What are Orthotics?

An orthotic is a thin plate device worn in the shoe which is used to improve the alignment of the bones in the foot as we walk.

The principle of using an orthotic is that the function of the foot as we walk has an impact on the function of the rest of the musculoskeletal structure. If the foot functions abnormally, such as pronating or supinating too much/little at the wrong time, then the soft tissues and joints in the rest of the body are forced to work differently.

Over time, this change to the function of the body can cause pain and stiffness to develop in different muscles, and the weight-bearing joints to "wear out" quicker, increasing the risk of developing oesteoarthritis and some other degenerative diseases of the bones.

The chronic low levels of physical stress caused by abnormal foot function disrupts the health of the rest of the body, increasing the risk of stress-related health problems such as unrefreshing sleep, weight fluctuations, intestinal changes and emotional problems.

By placing an orthotic device beneath the foot to control the abnormal function in the foot, the rest of the body no longer has to compensate and is free to return to a better function and alignment, and in turn a better state of health.

Of course, the success of using an orthotic depends on a thorough understanding of how the foot is functioning, and the ability to create an orthotic that most effectively optimises foot function for each individual.

Types of orthotics

True orthotics are designed specifically for each foot. There are many types of shoe inserts, arch supports, heel lifts and anti-pronation shoes available over-the-counter, but most of these do not actually change the function of the foot.

Of those that do manage to change the function of the foot, because they are made for the "average" foot and every single foot is unique, the benefits are typically limited.

Functional v. Accomodative

Functional orthoses are made of rigid or semi-rigid material and provide the greatest level of control to the foot through the gait cycle.

An accomodative orthotic is normally reserved for use with some diabetic patients, whose feet are more sensitive. They are made of softer materials at the expense of some control so as not to cause unnecessary pain and discomfort.

Full length or heel cups?

In order to be effective, the rigid part of the orthotic should extend to just behind the toe joints. Heel cups and half length orthotics do not provide the necessary control to the forefoot during the proplusion phase of gait (the bit as the heel comes off the floor and the toes prepare for push-off), and it is here that control is really required. Foot function occurs all the way through the gait cycle, so orthoses need to provide control throughout the entire gait cycle. Full length orthoses are therefore the most effective.

Shoe Fit

Although some types of orthoses can be bulky and require different shoe styles to accomodate them, the majority are made to fit easily into most normal shoes, including fashion and dress shoes.

Shoe styles

Wearing orthoses may require a change in the type of shoe you wear. Certainly to begin with, as foot function adapts and changes, it is advisable to choose shoes which offer the right amount of support around your feet and don't change the alignment of the feet- such as high-heeled shoes.

After your feet have adapted and depending on your particular foot function, it is normally possible to choose from a wide variety of shoe styles. It is always recommended not to wear high-heeled shoes, but if you must wear them, limit their use to give your feet and the rest of your body time and space to recover.

There are rarely difficulties in choosing appropriate shoe styles for men, it is ladies who may experience some difficulties.