An orthotic for the foot is an orthopedic device designed to adjust or accommodate for a variety of biomechanical foot disorders. Orthotics range from a temporary over-the-counter device to more permanent devices customized to your individual foot alignment. Orthotics can be used to treat a variety of conditions including but not limited to Achilles tendonitis, posterior tibialis tendonitis, plantar fascitis, metatarsalgia, iliotibial band syndrome, knee pain, hip pain, and lower back pain.

Temporary over-the-counter orthotics may be utilized to alleviate acute discomfort or in some cases determine the appropriateness of a more permanent custom device. There are two major types of custom orthotics, accommodative and biomechanical. Accommodative orthotics are typically composed of softer materials and function to provide cushioning and shock absorption to the lower extremities. Biomechancial orthotics are typically composed of slightly more rigid materials and function to correct faulty alignment of the foot. This type of orthotic may include posting (small wedges that correct the alignment of the front and back of the foot and control excessive movement) depending on your foot’s alignment. Biomechanical devices are often appropriate for individuals who have excessive pronation (rolling in of the foot) during functional activities such as walking and running.

Measuring for custom orthotics typically takes 45 to 60 minutes including fabrication of a mold of your feet. Measurements are taken in a variety of weight-bearing and non-weight-bearing positions and include available motion at a variety of joints in the feet, knees, and hips. Additionally, evaluation for custom orthotics includes gait analysis during walking and when appropriate, running. Custom orthotics should take into account your lifestyle including sports participation and shoe wear.

Not everyone requires a custom foot orthotic and much of the time physical therapy is prescribed in conjunction with orthotics to improve muscular flexibility and strength, joint mobility, and core control. This typically results in improved outcomes in conjunction with a custom foot orthotic. You may be a candidate for orthotics if you experience any of the following:

*Chronic foot, knee, hip, or back pain.
*Pain associated with your feet rolling in when you run or walk (pronation).
*Lower extremity pain when participating in athletic events.
*Frequent, recurrent ankle sprains.
*Persistent, recurrent tendonitis in the lower extremities.

If you or someone you know is experiencing these problems contact a qualified healthcare provider to see if you are a candidate for foot orthotics.

The author of this article is Jenni Masterson, PT, MSPT, OCS, ATC, CEAS from NovaCare Andersonville.