toe. This leads to excessive pressure on the 2nd metatarsal head where calluses can form. Recommendation: Orthotics with more arch support to keep the foot in alignment with a metatarsal pad to cushion and reduce the stress on the ball of the feet. Shoes a size or a half size larger are recommended.

9. Plantar Fasciitis: Plantar fasciitis is the inflammation due to repeated overstretching of the plantar fascia ligament, the foot's fat pad from over-pronation. Recommendation: An orthotic to bring the foot back to sub-talar neutral.

10. Sesamoiditis: Inflammation of the sesamoid bones. Recommendation: An orthotic with a V-wedged cut out or a 1st ray cut out.

How Orthotics are Made:

Plaster Manufacturing

Step 1

The positive model is created by pouring liquid plaster into the original impression. Once hardened, the cast is removed from the impression. A series of modifications are carried out according to the desired prescription.

Step 2

The vacuum forming of the desired material is next.

Step 3

Detail: Orthotic before finishing.

Step 4

Orthotic is ground to shape, finished, and covered according to prescription.

Digitized Manufacturing

Step 1

Begins with the laser scanning of the negative cast, this information is then processed on the computer to produce the digital image on screen. Postings are implemented, and the corrected positive cast is ready to be produced.

Step 2   (Milling Positive)

The milling stage is where the corrected positive model is produced. The "cast" is made from particle board. Once milled, it is sent to the forming department.

Step 3

The vacuum forming department is where the raw orthotic material takes on its custom form. Here the desired material is heated and molded to the positive model of the patient's foot.

Step 4

Once cooled the orthotic is ground to shape, finished, and covered according to prescription.

or.... Step 2  Direct Milling

The Negative of the corrected cast (The actual orthotic) is directly milled from thick orthotic material, usually polypropolyne.  Step 3, Vacuum forming can be skipped and Step 4 is next.

Frequently Asked Patient Questions:

Why Custom Orthotics 

Custom made foot orthoses (often called orthotics) can help to alleviate painful or debilitating conditions of the knee, lower limb and foot. They can also help improve balance and accommodate foot deformities that are inherited or that result from injury. Pedorthists typically use a combined approach of orthoses and footwear to create a biomechanically supportive system that addresses the specific condition.

What is an Orthotic?

An orthotic is a device designed to align the foot and ankle into the most anatomically efficient position. The plastic body of the orthotic helps to re-align the foot by redirecting and reducing certain motion that takes place during the gait cycle. Since your feet are the foundation for your upper body this new alignment often helps alleviate problems in other parts of the body.

Who needs orthotics?

If you experience fatigue or tired legs during route activities or if your feet are killing you, you may be a candidate for orthotics. Orthotics can even help with other problems like knee or lower back pain.

What specific conditions are helped by orthotics?

Orthotics can provide relief for Plantar Fasciitis, Achilles Tendonitis, Arch pain, Metatarsalgia, Neuroma, Sesamoiditis, heel pain, Arthritis, Bunions and many others.

How are orthotics made?

Orthotics are made from a mold of the patient’s foot. Corrective modifications are built into the mold then a thermoplastic material is molded over the model of the foot. The plastic is trimmed to specific anatomical land marks then additional corrective postings are added to further assist in controlling and realigning the foot.

Why do new orthotics sometimes feel uncomfortable?

Since the orthotic works to realign the structure of your foot you may feel pressure in some areas as the orthotic attempts to do its job. For this reason orthotics should be worn in two hour intervals and slowly extend the wear time over a period of two weeks.

What kind of shoe do I need for my orthotics?

For the most part any shoe that has a removable insole will work with your orthotic. Just remove the insole that came with the shoe and replace it with the orthotic.

Should I wear my orthotics all the time?

The longer you wear your orthotics the more benefit you will get out of them. If your daily activities vary to the extent that you change your footwear, then you should have a second pair of orthotics designed for that specific activity. (i.e. going to the gym after work)

Will my muscles get weaker from wearing orthotics?

Orthotics will not reduce muscles tone. They will help position your foot so you will be using the right muscles at the right time, reducing fatigue and allowing your muscles to be used more efficiently.

Will I become dependant on my orthotics?

If you call eye glasses or a hearing aid a dependency you may become dependant on your orthotics. Listen to your body if you have pain or discomfort that your orthotics helped to alleviate or minimize you may want to wear them all the time to prevent the problem from reoccurring.

How long will my Orthotics last?

The expected life of an orthotic can very greatly from patient to patient depending on his or her foot structure, type of activities, type of orthotic and the materials used in the device. Re-fabrication may be needed after two or three years, or as many as ten years. Your podiatrist will want to assess your progress and determine when to replace your orthotics. Perspiration and time may change the color and appearance of the top cover. Although this does not affect the function of your device, you may want to have the top covers refurbished at the lab from time to time to keep your orthotics looking fresh.

What about cleaning and maintaining my orthotics?

Orthotics can be hand cleaned with mild hand soap and air dried.