Custom-Molded Orthotics
The making of orthotics is as much art as technology. It is
essential to perform a complete foot and ankle exam and check foot position
prior to manufacturing of orthotics. The University Foot and Ankle Institute
will perform a gait analysis and examination of the foot and then determine the
proper type of orthotic based on your foot type, pathology, activity level and
shoe type.
The subject of orthotics is complex but there are some basic
principles and examples that should give you an appreciation of their benefit.
First of all, orthotics can be prefabricated (such as the Dr. Scholl’s
products) or custom molded. The prefabricated (off the shelf) device gives
added shock absorption but fails to control excessive motion and breaks down
rather quickly. They are cheaper but tend to loose their benefit within 2 to 3
months versus custom orthotics that can last up to 2 years.
Custom molded orthotics are made specifically for each individual
patient’s foot. They are usually done with plaster molds. Particularly for
complex and unusual foot shapes Plaster molds work better. We will
evaluate your foot and decide which technique serves you best.
Orthotics achieve foot comfort by changing the way forces act on
the foot. In the flatfoot, there is a great deal of motion and some collapse of
the arch with each step. This creates fatigue of the soft tissue structures and
makes flatfooted individuals prone to conditions like tendinitis. Orthotics
help to control motion and collapse in these patients. Individuals with a high
arch foot usually have a much more rigid foot structure but have limited
contact with the ground. This creates areas of pinpoint pressure and the entire
body weight is distributed through a relatively small part of the entire
surface area of the foot. Consequently, a patient with a high arch is going to
be prone to calluses, pressure points, and even stress fractures in an impact
exercise program. Orthotics help these people by distributing body weight through
a greater surface area and decreasing the shear stress (sliding in the shoe) of
the foot in the shoe.
IS THIS YOU?
Orthotics from a Podiatrist versus
from Costco
What is the difference between the orthotics you
can get at Costco versus the ones you get from a podiatrist. The Costco foot
orthotics are fabricated from a weightbearing computer scan image of the feet.
Unfortunately, the foot orthotics manufactured from such an image are not truly
custom molded to a three-dimensional model of the foot. There is no intrinsic
balancing of forefoot to rearfoot deformities with these devices. Therefore,
true correction of alignment is not possible
Recently a mother brought her 10-year-old son
into my office for a consultation. The mom had been shopping with her son at
Costco several weeks earlier and saw the display for a custom pair of foot
orthotics. She made the decision to buy a pair for her son, who had flat feet
all his life. The mom had delayed taking her son to the doctor for an
evaluation and this simple system of purchasing the foot orthotics at Costco
seemed like an easy way out. With the Costco purchase, the mother
ultimately wound up buying an $89 pair of arch supports. The devices did not
fit her son and were uncomfortable to wear despite a three-week “break in”
period. There was no technician or qualified sales staff at Costco to modify or
change the orthotic devices.
The mother now realized that a better solution
would be available from a qualified podiatrist. The negative experience at
Costco had actually raised awareness about the possibilities of using foot
orthotics to treat foot pain and had finally motivated this parent to make an
appointment for his son.
My evaluation confirmed a congenital Rigid pes
planus deformity and after X-rays it was shown that the patient had a tarsal
coalition. In this patient and I determined that the patient would benefit from
resection of the coalition. After the patient had successful surgery he was
molded for cutom orthotics. My office staff confirmed that the patient was a
beneficiary of a medical insurance plan, which covered custom foot orthotics.
The out-of-pocket expense for my custom devices was actually less than that of
the Costco orthotics.
The bottom line is that orthotics will only work
when you have a proper diagnosis then you can select the proper orthotic to
that diagnosis. The techs at costco and at other orthotic stores that don’t
have a doctor on site can NOT make a diagnosis and cannot make the proper
adjustments to the orthotics to address the biomechanical problem at hand.
Serving communities of San Diego including
La Jolla, Del Mar, Poway, Rancho Bernardo, La Mesa
El Cajon, National City, Coranado, Solana Beach, Rancho Santa Fe,
Ramona, Escondido ,San Marcos, Vista, Oceanside, Carlsbad, Encinitas
Plantar Fasciitis/Heel Spurs, Bunions, Hammertoes, Ankle Fractures, Foot Fractures, Neuromas, Flatfoot, Achilles Tendon Disorders, Orthotics, Ingrown Toenails, Fungal Nails, High Arch, Diabetic foot and Charcot foot, Ankle Sprains and Strains, Ankle Arthroscopy,
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