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YOUR PODIATRIC PHYSICIAN
TALKS ABOUT
ORTHOTICS |
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What are Orthotics?
Orthotics
are shoe inserts that are intended to correct an abnormal, or irregular,
walking pattern. Orthotics are not truly or solely “arch supports,”
although some people use those words to describe them, and they perhaps
can best be understood with those words in mind. They perform functions
that make standing, walking, and running more comfortable and efficient,
by altering slightly the angles at which the foot strikes a walking or
running surface.
Doctors of podiatric medicine prescribe orthotics
as a conservative approach to many foot problems or as a method of control
after certain types of foot surgery; their use is a highly successful,
practical treatment form.
Orthotics take various forms and are
constructed of various materials. All are concerned with improving foot
function and minimizing stress forces that could ultimately cause foot
deformity and pain.
Foot orthotics fall into three broad
categories: those that primarily attempt to change foot function, those
that are primarily protective in nature, and those that combine functional
control and protection.
Rigid
Orthotics
The so-called rigid orthotic device, designed
to control function, may be made of a firm material such as plastic or
carbon fiber, and is used primarily for walking or dress shoes. It is
generally fabricated from a plaster of paris mold of the individual foot.
The finished device normally extends along the sole of the heel to the
ball or toes of the foot. It is worn mostly in closed shoes with a heel
height under two inches. Because of the nature of the materials involved,
very little alteration in shoe size is necessary.
Rigid orthotics
are chiefly designed to control motion in two major foot joints, which lie
directly below the ankle joint. These devices are long lasting, do not
change shape, and are usually difficult to break. Strains, aches, and
pains in the legs, thighs, and lower back may be due to abnormal function
of the foot, or a slight difference in the length of the legs. In such
cases, orthotics may improve or eliminate these symptoms, which may seem
only remotely connected to foot function.
Soft Orthotics
The
second, or soft, orthotic device helps to absorb shock, increase balance,
and take pres- sure off uncomfortable or sore spots. It is usually
constructed of soft, compressible materials, and may be molded by the
action of the foot in walking or fashioned over a plaster impression of
the foot. Also worn against the sole of the foot, it usually extends from
the heel past the ball of the foot to include the toes.
The
advantage of any soft orthotic device is that it may be easily adjusted to
changing weight-bearing forces. The disadvantage is that it must be
periodically replaced or refurbished. It is particularly effective for
arthritic and grossly deformed feet where there is a loss of protective
fatty tissue on the side of the foot. It is also widely used in the care
of the diabetic foot. Because it is compressible, the soft orthotic is
usually bulkier and may well require extra room in shoes, or prescription
footwear.
Semirigid Orthotics
The
third type of orthotic device (semirigid) provides for dynamic balance of
the foot while walking or participating in sports. This orthotic is not a
crutch, but an aid to the athlete. Each sport has its own demand and each
sport orthotic needs to be constructed appropriately with the sport and
the athlete taken into consideration. This functional dynamic orthotic
helps guide the foot through proper functions, allowing the muscles and
tendons to perform more efficiently. The classic, semirigid orthotic is
constructed of layers of soft material, reinforced with more rigid
materials.
Orthotics for
Children
Orthotic devices are effective in the treatment
of children with foot deformities. Most podi- atric physicians recommend
that children with such deformities be placed in orthotics soon after they
start walking, to stabilize the foot. The devices can be placed directly
into a standard shoe, or an athletic shoe.
Usually, the orthotics
need to be replaced when the child’s foot has grown two sizes. Different
types of orthotics may be needed as the child’s foot develops, and changes
shape.
The length of time a child needs orthotics varies
considerably, depending on the seriousness of the deformity and how soon
correction is addressed.
Other
Types
Various other orthotics may be used for
multidirectional sports or edge-control sports by cast- ing the foot
within the ski boot, ice skate boot, or inline skate boot. Combinations of
semiflexible material and soft material to accommodate painful areas are
utilized for specific problems.
Research has shown that back
problems frequently can be traced to a foot imbalance. It’s important for
your podiatric physician to evaluate the lower extremity as a whole to
provide for appropriate orthotic control for foot
problems.
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