Orthotics have many uses. Depending on the patients medical history, drugs, muscoskeletal pathology, footwear, skin type will make up the decision of if orthotics are needed and the prescription of the orthotics. There are many differences between over the counter and custom. The main thing is that you get what you pay for in terms of fit, durability, comfort and service. Most of the over the counter insoles will be too soft to provide support and so defeat the point of having an orthotics.
An orthotics is only as good as you shoe you place it into and so its important the shoes is stable and firm. Placing it into a soft unstable shoe will not provide enough stability for the orthotics to have a outcome in.
An orthotic though should never be thought of as a final cure. It should be looked as as part of a multi-disciplinary treatment.
Here is a list of reasons why a patient might need orthotics and why a podiatrist has prescribed them.
This is one of the main reasons a podiatrist will prescribed an orthotic. For pathologies such as diabetics, neuropathy, poor circulation, cancer, chronic pain issues and rheumatoid arthritis. Taking pressure under the arch and redistributing it to other places will help to increase circulation to areas that were under high pressure. This reduces pain, reduces risk of ulceration, reduced the formation of hard skin and callous / corns. A callous and corn can be as dangerous in a diabetic person as a melanoma! Supporting the arch take more pressure off the ball of
the foot during gait that metatarsal domes.
In people with neuropathy, elderly patients with falls risks, people with chronic ankle sprains increasing the point of contact increases neural feedback to the brain. This can help improve balance and reduce risk of falls and injury. One of the last areas in the foot to lose sensation is the arch. Therefore, having contact with the arch is important in people with these issues.
Sports and msk injuries
Chronic sports injuries often need help healing. When you injure your arm or a finger you can put it in a cast of sling. With the foot this is very different as a person needs their feet every day to walk and stand. This weightbearing means that areas never get chance to rest and heal. Orthotics can move areas of load, change mechanics and therefore allow areas to heal up faster.
Just like going to the dentist a podiatrist looks for pathological movements, weaknesses and structures that can cause injuries. If these are seen then orthotics may be prescribed to help prevent future complications. Just like people clean their teeth and use braces for prevention. Appropriate footwear and orthotics can play just as important part.
Everybody thinks that this is what orthotics are for, and yes they are correct in ‘some’ cases. Though that is dependent of the patient’s needs. Whether they need a devise that is palliative or aiming to change structural alignment. One that change aleignment are good for a few issuers such as knee arthritis, tibialis posterior dysfunction, excessive supination, hip bursitis, and a big leg length difference. To be able to have a orthotic that will realign a structure will depend on the patients mobility with their lower limb as you cannot change a ridged structure.