What is an orthotic?
An orthotic is an insole designed for the inside of a shoe in an attempt to:
1) improve foot and lower limb function,
2) improve shock absorption
3) and relieve symptoms.
There are many different types of orthotics available today.
Katriona has nearly 20 years of clinical experience in prescribing prefabricated, semi-bespoke and bespoke orthotics.
A bespoke/custom-made orthotic is individually-made for your foot. Katriona takes a plaster-of-Paris impression of the foot, and along with the measurements taken during the hands-on assessment, writes a specific personalised prescription. This device is then custom-made for your feet and biomechanics. The style can vary, and you may require a sports-specific pair of orthotics.
Types of Orthotics
Everyday orthotics have to be small devices with a slimline shell style and low heel cup as day shoes have room restrictions. These can also be made with a pitch in the shell thus allowing ladies to wear them in heeled shoes.
Running orthotics are often larger full-length and thicker devices with more cushioning to absorb some of the ground reaction forces of each step.
Football orthotics have to be exceptionally tight fitting to the foot and the boot as footballers typically wear boots on the tight side thus keeping good contact with the ball.
Ice-hockey orthotics are made slightly narrower in the shank as the sole of the ice hockey boot is narrow and does not flex. It is important that the foot translates accurately down through the blade of the boot and therefore the shell of this device must be fitted well to the foot.
Ski orthotics must be semi rigid with a narrow functional grind as the biomechanics of skiing especially within the foot is unique to this alpine sport. The foot should not move in the frontal plane but needs to be able to pronate and supinate fractionally allowing the skier to sharply transfer weight edge to edge.
Golf orthotics depend on your swing. The prescription of a golf orthotic can be different left and right and will be designed to provide good shock attenuation.
Diabetic/rheumatoid/arthritic orthotics are used for those feet which have reduced functional range of motion and often sensation. The shoe ultimately needs to be accommodating to the foot shape and then the orthosis is prescribed to reduce and redistribute high dynamic foot pressures. These devices tend to be bigger than a regular day orthotic as the materials used must be absorptive.
Richie brace/neurological orthotic is a remarkable device that helps specifically with foot-drop and non-operative adult acquired flatfoot secondary to posterior tibialis tendon dysfunction. It combines a custom-made orthotic with an ankle brace, improving the control of the foot while keeping frontal plane alignment.
Children’s orthotics will not change the shape of their feet but it can help reduce the stresses on the musculoskeletal system during exceptionally important years of growth. Orthotics can encourage better postural alignment above the foot as the bones and muscular strength are developing. Common conditions prescribed for include paediatric flatfoot, excessive in-toeing, growth related injuries e.g. Sever’s disease, Osgood-Schlatter disease, Legg-Calve-Perthes disease (LCPD), sports injuries, ankle injuries and patellofemoral pain. For children aged 15 years or younger a special discount program is available, this makes growth-related replacement orthotics more affordable.
The custom-made orthotic, therefore, caters to your needs allowing for differences in size, shape, material, padding, and even the colour that is required, but most importantly the control within the device is bespoke to your individual requirements/injury. A custom-made orthotic costs more than the prefabricated devices due to the increased time and clinical skill it takes to make these devices. There is a separate charge for the casting appointment which is required for a custom-made orthotic.
Health insurance will often cover neither biomechanical assessments nor orthotics.
Alternatively, over-the-counter orthotics can be provided. These offer generic, minimal support and are often sufficient to resolve simple conditions. Often Vasyli devices are used for adults. Katriona can also adapt prefabricated orthotics making them semi-bespoke, increasing or decreasing control on either or both feet.
How long does it take to get a pair of custom-made orthotics?
Once the cast and measurements have been taken, the casts and the prescription are sent to an external laboratory where the device is manufactured specifically for you. The whole process normally takes about 4 weeks.
How long should my custom-made orthotics last?
Most orthotic shells are extremely durable and are made from a high-density plastic (polypropylene). The top-covers and padding generally need to be replaced every 2 years but it is usage specific e.g. if you wear them every day all day, the top-covers may need to be replaced earlier. The shell itself should last a minimum of 2 years but can last up to 10 years. Your biomechanics tend to change more quickly than the device.
Please note, insurers will not pay for orthotic devices, and payment is required on the day of your appointment.