What are Orthotics?
Foot orthotics are shoe inserts which are designed to support, align or improve the function of the foot.
There are many types of orthotics available depending on individual patient’s requirements. They range from the off-the-shelf variety to ones which are bespoke, i.e. made individually for you the patient.
People of all ages and abilities wear orthotics ranging from the elderly to athletes. They are for are used to help a wide variety of foot problems.
How do Orthotics work?
The human foot is better adapted to walk on soft natural surfaces such as sand and earth. However most of the time we walk on hard flat surfaces such as pavement. This can cause our feet to roll inwards or Pronate. Similarly if our feet Supinate (roll outwards) too much this can also cause problems. The word orthotic comes from the Greek word “Orthos”, meaning straight. Thus Orthotics help to hold the foot in a more “neutral” position. Otherwise poor foot alignment can cause wear and tear on our bodies. Pains can then develop in our feet, legs, knees and back.
Holding the foot in a more neutral position to reduce excessive Supination or Pronation can help to improve your posture and relieve many complaints.
When are Orthotics used?
Orthotics are beneficial for a range of foot, back, leg and knee problems. These include:
- Heel pains, such as Heel Spurs, Plantar Fasciitis and Achilles Tendonitis.
- Knee pain caused by too much rotation of the leg when standing and walking.
- Lower back pain if the pelvis is tilted too much on standing.
- Flat feet which become tired and painful.
- Ball of foot pain such as Neuroma and Metatarsalgia.
- Corns and Callouses can be relieved by reducing forces on these painful areas.
- Shin pain such as shin splints.
- Increasing shock absorbency for people who are on their feet for many hours.
What happens if I need Orthotics?
If a need is identified for you to have orthotics, your individual requirements will be discussed. You will then need to make an appointment for a podiatric biomechanical examination, so that your foot and ankle joints, your posture and gait (how you walk) can be assessed. You will need to bring a range of your shoes with you so that any tell-tale wear and tear on them can be analysed. This will help the podiatrist to see how your foot is functioning while wearing them. Shoes are also important as the type of orthotics prescribed depends on the type of shoes that you wear, as the fit differs substantially from type to type of shoe!
During the assessment you will be asked many questions particularly regarding any foot, back, leg or knee pains you may be having. The answers that you make will affect any diagnosis made.
Digital photographs of your feet from various angles may be taken (with your permission) to aid in the manufacturing process of the orthotics.
When this is done, Plaster-of-Paris casts of both feet are taken. This is to provide a 3 dimensional image of your feet. The casts are then removed from your feet and when they are dried they are sent to the Laboratory which for manufacturing. The manufacturing process takes approximately 4 weeks. Your casts are scanned and the orthotics are manufactured using this 3 dimensional data.
When your orthotics are ready, we telephone you and get you to come in for a fitting. This is to ensure a comfortable fit. Please bring the shoes with you than you want to wear them in!
We then want to see you again after 1 month to check that you are happy with your new orthotics and to review your treatment.
Sometimes orthotic treatment is combined with Physiotherapy to help strengthen patient’s core stability and address other factors if they are affecting the feet. This is because with some problems (such as plantar fasciitis) a combination approach is very effective. Physiotherapy for foot and leg problems is provided at additional cost by one of our Physiotherapists.
Orthotics Frequently Asked Questions:
I’ve been shopping around. I can get Orthotics cheaper elsewhere. What’s the difference with yours?
Our orthotics are only prescribed with a full biomechanical examination, not just a cursory glance at your feet, such as you may get elsewhere if you are sold off-the shelf orthotics. The Laboratory we use in America is one of the best in the world and this is reflected in the price. They are a premium product.
I can get NHS Orthotics. Aren’t they the same?
Often there is a long wait for an NHS Orthotics appointment. Often when patients have their feet assessed for NHS Orthotics they are asked to stand on a piece of paper which is drawn round. The orthotic prescription is then based on that. Thus this is not a 3 dimensional image of the foot and so the orthotic may not fit as well as one made from a cast. As the orthotics are free to the patient, they have little input as to the style of the orthotics prescribed.
My friend went somewhere and had her feet scanned. Why don’t you do that?
Foot scanners are pressure plates which are connected to a computer. The patient walks on the pressure plate, a picture of weight distribution is drawn and the Laboratory manufactures an orthotic from the data.
We do not do this because although such devices from a practitioner standpoint are quick and easy to use, they produce 2 dimensional data which then has to be converted to 3 dimensional data. The patient has to be told how to walk on the pressure plate, so this may not be a true reading of their gait which can add inaccuracies into the prescription. Many orthotics manufactured in this way look surprisingly similar, this is because the programs used to interpret the data often rely on a template system.
Whereas when you have you feet casted this is a cast of your foot, not a template, and it already is a 3 dimensional image of your foot. Our Laboratory then scan this to make your orthotics which represent your feet, not a template.
How long will my orthotics last?
Your orthotics are guaranteed for life to not break. That means that the shell will not break unless you put extreme repeated stress on them such as habitually climbing ladders or digging. It does not mean that they are the only orthotics you will ever need, because your feet and your body will change throughout your life. For example if you developed arthritis, gained or lost a lot of weight or had injuries to your body. This may then over time affect the optimum prescription for you. Normally when patients are happy with their orthotics we want to see them in 2 years time just to check they are still happy and nothing has changed. If anything has changed you can always be reassessed.
Will my orthotics fit all my shoes?
No. They will not fit backless sandals or flip-flops because they can fall out. Another reason we look at your footwear during assessment is to ensure that what we prescribe will fit your shoes. Therefore you need to wear a shoe which is deep enough to accommodate your new orthotics. Also if you specifically wanted orthotics to fit walking boots for example, they would not necessarily fit court shoes. Whereas, if you wanted multi-purpose orthotics we could prescribe them.
Similarly if you are a sports person, the orthotics prescribed for your trainers may be different to those prescribed for your brogues.
Do you do a discount for second pairs of bespoke orthotics?
Yes we do.
Do I need several pairs of Orthotics?
Only if you a) you wear different types of shoes such as walking boots and court shoes because orthotics for court shoes are narrower. Or b) you want another pair because you do not want to keep switching your orthotics between shoes.
We do NOT normally prescribe several pairs so that you can get used to wearing one pair before going on to another pair. Your orthotics should fit correctly without needing multiple pairs.
Will my feet feel funny when wearing my Orthotics?
If you are not used to orthotics your feet will feel different. You may notice a raise under your arches, whereas before you didn’t. This is normal and your feet should get used to this. This is why we give you instructions about wearing them. Sometimes there is a wearing in period, but we expect you to have a reduction in symptoms after a month. Wearing your orthotics should not be painful.
How may it affect you after a treatment?
We aim for a 50% reduction in symptoms. We do not make excessive claims because it is unfair to patients to do so. Sometimes orthotics are part of the treatment and not the whole treatment, hence the combination with Physiotherapy. Frequently though, patients do have a massive reduction in pain.
There is no “hard-sell” with our orthotics because we want you to be happy that you had them from us. Thus after a podiatric biomechanical examination you are free to go away and think about it if you want to!
Fees
Podiatric Biomechanical Examination: £65.00.
Bespoke Orthotics: from £380.00. This includes the biomechanical examination fee of £65.00.
We also offer other cheaper types of orthotics, however please contact Robin directly on robin.crawley@holistic-care.com for more information.
