What You Need to Know About Orthotics

Anthony Robinson30th of May 2019www.completepodiatry.com.au / blog / treatments / need-to-know-about-orthotics

What you Need to Know About Foot Orthotics

Have you ever been sold a pair of orthotics and were not really sure why you needed them or how they would help you?

We see many clients at Complete Podiatry for a review or second opinion about the foot orthotics they are wearing.

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Orthotics come in a wide variety of shapes and types

Not All Orthoses Are The Same

What I have noticed is that there is a VERY wide range of devices that are referred to as ‘orthotics’ and not all of them are going to do much to help your foot pain.

If you go to any pharmacy or shoe shop you will find a display of ‘foot orthotics’.

People sell ‘orthotics’ ar local fairs and shows.

There are franchise chain stores from the USA in our home town of Adelaide now that push orthotics.

You can even go on a cruise and buy a pair of orthotics now.

Now does this mean that all of these orthotics are the same and will be appropriate for your medical needs?

No, definitely not.

There Are Big Differences Between “Orthotics”

Many people drive cars however we all understand there is a big range of cars on the market.

If you think of the difference between a Moris Minor and a Bently, is it right to say that one is the same as the other because they are both cars?

I don’t think so.

The majority of the people selling orthotics have no understanding of what orthotics do and how they work.

Most of these people have just taken the following assumption and built a business model about it: Podiatrists charge a reasonable amount for orthotics so I can make a quick buck by selling orthotics too.

Let me ask you two questions:

  1. Would you let anyone but a dentist fill a cavity in a tooth on a cruise ship?
  2. Would you buy false teeth from a local fair?
  3. Would you let someone who was not a doctor operate on you?

No? OK.

Just like you wouldn’t do the things above because it is unsafe, you shouldn't buy an orthotic from an unqualifies health practitioner let alone a business.

How Orthotics Work

There are big differences in the world of orthotics and unfortunately, the majority of people selling them don't really understand how they work.

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This is NOT how orthotics work

Some think they hold the bone of your foot in the ‘optimal ‘position while others think they support your arch and stop it from collapsing.

What foot orthotics actually do is to change loading in the body by altering the magnitude and direction of the force that is generated when your foot contacts the ground.

Every time your foot hits the ground, the ground hits back with an equal but opposite force (that's physics baby!).

The forces generated by this collision will cause stress on all the different tissues in your foot, leg, and body.

Different tissues (bone, ligament, fascia, tendon, etc) cope with different forces in different ways and, if some of the tissues in your foot or leg are damaged, weak, or traumatised, these ‘normal forces’ can cause pain and dysfunction to be produced.

Foot orthotics change the way the forces generated by your foot hitting the ground load the various parts of your foot, leg, and body.

Why Are Podiatrist Prescribed Orthoses Different?

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Digital, custom prescribed orthoses

As Podiatrists, we are trained to:

  1. Diagnose what part of your body is damaged
  2. Determine what forces have contributed to this damage
  3. Develop strategies that will help to reduce these damaging forces
  4. Improve the healing of the damaged tissues
  5. Make the tissues stronger so they can tolerate higher loads

As you can read from the above, orthotics should be PART or the strategy to manage foot or leg problems, not the only strategy.

Orthoses Are Part of the Treatment, Not All Of It

When we prescribe an orthotic to help a client get back to doing the things they love without pain, we do so as part of a larger, holistic management plan.

Our client’s management plans are written documents that explain the pathway of care they require to get them better and usually include pain management strategies, hands-on care to heal damaged tissue, an offloading strategy (orthotics or something else) to reduce the stress in the damaged tissues and a long term strengthening plan.

The orthotics we prescribe are customised to a high degree and made from a 3D laser scan of our client’s feet with specifically designed prescription variables that work to reduce the stress and load in damaged tissues.

This is what we refer to as a high-dose orthotic versus the off the shelf orthotics which are low-dose (not made to your foot shape, not prescription variability, cheap materials).

The Difference Between Podiatry Orthotics and Shop Bought Orthotics

A low dose orthotic is very generic and may work for you or it may not, where a high dose orthotic is designed for YOUR requirements.

A high dose orthotic takes into consideration your anatomy, your function, your exercise habits and much more to ensure it is most likely to have a beneficial effect on your life.

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Many people try a low dose orthotic when they have foot pain and find that it doesn’t help them feel better and then say “  I’ve tried orthotics and they don't work”.

However, we now understand there is a big difference in low dose orthotics and the high does orthotics Podiatrists prescribe.

To further illustrate this dosing concept, let’s think about how blood pressure medication works.

If you take a very low dose of a blood pressure medication it may not have any effect on lowering blood pressure, however, with a higher dose specified exactly for your circumstances, the medication has a great effect.

Just because a low dose of blood pressure medicine does not work, do we then claim the medication does not work at all?

A low dose orthotic is very generic and may work for you or it may not, where a high dose orthotic is designed for YOUR requirements.

Podiatrist Prescribe Customised, High Dose Orthotics

The reality is that the only health practitioners who are trained and qualified in the digital modelling, prescribing and designing of custom made orthotics are Podiatrists.

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We see many other health professionals using low dose orthotics for their clients with little understanding of their mechanism of action or the training to adequately prescribe the appropriate type of orthotic.

No other health profession undertakes the years of training or has the experience to appropriately assess your biomechanical requirements, develop a 3D model of your foot then appropriately prescribe and design a functional, high dose foot orthosis

Now, the next time a friend, family member or you are considering orthotics, I challenge you to get the best help you can by seeing the only health professionals qualified to prescribe orthotics.

 

Anthony Robinson

Owner and Principal Podiatrist, Complete Podiatry