Why we use orthotics in our office?

1) 95% of people have pronated feet and some more severe than others. This is where the arch of the foot is not supporting the persons body weight and collapes and the foot rolls in.  This process lengthens the foot, fans the toes and reduces the ability of the foot to absorb shock. Pronation can cause a host of conditions such as bunions, platar fasciitis, metatarsalgia, Morton's neuroma, shin splints, knee pain, ACL tears, hip bursitis, ilio-tibial band syndrome, and low back pain and instability.

2) There are many variations in techniques for casting orthotics such as weight bearing, non-weight bearing, slipper cast, and computer imaging just to name a few. The end product and results may vary.

3) At our office we cast with a  non-weight bearing maximal arch subtalor stabilization. Which means we cast with the arch at its highest point keeping the foot and ankle in a neutral position. This allows uniform support throughout the arch of the foot with minimal collapse of the arch. The thickness of the acrylic orthotic is determined by the individuals weight and activity.

4) Just walking can deliver 1-3 times a persons body wieght on the orthotic. So although it may seem ridgid to touch it is felxable under a load.  Running can deliver 3-5 times a persons body weight. So you can see that they need to be individually made for the persons lifestyle and for each foot.  Feet can be different in arch and size.

5) The difference between arch supports and orthotics is large.  Pulled off a shelf arch supports are generic and not intended to be a perfect fit.  Most of the arch supports that I have seen are either made out of a rubber sponge material or a thin plastic.  This type of appliance will not support the arch under pressure. If you get lucky, it may help minimize the pain, but it won't get at the cause of the biomechanical problem, which for most people, the arch needs to be raised and the first metatarsal needs to be lowered.

6) If we can get people in orthotics early enough, we may be able to prevent surgery down the road.  The time to treat the foot is when you can still move the foot.  Pronation is a progressive disorder that can effect the kinetic chain (foot, knee, hip, and back). My observation has been that people who wear orthotics are more biomechanically stable, and less subject to injury and back pain.

Dr. Rick Haas DC, FACO