Custom Orthotics
Foot health is one of the most important aspects of quality of life. If you think about the amount of time you spend in different positions, the top three are typically sitting for work, sleeping at night, and standing/walking for everything else in between. This is why I always recommend getting a good desk set up, investing in a quality mattress, and considering how supported your feet are throughout your day.
When considering prescribing an orthotic, we consider usage to correct biomechanics of gait, relieving pressure and pain, and supporting from the bottom up. I received my first pair of orthotics in my early 20’s as a professional dancer. I have quite flat feet, and was getting foot pain from standing most of my day. As a dancer, the last thing I wanted was to be thinking about how my feet hurt while trying to perform or learn new choreography. I also enjoyed cross-training at the gym or outside running, both of which started to aggravate my feet.
When considering getting custom orthotics, you can either take the leap or you can start with an over the counter option. I always recommend calling your insurance to check the requirements and details of your coverage. Typically a doctor’s note is recommended, and can often come from a family physician or a chiropractor. I always include the details of my patient’s history, physical exam, and diagnosis in my prescriptions for insurance with headers so all details are clear and easy to find for insurance agents.
During your intake, a typical physical exam for ankle/foot will be performed, as well as a gait analysis. The gait analysis is the opportunity to take a look at the biomechanics of how you walk, and to incorporate them into your orthotic prescription. I also include a PDF of your gait analysis separate from your prescription for insurance purposes.
When casting, I have found some issues with various techniques. The options typically on the market are digital screen with an app/iPad, foam imprint, or plaster casting. The digital option is the quickest and cheapest. The foam imprint is also very clean and quick. My personal issues with these two is that I find the product doesn’t quite capture the three dimensionality of feet, and the orthotic is just too flat to offer the support I am looking for. The plaster casting is not as common because it takes more time and can be more messy for the doctor. I still do plaster casting because with it, I am literally sending a mold of your foot to the pedorthist.
When creating your orthotics the pedorthist will often contact me for further information or clarification as to the goals and examination of each patient.
Beyond orthotics, I recommend a few things. First, add some rehabilitation exercises into your daily life. They are very easy to do, even while sitting watching TV. By strengthening the muscles in your feet, you are improving your local stabilizers, relieving pressure from your global movers (muscles in the calf) that are trying to stabilize your ankle/foot. Next, I recommend getting a quality pair of shoes. If you are experiencing pain, you want a balance of cushion and support. If they are really bad (very painful with walking), I recommend trying out a shoe with a roll bar or a stiff shank. The stiffer the bottom of your shoe, the more the shoe rolls through gait for you passively, so your muscles (active) don’t have to work as hard.
I also recommend a few things for recovery. I find walking around at home painful after a long day of standing. I wear recovery sliders made for ultra marathon runners (Hoka brand). The support created for people running a lot throughout the week take the stress off my foot at home and provides comfort when not training. I also recommend having baths, using heat/cold therapy, and of course seeking out manual therapy for relief. Having regular chiropractic and massage appointments really help release tight tissue, decreasing pain and increasing function.
Overall, orthotics might not be necessary for everyone, but with insurance coverage, if you are interested, start with one pair and if you don’t find they make a difference, pivot and try boosting your rehab and manual therapy. Often patients with foot pain are ready to try everything and anything to get some relief and improvement with their function.
If you have any questions about orthotics, reach out and ask. Go into the clinic and hold a few pairs in your hands so you can inspect exactly what they will look like. Orthotics are very easy to move from shoe to shoe, so even getting one pair will allow you to get comfort while wearing most of your footwear. Think of orthotics just another tool or technology you can use to move more, and feel better.
To book a free appointment at Made To Move to discuss potential use of orthotics for your goals and concerns, please select the meet and greet option. This will give you 15 minutes with Dr. Gray to chat about what you’re looking to gain from your orthotics and any other questions you may have. Looking forward to meeting you and getting you back on your feet!
