What are orthotics?
Orthotics, which are often used in the treatment of biomechanical disorders, are custom molded inserts for shoes that correct foot function and improve efficiency during gait. They are not only useful for the treatment of foot problems, but also can be used for the treatment of ankle, knee, hip, and lower back complaints when these disorders have their origin with abnormal foot function and gait.

Why do I need orthotics?
Everyone's foot structure is different. Just as each individual's eyesight, personality, and medical problems are unique to that person, so is the foot structure unique. The foot is composed of 26 bones, 107 ligaments, numerous tendons, and 19 muscles originating in the leg and the foot. The way these bones, muscles, and tendons work together determines the balance and alignment of the foot. This, together with your weight, the type of work you do, the amount of time you are on your feet, and the type of surface you stand on all day, not to mention the type of shoes you wear, also contributes to the delicate balance and alignment of your feet. A perfectly balanced and aligned foot is extremely rare.

Practically all foot problems are directly or indirectly related to foot malalignments. If you are experiencing any foot pains, deformities, fatigue, cramps, etc., you probably have an imbalance in your feet. Orthotics are designed to correct or rebalance that abnormality. Just as glasses or contact lenses help to correct your eyesight, orthotics help re-balance your foot structure to reduce abnormal stresses or abnormal areas of weight bearing in your feet that lead to discomfort and that can cause more serious problems as time passes.

What do orthotics look like?
There are many types of orthotic devices that can be prescribed: some are rigid, some soft and flexible. The doctor will decide which type you need depending on the problems you are having. In all cases, the devices fit in closed shoes and can be transferred from one pair of shoes to another.

How long do I have to wear orthotics?
Depending on your problem, orthotics should be worn the majority of the time you are on your feet, if possible. Once you become accustomed to them, you will probably feel uncomfortable without them. This is not to say that you must wear orthotics when you want to dress up on occasion with shoes that are not compatible with the devices.

What type of shoes are compatible with orthotics?
Any closed shoe with a heel height up to 1-1/2" or less. Orthotics are are not as efficient in heeled shoes that are higher. For backless shoes special modifications have to be made on the orthotics. For those who want to wear sandals, the Birkenstock sandal/orthotic can be prescribed. The shell is a sandal but the foot bed is an orthotic.

Can orthotics be used for sports activities, ie, running, aerobics, etc.?
Definitely! In fact, many professional and amateur athletes treated in this office would be unable to perform without their orthotics.

Do orthotics ever have to be replaced? Can they break?
If you are an adult, it is likely that your orthotic prescription will have to be changed every three years. Younger adults, under the age of 21, need to be reevaluated every 18 to 24 months and possibly sooner if the child has a growth spurt. Most orthotics can withstand a lot of abuse but are not invulnerable to extreme heat, theft, or the dog chewing them up!

What is involved in having orthotics made?
A detailed biomechanical evaluation with objective measurements of the joint movements in your feet, ankles, knees, and hips is necessary to prescribe orthotics to fit your individual foot. Occasionally, certain muscle groups may also be treated, along with posture, evaluation of pelvic tilt, back problems or malalignments such as scoliosis of the spine. Gait or walking analysis may also be included. This examination, along with angular measurements of the bones of the foot seen in your x-rays, is used to determine a prescription for your orthotics. A plaster cast is then taken of each foot to get an exact impression of the foot in the "neutral" position. This is the position the foot should be in to be perfectly balanced.

These casts, along with the prescription, are then mailed to an orthotic laboratory that actually constructs the orthotics through 27 different manufacturing steps to get the final finished product, which is then mailed back to our office. The day your orthotics arrive, you will be notified so you may come in and have the orthotics dispensed, along with instructions for wearing. The "turn around time" is usually two to three weeks.

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