Orthotics are defined as “a device capable of controlling motion in the foot and leg by maintaining the foot in the most optimal and neutral position.” Orthotics should make you feel more balanced, stronger, faster, and just better in your general daily functioning. Orthotics can be made out of all types of materials, foams of different densities, EVA (ethylene-vinyl acetate), plastic, poly-propylene, acrylics, co-polymer, etc. A custom orthotic is a device that is made just for you, for one individual, based on their anatomy, joint arthrokinematics, activities, lifestyle, and goals.
Throughout my career, I have worked with patients of all ages and athletic abilities to provide the best possible plan to help them return from injury, prevent injury, or to improve their performance. Orthotics sometimes can be a big piece of that plan. Often times we start with an over-the-counter (OTC) device (which runs about $50) that can be customized and manipulated in order to ensure we create the best possible orthotic. Through accurate anatomical placement and sizing of ‘posting’ we can optimize the way that the foot interacts with the ground and affects that it has on the mechanics of the foot, ankle, tibia/fibula, knee, femur, and hip. Posting can be made of different types of material, different densities, and different thicknesses in order to customize the orthotic for the needs of the individual. This OTC, temporary device will last most people 6-12 months before it should be replaced as it is most likely not providing the same level of support that it was on day one.
Once we have the custom OTC (temporary) device dialed in, we can opt to go with a custom permanent orthotic. This permanent device is made from much more durable and expensive materials and will typically last 10-15 years. These devices typically run about $200 and are fabricated by one of the top orthotics labs in the country. This process involves casting of both feet with plaster. This ensures a true representation of an individual’s foot for the best possible custom orthotic.
Who can benefit from orthotics? Anyone complaining of chronic foot, ankle, knee, hip or low back pain. Active people who have struggled with achilles tendons, patellofemoral syndrome, shin splints, hip bursitis, bunions, arch cramping, etc. Orthotics should improve your lower extremity mechanics. You should LOVE your orthotics or they are not right for you! Feet are like snowflakes, there are no two alike! Having a biomechanics expert who understands foot arthrokinematics and orthotic fabrication can make a huge impact on your daily life.
John-Henry Anderson, PT, DPT, SCS is Board Certified as a Sports Physical Therapist and works at APRS Physical Therapy West in Bozeman, MT. He specializes in lower extremity and shoulder injuries and works with athletes of all ages and abilities.