What Is A Custom Orthotic?
A custom orthotic is an insert that fits in your shoes and allows your foot to remain in a certain position when standing, walking, or running. Ideally, you want your foot to be in a neutral position, neither pronated (flattened out) or supinated (on the outside edge of your foot.) The reason it is important for your foot to be in a neutral position is so that all the tendons, ligaments, and joints are biomechanically stable and they are in the position to keep your foot functioning in the most efficidnt way possible. This prevents increased stress on certain tendons and joints and ligaments, and prevents injury in your foot. If you have had an injury, such as an overuse injury, it is the best way possible to prevent that injury from recurring again. In addtion, it evens out and areas of increased pressure, decreasing extra weight to certain areas that may cause increase in edema or swelling, and thus overall decreasing your pain. A custom orthotic is one that is made custom to you, much like custom eyeglasses. Our staff will take a slipper cast mold of both feet, and you will always receive a pair of orthotics even if you are having pain in only 1 foot, as both your feet will benefit from the custom orthotics. The slipper cast mold is total contact to the arch and contours of your foot, so it is a perfect representation of your feet. The slipper cast molds harden in a matter of minutes, and they are sent to the lab where an orthotic is manufactured that represents the exact impression of your feet. The Dr takes into consideration the physical exam, Xray findings, and the biomechanics of your foot to write a prescription that is sent with your slipper cast molds as they are fabricated. The representatives at the lab work in close contact with the doctor and our staff to make sure all the specifications are met. Some of the specifications to be considered are: the material and thickness of the shell (the part that extends from the heel, across the arch, and ends just before the ball of the foot), the material and length of the topcover, and any other custom accomodations, padding, or cutouts that may enhance the fit. So as you can see, a lot of consideration is taken for these custom orthotics, that make them a step above a regular over the counter option.
There Is A Misconception Out There That Custom Orthotics Only Fit In One Type Of Shoe
As someone who has several types of shoes, I can tell you that this is definitely a misconception! If that were the case, then I myself would only wear 1 shoe, and this is not the case. Since as I mentioned above that the actual orthotic can be manufactured according to different specifications, this in turn means that a custom orthotic can fit in to many different types of shoes. The shell does not differ, it is always the same length. The shell always goes from the heel, across the arch, and ends right before the ball of the foot. This makes sense, as it is rigid, and needs to allow your toes to bend! However the topcover determines the length of the device. A custom orthotic typically comes in 3 lengths: full length (the topcover goes all the way to the toes), 3/4 length, (the topcover goes to the slucus, or just before the toes) or and dress length (the topcover only covers the actual orthotic shell and does not extend further.)
The Control Is In The Rearfoot
We are very particular in how we capture the nuances of your feet, and it starts with how we make the slipper cast mold. Our staff will placd your foot in a neutral position and take the mold in that position. This is important because this way, we can confirm that the rearfoot is in a neutral position and captured this way. The control of the foot starts with control of the rearfoot. Once the rearfoot, (think heel) is supported in a neutral position, it carries to the rest of the bones and joints across the rest of the foot. So as long as there is control starting from the rearfoot, the length of the orthotic can be changed with the length of the topcover. It can be longer or shorter, and extra padding can be added or taken away depending on the area that needs it or doesn't need it.
They Are Not only for Gym Shoes
Typically, people think that custom orthotics are made for gym shoes. However this may be a misconception because many injuries and pain comes when exercising, so the assumption is that they are always made for gym shoes. However, they can also be made for different types of shoes.
Other Sports Shoes Or Even Cleats
Since the control is in the rearfoot and the shell, custom orthotics can be made for other sport shoes such as court shoes (think volleyball or tennis) and even cleats for soccer or football or softball. They can even be modified to fit cyling shoes. Cleats and cycling shoes typically do not have a high heel counter and are very shallow, but as long as the prescription for the orthotic allows for the shell to be thinner but still of a durable strong material, then the orthotic can be made to fit into those shoes. If you are an avid skiier, or if you have hockey skates/boots, then orthotics can be fashioned to fit those as well. You always want to do everything you can to prevent any sports injureis, and custom orthotics can help you with this.
What About Casual Shoes, Flats or Ballet Flats?
The same goes for casual flats, dress flats, and even ballet flats. If there is ample space in the rear of the shoe but a full length orthotic may have too much padding and may not allow space for the toes, then this is where a 3/4 length topcover or even a topcover that only comes to the end of the orthotic shell comes in. This makes it very easy to slip in and out of different casual shoes. As for casual shoes such as Converse, orthotics can fit into these shoes as well! This especially helps if the insert can be removed. By removing the insert that the shoe
What About In The Winter or Spring - Can I Use Them With Snow Boots Or Rain Boots?
Even though the weather is gertting better, we cannot forget the spring season with lots of rain or winter with lots of snow! Because Ugg boots or the sherpa lined type boots typically do not have any arch support, we recommend placing your custom orthotics in these boots. Since they tend to have a round toe box and can stretch a little, our patients find these very comfortable with custom orthotics. In addition, if you have rainboots, these also tend to be loose fitting and flat with no arch support, so placing an orthotic in these boots will work well.
There Are Some Instances When They Can't Be Worn...
Of course, there are some shoes where custom orthotics will not work with the shoe. For example, a shoe with an open back will not allow the orthotic to sit in the heel and be supported. Examples of this are shoes such as mules or flip flops or sandals, both flat and high heeled. Another example of shoes that may not work with your custom orthotics is a shoe that has a built in arch support that cannot be removed. If it cannot be removed and the orthotic is placed on top of this, it could alter the support and actually become uncomfortable.
There are so many ways to wear your custom orthotics, it is just a matter of being aware of which types of shoes they can fit in. It is your best bet for compliance and following your doctor's directions to get out of pain and remain pain free.