A patient guide to foot Orthoses & Insoles (Orthotics)
What are Foot orthoses?
Foot Orthoses or Orthotics are medical devices that fit into shoes to improve foot function and comfort by supporting the foot and changing and reducing the load and stress that is loaded through the foot and leg during walking, running and activity.
Foot orthoses are designed to work with your everyday footwear when completing your day to day activities or job.
They are also used or for sporting activities when the loads going through the foot and leg are increased. This can be in a single direction or multi directional. such as high impact sports where parts of the foot are subjected to increased loads.
They are designed for the function they are trying to achieve so there is a vast availability and designs; there is no one size or shape that fits all.
Foot orthoses are used for used for a wide range of foot and leg problems, in all populations and ages. Often used in combination with other treatments, such as a change in footwear, and stretching and strengthening regimes.
What conditions are foot orthoses are used for?
They are used part of a treatment plan. At Evolution Podiatry we recommend there use as part of a treatment plan, not just in isolation. This includes stretching and strengthening rehabilitation of weak or painful structures.
Common Conditions include:
Adult acquired and painful flat feet:
Forefoot pain including neuroma and bursitis.
Painful corns and calluses.
Joint pain: such as big toe joint pain (hallux limitus)
Heel pain: including plantar fasciitis.
Shin pain: (Medial Tibial Stress Syndrome).
Knee pain: including patellofemoral pain and osteoarthritis.
My Children have flat feet do they need orthoses?
Most children with painless flexible flat feet do not need shoe inserts (orthoses). Good fitting shoes should provide support please see our previous blog: A Guide to Children’s Shoes.
Orthoses are only used in children with flexible flat feet when they are severe or there is pain or tripping. These children often have other problems besides the flexible flat feet.
Rigid flat feet are treated using orthoses. Sometimes, there may also be the need for surgery.
Orthoses (insoles) are not able to change the shape of the foot in the long term. They are designed to hold the foot in a better position so that it can work more efficiently. This is to relieve any symptoms associated with the flat foot and help prevent progressive deformity of the foot. Orthoses are often required as the child grows in order to maintain the position of the foot.
For more further information please see our post on Flat feet and children.
How Evolution Podiatry creates foot orthoses?
We use the most current 3d Scanning technology, to take a scan of the foot.
We have found this technique to be reliable and repeatable way to capture the foot.
How are they designed?
Orthoses are designed with the patient’s needs at the centre. Factors that are crucial is and when are they going to worn doing what activities in what kind of footwear.
It is essential to establish what are they trying to achieve, whether this is cushioning and or offloading for painful corn, to reducing the stress through a painful tendon in a runner.
This will be based on materials selection & density are dependent upon what the function of the orthoses aiming to achieve.
When walking there is up to 120% of the body weight being loaded through the foot, this has been shown to rise up to 250% during running. An orthosis needs to be able to withstand and function under these conditions, so maybe firm and hard materials are used.
(The Office for National Statistics reports the average man in the UK is said to be 83kg (13.1stone) and women 70.2kg (11stone).
Other factors that play are the role in choice are activities they will be used for, the range of motion of the joints within the foot, and weight of the patient.
What are they made from?
This will vary, as again the materials are based upon what is the purpose of the orthoses.
As previously mentioned the early days leather and cork was the go-to material. These days orthoses come in a variety of materials for the shell and covering materials, each material offering different benefits.
Typical materials used for the shell includes polypropylene, carbon-fibre and nylon, with top covers made from a variety of materials inclusive of leather, vinyl and puff.
Will they fit all of my shoes?
It is essential to look at footwear before starting to wear orthoses; some shoes cannot accommodate orthoses. They work best in lace-up shoes with space within the toe box. There is an element of trial and error, especially ladies dress style shoes and heels they are less likely to work to their full function.
Footwear is discussed in the assessment phase.
Do I need different orthoses for sport?
This is very much dependent on what kind of sports & activities you do. Orthotics for high impact sports may be different to your everyday ones.
What is the difference between Custom & Pre-fabricated orthotics?
Here at Evolution Podiatry, we use a both often in combination. A custom or bespoke device is made following taking a mould or scan of the feet; this is adapted according to your prescription & needs.
A pre-fabricated orthosis is a pre-made device that is manufactured to help and assist a range of patients, they are available in varying materials, heights, widths etc.
They are often used as first-line treatment, and are often in stock or can take 2-3days for delivery.
Would like to know more or book an appointment, please get in contact
To contact us or make an Appointment 0208 962 0635
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