What are orthotics?
What are they?
Orthotics are medical grade innersoles for your footwear. They are prescribed by your Podiatrist after careful and detailed assessment of your biomechanics and daily work and activities.
How are they made?
Your Podiatrist will conduct a biomechanical assessment (how your legs and feet move), a mould of your feet is then created by taking a cast of the feet. Your Podiatrist using the results of their assessment creates an individualised prescription for the orthoses, the cast and prescription are sent to a specialist manufacturing lab who builds the orthotics.
How do they work?
The orthoses aim to correct and accommodate for misalignment in your legs and feet e.g. flat feet (excessive pronation). Through the cast and manufacturing of the device from the mould of your foot each orthoses is specific to individual foot sizes and shapes.
The different types
There are several different types of orthoses with a combination of styles, designs and materials. The two main types of orthoses are functional and accommodative orthoses. Functional orthoses typically are more rigid than accommodative orthoses. The most common materials used for orthoses are Polypropylene (plastic) and EVA (foam) with both being available in different thicknesses and densities (how hard it is), in some cases carbon fibre is used for certain sporting applications. With polypropylene orthosis another option for shell shape is called a “Hook” shape where the base is modified to reduce the bulk of the shell and allow for easier fitment into narrow footwear e.g. womens flats or casual shoes.
Most orthoses will replace the original innersole in a shoe so they will be ‘full length’ and cut to the shape of the original shoe innersole. There are other options with 3⁄4 length insoles which stop just behind the balls of the foot. Sulcus length orthoses are also possible, these devices will extend from your heel to the base of your toes.
There are also orthoses that extend up the sides and back of your foot, these are used in more complex cases (discussed later), they are known as Supramalleolar orthoses (SMO) and Ankle Foot orthoses (AFO). SMO’s extend up the sides of the ankle to the ankle joint and are used mostly in children and teenagers to provide more stability to the ankle joint. An AFO extends up the lower half of the leg and typically ends around where your calf muscle is largest (¾ up the shin). Both types of these orthoses are fastened with an adjustable strap and require further assessment and casting to ensure maximal comfort.
What do they treat?
Orthoses can treat a wide range of ailments and disabilities relating to the leg and feet.
Typically the main clinical indicator for orthoses is pain in the feet or legs e.g Plantar fasciitis or knee arthritis.
They aim to improve your gait cycle (walking pattern), so if you have a leg length discrepancy (one leg longer than the other) affecting how you’re walking an orthoses can be made to reduce/ accommodate for this.
Disfigurement from injury, orthoses can be casted to match feet that have been remodelled from trauma or surgery.
Systemic/ progressive conditions such as Multiple sclerosis which can lead to Foot drop (inability to lift your toes off the ground) can be treated with SMO’s and AFO’s.
Congenital diseases which lead to impaired or stunted foot and leg development often can be improved and compensated for with custom orthoses.
Range of biomechanical disorders/ conditions e.g. PF, TB, neuroma, Loss of muscle function due to condition e.g. MS leading to foot drop, stroke and Congenital deformities.
