July 18, 2014 6 a.m.
Your feet are subjected to a great deal of load each day and get quite a workout. The pressure on your feet can exceed your body weight while walking, and can be three or four times your body weight while running. Without the proper posture and support, your feet tend to pronate (roll inward), causing pain or strain in your heel and arch, ankles, knees and lower back. Patients are always complaining about their feet and ankle pain, and looking for non-invasive ways to avoid surgery. Often, they ask me questions about custom orthotics and if it will improve their quality of life. Here are some of the more common questions and how I counsel them.
What are custom orthotics?
An orthotic is any device inserted into a shoe, ranging from an accommodative cushioned support pad to a custom-made shoe insert, to correct an abnormal or irregular walking pattern. Often referred to as arch supports, orthotics allow people to stand, walk and run more efficiently and comfortably. Orthotics are used by adults and children.
Custom orthotics are different than over-the-counter orthotics or inserts because they are made from impressions created by your feet, and prescribed by a podiatrist or medical professional. Prescription orthotics are custom made to your feet. They are designed to correct the alignment and function of your feet and lower extremity when worn in your work, casual dress, athletic or high-heeled shoes.
What are the advantages of custom orthotics over over-the-counter orthotics?
Many over-the-counter orthotics are available to help people with mild symptoms of heel and arch pain and foot strain and injury; however, they cannot correct the wide range of symptoms that prescription foot orthotics are able to address. By properly balancing your foundation, custom orthotics will lessen the pain in your feet, ankles, legs, knees, hips and back.
Orthotics may be particularly helpful for children who are still growing. Wearing orthotics every day will help reduce the pain and cramping in a child’s knees, feet or legs. Using orthotics early, especially for a child that has metatarsus adductus, may help reduce the need for braces or corrective surgery. If a child has Sever's disease, wearing an orthotic will help reduce heel pain and prevent limping. Although Sever's disease usually heals quickly, it may reoccur if long-term measures are not taken to protect the heel during a child's growing years.
Are all orthotics the same?
Orthotics take various forms and are constructed of various types of materials. Each type is designed to improve foot function and to minimize stress forces that ultimately cause deformity and pain. There are four primary types of orthotics, and each type functions differently.
* Rigid orthotics are designed to control function and primarily used in walking or dress shoes. They are composed of a firm material, such as carbon fiber or plastic. Rigid orthotics are very effective at controlling motion in the major foot joints directly below the ankle. Consequently, they tend to reduce or eliminate strains, aches and pains in the ankles, legs, thighs and lower back.
* Soft orthotics are designed to absorb shock, improve balance and reduce pressure off uncomfortable or sore spots. They are particularly effective for arthritic, deformed and diabetic feet. The soft orthotics are generally made from soft, cushioned materials. They can be worn against the sole of the foot, extending from the heel of the foot to the toes.
* Semi-rigid orthotics are a combination of the above types, designed specially to provide foot balance for walking or for participating in all-purpose or high-performance sports activities. The semi-rigid orthotic is made up of layers of soft material that is reinforced with more rigid materials. These types of orthotics are also prescribed for children to treat flatfoot, as well as in-toeing or out-toeing.
* Orthotics for children are designed specifically to address a child’s physical condition, growth stage and activity level.
Which orthotic is best for me?
Your podiatrist can evaluate your foot type, specific skeletal or muscular problem, and style of shoe gear to determine the type of device that is best for you.
There is a wide range of custom orthotics. These include orthotics designed to accommodate such things as: men’s dress shoes or women’s flats; high-heels or open-backed shoes; high-performance orthotics for running and all-purpose sports activities; heel spur orthotics for patients suffering from heel pain; maxi shock orthotics that provide plantar arch reinforcement for impact absorption; orthotics that fit particularly small heels; orthotics designed for progressive foot disorders of geriatric patients; entry-level custom devices suitable for managed-care patients; and Medicare-approved inserts for diabetic patients.
How much do they cost?
Costs vary on a case-by-case basis depending on the complexity of the condition and type of orthotic selected. The initial physician’s exam is typically covered by your insurance carrier. Contact your insurance carrier to see if you are covered for custom orthotics. Out-of-pocket costs could range from $300 to $500.
A podiatrist can evaluate your foot type, specific skeletal or muscular problem, style of shoe gear and provide you with quality custom orthotics that are best for you. If you are interested in obtaining an evaluation, contact Dr. John Sigle at (217) 787-2700 for a consultation or go to http://www.myfootandanklecenter.com.