What are foot orthotics used for?

A range of health professionals use foot orthotics to treat a wide range of different types of foot problems. There are a wide range of options in foot orthotics that can be used to do this and the choice will come down to the expertise of the health professional, the needs of the patient and what the best research evidence shows. There are also a lot of opinions and theories about foot orthotics and foot biomechanics that also need to be taken into account when making clinical decisions about foot orthotics.

Foot orthotics need to be different for different problems and different feet and they are a lot more than a simple arch support that you can buy in a shop. They can be used to change foot function if there is a biomechanical problem that is causing pain. This could be, for example, a problem like overpronation causing things like plantar fasciitis and knee pain in runners. They can be used to get the pressure off a painful area anywhere on the bottom of the foot. This can be especially important for people with diabetes who are at high risk of pressure area becoming painful.

Foot orthotics start off as a basic shell that is supposed to be the shape of the foot. A clinician can use a mass-produced premade device that is about the shape of the foot. The other option is to take a cast or scan of the foot that is used to make a custom made device that is the exact shape of the foot. There are a number of options here in the process and the material that gets used as well as how rigid the foot orthotic is. The final decision is going to be based on a number of things such as body weight, activities and just what clinical affects the clinician is recommending that be achieved.

There are many modifications that a clinician can make to that basic shape of the foot orthotic to get the desired clinical effect. For example, if the calf muscles are tight, then a heel raise might be added (and stretching exercises will also be prescribed). If there are any prominent bones or soft tissues under the foot a groove or cavity might be added in the foot orthotic. If the big toe joint is not moving how it should, then something like what is called a Cluffy Wedge or a Kinetic Wedge might be used. The Cluffy Wedge is attached to the end of the foot orthotic and holds that big toe in a slightly raised position. This has been shown to help the big toe joint to work more efficiently. Foot orthotics can also be covered in a variety of different materials depending on what is required. For example, a softer shock absorbing material can be used if more cushioning is needed. An absorbent material or leather can be used if there is a problem with too much sweating. If someone has a pressure area or a callus under the ball of the foot, then there is going to be a cavity created in the foot orthotic to reduce pressure on that area.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.