Our Podiatrist In Scarborough, ME Can Help With Biomechanical Analysis

 

CUSTOM ORTHOTICS

Orthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe orthotics that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotics are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription foot orthoses can since they are not custom made to fit an individual's unique foot structure.

Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.

Semi-Rigid Orthotics

Semi-rigid orthotics provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials. Semi-rigid orthotics are often prescribed for children to treat flatfoot and in-toeing or out-toeing disorders. These orthotics are also used to help athletes mitigate pain while they train and compete.

Frequently Asked Questions:

What is the difference between an over the counter insert and a custom molded orthotic? 

An insert is usually over the counter and prefabricated. These can be compared to buying reading glasses at the store.  Some people do well with OTC inserts like Powersteps and their condition improves. Custom orthotics are like getting prescription eye wear. The orthotics are used to treat a specific condition and corrections are made based on a biomechanical exam. A 3 dimensional picture is taken of the foot with a cast or a digital image and sent to a lab for fabrication and sent back to the office for dispensing to the patient.

Not all patients need custom molded orthtotics. OTC inserts that Dr. Kurlanski recommends.

How long do custom molded orthotics last?

Generally 3-5 years. Sometimes the top covers may need to be replaced if they become cracked or worn. For children it may be 1-2 years depending on growth.

How long do over the counter inserts last?

We recommend replacing over the counter inserts every 6-12 months.

What kind of shoes can I wear my orthotics in?

We recommend you wear the orthotics in the shoes you wear the most often and do the most activity in. Sneakers, mocassin and lace up style shoes work best. Several women's shoes now come with removable foot beds to accomodate orthotics. It is a good idea to bring in your shoes when you are getting casted and when the orthotics are dispensed. No orthotic will work in all shoes.

How often should I been seen after I get orthotics?

Initially, the patient is seen one month after the orthotics are dispensed then every one to two years for follow up. Occasionally orthotics may need to be adjusted after they are dispensed. Most often this can be done in the office.

Conditions treated with orthotics:

  • Plantar Fasciitis or Heel Pain
  • Hallux Limitus
  • Bunions
  • Posterior Tibial Tendonitis
  • Peroneal Tendonitis
  • Arthritis
  • High Arches
  • Neuromas
  • Flat Feet
  • Tarsal Tunnel
  • After Surgery to Maintain a Correction or Prevent Future Problems

Recommended Break in Period for Orthotics

Like new eyes glasses or contacs, orthotics should be broken in gradually. After they are dispensed wear them for one hour the first day, two hours the next day, four hours the following day, increasing the time over the next 2 weeks until the orthotics can be worn comfortably for 8 hours. Avoid exercising in the orthotics until they are comfortable. If the orthotics squeak talcum powder can be added to the shoes with the orthotics.

What make a good orthotic?

  • Orthotics work best when you know what you are treating, tarsal tunnel, posterior tibial tendonitis, hallux limitus etc. The orthotic should address the pathology not the activity. They are not a cure all and sometimes surgery is indicated. 
  • The patient is scanned or casted in neutral subtalar joint with the midtarsal joint locked and the first metatarsal phalangeal joint plantarflexed.
  • The orthotic should control the rearfoot and conform to the arch. 
  • The material is appropriate for the patient's weight and age.
  • The shoe is deep and wide enough to accomodate the orthotic and the orthotic is appopriate for the shoe.

Tips for Breaking in Your Brand New Orthotics!

When you first wear your new Orthotics, expect to feel different.  This is quite normal.  Orthotics will change the way you walk.  It is important that you understand that we are changing your body’s posture and alignment.  By changing the way you walk, we can cause dramatic changes in both the position of your joints, as well as increase your muscle balance and stability. Our goal is to increase your ability to walk, run, or perform in life or sports better and pain free.  While your muscles rebalance during the break in period you should begin to notice changes not only in your feet and legs but your entire body.

We recommend that you wear your Orthotics the 1st day for an hour and increase the time you wear them by 1 to 2 hours a day. It usually takes one to two weeks to become completely used to wearing your Orthotics but this can differ from person to person.  We recommend you break them in slowly by wearing them as instructed and increasing the wear time in small amounts until you can wear them all day.  The slower you start the easier the break-in period will be.

You should start each day with your Orthotics in your shoes.  The time you wear your Orthotics counts whether you are standing or sitting. This is because the Orthotics holds your foot in its neutral position and your foot and muscles will become used to this position whether you are walking or not.  When you first put your Orthotics in expect to feel different.  This sensation should disappear within a few weeks.  After approximately two to eight weeks, you will probably no longer even notice you are wearing Orthotics.  As with any medical appliance, your body must adjust to their use.

If during the break in period you forget to take out your Orthotics and mistakenly wear them too long and you become uncomfortable (your arches, legs or knees may feel like you “over did it”) you may decide not to wear them the next day.  This is a big mistake!  If you don’t wear them the next day, at least half as many hours as you wore them the day you forgot to take them out, you will aggravate your muscles.

Until you become used to the feeling of wearing your Orthotics, do not exercise in them.  In most cases this usually takes a minimum of four or five days.  For runners, we recommend waiting a minimum time frame of 1 to 2 weeks to give your muscles a chance to adapt to this new position.

Wear socks or stockings when wearing your Orthotics.  Orthotics can be cleaned with a mild soap or detergent and a soft cloth or sponge.  Let them air dry thoroughly, usually overnight, before replacing them in your shoes.

Remember that your Orthotics are undoing damage that took years to make.  Listen to your feet and please be patient.