Solent Podiatry Isle of Wight Chiropody & Podiatry specialising in Biomechanics

What are orthotics?

Functional orthotics are custom-made medical appliances that are worn in your shoes to correct your specific postural imbalances. A plaster cast of the feet is taken non-weight bearing so the foot is held in what we call neutral, which means it is neither pronated nor supinated.

Orthotics can help relieve pain and/or discomfort experienced in your feet, knees, hips or back, which may be caused by poor foot function, postural imbalances and poor alignment. Orthotics will realign and/or stabilise the bones in your feet, and in turn restore the body’s natural walking pattern.

Orhotics have a variety of benefits they control and/or correct abnormalities in walking patterns, reduce the risk of injury, improve proprioception, allow for fine tuning for the competitive athlete, provide cushioning and shock absorption for the person who stands all day. They aid the older patient who requires stability, support and comfort and improve quality of life. Help patients with back, hip, knee and foot problems that result from faulty biomechanics and can prevent many common foot complications that could often require surgery.

An analogy can be made between orthotics and eyeglasses. Both adjust bodily imperfections that inhibit people from functioning at their maximum physical potential. Almost anyone can achieve some benefit from an orthotic. There are several common symptoms that may indicate misalignment of the feet. We live in a flat world made mainly of concrete under foot, which has a high energy return. This can create a negative shock wave, which passes up through the body affecting various joints, especially the back. Orthotics help to prevent this making our lives much comfortable on a daily basis.

Why do I need them?
Your biomechanics specialist has determined that your foot and leg function may be improved and pain may be reduced by using an orthotic. By reducing excessive motion and encouraging your foot to move in the right direction at the right time, orthotics allow the bones and muscles of your feet, legs, pelvis and back to function correctly, thus reducing excessive stress and strain.

Why haven’t I needed them before?
Our feet were designed for walking on uneven ground of varying densities (grass, mud etc.). It is rare for anyone to have perfect foot function and walking on hard flat surfaces aggravates any abnormal function. Increased levels of activity or reduced function with age can all contribute to the onset of symptoms. The average person takes 5,000 to 18,000 steps per day (2,500-9,000 per foot). It only takes a small level of stress, repeated thousands of times a day, to either cause or aggravate injury.

Can I be certain they will get rid of my problem?
Much like most treatments, no guarantee can be given. However, your specialist has performed a detailed biomechanical assessment to try and determine the potential benefit of orthotics. These should form part of a wider treatment plan, with many patients needing a combination of interventions that regularly include footwear changes, stretching and strengthening exercises. Orthotics form part of this process but cannot cure everything. If you still have symptoms, further investigations, injections or even surgery may be required to resolve your problem. Many people develop injuries and the underlying foot and leg function prevent the injury from healing. Orthotics can help to reduce stress to the injured area and allow it to heal. As long as appropriate strength and flexibility are restored, you may be able to walk or exercise without your orthotics. However, if the problem returns, this is probably an indication that you need to use orthotics for this level of activity.

Will I need to have an orthotic for every pair of shoes?
Custom made functional orthotics are made to the foot not the shoe and are therefore transferable from shoe to shoe. However, the orthotic requires a shoe of sufficient length and fit, preferably with a fastening to hold the orthotic in position and to allow it to function correctly. It depends on the shoes. Many slip on shoes have to be tight in order to stay on the foot. Therefore, when an orthotic is placed in the shoe, the shoe either becomes too tight or the heel slips out of the back of the shoe. Whilst slimmer versions can be made, this reduces the support of the orthotic and therefore the potential benefit. Usually, in order to try and resolve the problem, your specialist will advise you which type of shoe you should be using. This is often a wider style and fit with a lace or adjustable strap to hold your foot in position. Whilst this may not be your preference, this is probably what is required to help you get over your problem and potentially return to wearing the shoes you prefer.

I only have a problem during sport; do I need them for everyday?
The orthotic is changing the way in which you foot functions, it takes time for your body to adapt. If you simply wore the orthotic for sport, your body would have to adapt each time you played. This can cause discomfort, which is incorrectly blamed on the orthotic.

As our knowledge of body function has improved, it has become apparent that poor position (posture) and muscular control of the pelvis and spine can affect the way in which the legs and feet function and vice versa. In many cases, it is a combination of postural and foot related problems. Our assessment includes an evaluation as to which aspect is the source of the primary problem. If necessary, we can utilise sophisticated computerised gait analysis to help determine the source of the problem. In some instances, orthotics can be used to help improve your overall function and posture whilst you are performing your stability exercises. When appropriate strength and stability have been achieved, you may be able to dispense with the orthotics. However, if symptoms return and you have continued your exercises, this probably means that you need to continue using the orthotics.

In some instances, the degree of control needs to be increased over a period of time or adapted as your posture and mechanics alter. Following the initial assessment a follow up appointment at six months is recommended, and then a yearly review may be of benefit as it is more likely that function has been affected by altered strength and flexibility and this can be addressed.

What happens at the end of the biomechanical assessment?
You will be given a written report in an A4 folder full of other information to help you succeed. Then a non-weight bearing plaster of paris cast is made of your feet, this is what the manufacturer uses to make your orthoses in the laboratory. All of the Solent Podiatry orthotics are manufactured combining the use of the most traditional and latest techniques in cast preparation and orthotic construction. These special one off orthotics go inside your daily and sports footwear, they helps to cure your injury by correcting any biomechanical dysfunction and making you as efficient as possible. They can last as long as ten years if looked after. You are given thorough instructions with orthoses on how to use them in the first few days as you adapt to them. You will be contacted by telephone 10 days after to see how you are progressing. We then write to you after six months and a year to advise you to have a short a review. This allows both the patient and practitioner to make sure that you’re set perfectly for the rest of your life, providing comfort and efficiency.

IOW Gazette - August 2008
This 16 year old, came to us after seeing another podiatrist. She was complaining of pain in the balls of her feet radiating up her legs, particularly bad first thing in the morning and after a long day. The pain was so bad that it prevented her from walking to school ...
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The Ultimate Biomechanical Assessment
Functional Orthotics
Solent Podiatry Isle of Wight Chiropody & Podiatry specialising in Biomechanics