What is foot orthotics and how do they work?

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Published: 17th July 2009
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This article sheds more light on the term "foot orthotics" - what they are, how they work, the different types of orthotics available and which common complaints can be treated with orthotics.

What does the term "orthotic" denote?





The word orthotic comes from the Greek 'ortho' - to correct. The correct term for orthotic is foot orthosis (plural: orthoses) which means a device designed to correct the foot.



Orthotic insoles are a device placed inside the patient's shoes with the purpose of correcting faulty foot function. Poor foot biomechanics can be blamed for many common foot conditions such as Plantar Fasciitis (heel pain) and Metatarsalgia (ball of foot pain). However, research has shown that bad alignment of the feet also has an effect on other parts of the body, including the knees and lower back. Hence, orthotics is now being used to help treat a variety of conditions, including shin splints, knee and back pain.

What does faulty foot function mean?





The most common display of faulty foot biomechanics is 'over-pronation'. Over-pronation is a condition whereby the arches are lowered and the feet and ankles rolling inwards excessively during walking and running. It is believed by podiatrists that over 70% of the population actually suffers from mild to severe over-pronation. Over-pronation should not be confused with flat feet (Pes Planus). Only 5% of the population is flat-footed, i.e. no arch is present whatsoever under the foot. Over-pronators on the other hand do have an arch present, but the arch will lower significantly during walking and running, and the ankles will twist inwards.



Over-pronation causes the legs to rotate internally, which leads to an irregular motion in the knee joint and it also forces our pelvis to tilt forward which puts tension on the muscles in the lower back.

How does orthotics work?





Orthotics is designed to correct faulty foot function reducing the amount of ankle role and arch flattening during the gait cycle. In turn this will reduce the amount of internal rotation of the ankles, legs and knees. By correcting over-pronation orthotics re-align the feet and ankle bones to their neutral position, restoring our natural foot function. Therefore, orthotics not only helps alleviateproblems in the feet but also in otherparts of the body such as the knees and lower back.

What different types of orthotics are available?





There are a number of different types of orthotics available, however they all are designed to achieve the same goal. Generally, there are 2 types of orthotics: custom-made rigid orthotics and so called pre-made, off the shelf orthotics.



Only podiatrists can prescribe and dispense custom-made rigid orthotics. They are made from a plaster cast (foot impression) and they can be quite expensive.



Custom rigid orthotics is for patients withserious biomechanical disorders and/or foot deformities. Most people simply suffer from fallen arches (over-pronation) do not require an expensive rigid orthotic. Research has shown that for 80% of people suffering from over-pronation an off-the-shelf pre-made orthotic will provide sufficient correction. Pre-made orthotics is also softer than custom-made's and easier to get used to.



What is the difference between orthotics and cushioning footbeds?



Regular cushioning footbeds are only designed to provide a cushioning effect and shock absorption. They may feel comfortable at first however they do not address the biomechanical of over-pronation, as an orthotic does.



Which conditions can be treated with orthotics?



Orthotics are found to be very effective for treating heel pain, heel spurs, Plantar Fasciitis, bunion pain, Achilles Tendonitis, Ball of Foot Pain, Morton's Neuron and many other foot complaints.



Because our feet are the foundation of our bodies many problems in the legs, knees and back are connected to faulty foot biomechanics. This is why orthotics are now being used in the treatment of shin splints, knee pain and lower back pain and many physiotherapists and chiropractors have started using orthotics.



Sources:



The Journal of American Podiatric Medicine May 1999, Sobel E, Levity S T, Caselli MA Division of Orthopaedic Sciences, New York College of Podiatric Medicine. Vol. 94 Number 6542-549 2004 Journal of American Podiatric Medicine" The Conservative Management of Plantar Fasciitis" - Pfeffer GB, University of California, San Francisco, CA.



"Chronic Low-Back Pain and Its Response to Foot Orthotics" - HOWARD J. DANANBERG, DPM, MICHELLE GUILIANO, DPM

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