Custom Orthotics
Custom made orthotics are prescription medical devices that are
designed to improve biomechanics of your foot, provide control and
support that your foot requires. If properly prescribed custom orthotics
will alter the way your feet interact with the ground, controlling the
foot motion and eliminating the stress on joints, muscles tendons and
ligaments. Putting the foot into a correct position while walking,
running, and standing will improve your overall skeletal alignment (knees, hips, spine) often eliminating the specific cause of your pain
not just the symptoms.
Who Should Use a Custom Made Orthotics?
Almost anyone can use orthotics, ranging from children to adults. However, we have to keep in mind that everyone’s feet are unique and that orthotics have to be specifically designed and custom fitted to each individual in order to eliminate the problem. An analogy can be made between orthotics and eyeglasses—both devices require detailed examination in order to determine the proper degree of correction or support needed. Most qualified practitioners in assessing and treating feet are Chiropodist and Podiatrist.
Custom orthotics are prescribed to treat a variety of conditions. Some of the most common conditions are listed below:
- Flat feet, high arched feet
- Bunions
- Chronic heel (e.g., plantar fasciitis), knee, or low back pain
- Frequent ankle sprains
- Gait abnormalities (e.g., feet point inward or excessively outward during walking)
- Shin splints
- Morton’s neuroma
- Ankle instability
- Diabetes and arthritis
The feet should not hurt and presence of pain indicates that something
is wrong and as such it needs to be treated immediately.
How Does an Orthotic Work?
As previously stated custom orthotics are used to treat abnormally functioning feet during the gait/walking cycle.
One of the foot's main functions is to absorb shock as the body's weight shifts with each step. It does this through a complex process in which the arch of the foot flattens slightly. This process is known as pronation and it helps in absorption of the shock when the entire body weight is placed on the foot. There are two major problems that can occur in this mechanism. If the foot flattens too much it will cause the arch of the foot to collapse resulting in flat feet. However, if the foot doesn’t flatten enough which is usually a case in high arched feet, too little pronation, it will send the shock throughout the leg, resulting in knee, hip and possible lower back pain. Improper redistribution of body weight will result in the previously mentioned conditions.
Problems can present at any stage of the gait cycle and custom orthotics are prescribed to address the specific problem. Therefore, a complete biomechanical exam of the foot, both weight and non-weight bearing and gait analysis by a chiropodist/podiatrist is necessary to obtain a detailed clinical picture of the patient.
How Are Orthotics Made?
One of the most important parts in this process is a prescription that
addresses the specific problem and the cast (mold) of the patient’s
feet. This cast is than used to produce a shell of the orthotic and
based on the Chiropodist/Podiatrist prescription certain materials and
modifications are added in order to achieve a custom made orthotic. A
various types of orthotics are available, ranging from diabetic, which
are accommodative to highly corrective (i.e. gait plates).
The
top picture is a cast (mold) of a patient’s feet created by using
Plaster of Paris.
The picture to the left is a custom made arch support with deep heel cup.
3D Optical Laser Scanner
Our clinic also offers the latest technology in the orthotic casting
through the use of the next generation 3D optical laser scanner. 3D
laser is the only laser that allows the clinician to hold the foot in
the correct, neutral position as it was the case with plaster casting,
to achieve a true tridimensional image of the foot. It gives a reading
almost every four hundreds of an inch making it most accurate way of
taking a cast. It also allows for the quick check of the cast to see if
the cast taken corresponds to biomechanical examination of the foot.
This further improves accuracy of the orthotic device.
3D laser system differs from pressure scanners or pressure mats because
it allows for the true volumetric cast to be taken which can be further
modified in 3D, with needed corrections. Any other system captures the
foot in a 2 dimensional way which only shows the pressure points when
weight is applied on the foot but it doesn’t allow either for the NON
WEIGHT BEARING correction nor the volumetric cast to be taken. Pressure
mats or scans were developed for gait analysis and not for volumetric
scans which can be used in orthotic making.