Orthotics

Custom orthotics are shoe inserts which help control abnormal foot motion, especially excessive pronation and supination of the lower ankle or subtalar joint. They provide stability for the foot and correct  injury causing inbalances. 

As the illustrations of this right foot show, pronation occurs when the heel bone angles inward and the arch collapses, while supination is the opposite. Supination and pronation are a normal part of the gait cycle. They allow the foot to absorb shock and adapt to uneven surfaces. However, too much of these motions may cause injury. Many problems with the feet, legs, knees and hips are caused by excessive pronation or supination. Orthotics may prevent injury or deformity from occurring or halt the progression of existing problems and allow healing to occur. If your feet match the illustrations and you suffer from sore hips, knees, shins, arches or metatarsal bones, you may need orthotics. They are also useful in optimizing performance and enhancing comfort for athletes.

Functional orthotics are made from impressions that capture the contour and alignment of the foot. A mold is generated from the impression and is modified to compensate for angular differences between the forefoot and heel which can lead to excessive foot motion. There is a difference between custom functional orthotics and "orthotics" made in sporting goods stores. The functional orthotic has forefoot posting added to the ball of the foot on the casts. This posting corrects for angular abnormalities between the forefoot and heel. When posted in this manner, even support is provided from the ball of the foot, through the arch and back to the heel. This results in an orthotic that has a smoothly contoured transition from the forefoot to the heel as opposed to just putting support in the arch- something which is not well tolerated and does not address the underlying problem.

A thermoplastic material is either milled or molded to the shape of the corrected impression and this becomes the orthotic. This process results in an orthotic that is thin, retains its shape regardless of the contour of the shoe and affords shock absorption. Depending on the intended use of the orthotic, various modifications in design and material may be used. For example, padded top covers are added for running and for cycling they are made narrower and have  forefoot extensions and thin top covers.