Four things to know about orthotics from DR. NIRAL PATEL


What are orthotics?

Orthotics are medical devices that are prescribed by your podiatrist to help align and improve conditions that are related to your feet. They are designed by using a laser scan which is done in the office and then fabricated and customed in a lab along with the specific prescription that the doctor sends. The prescription may involve changing the density of the orthotic, changing the support structure of the orthotic, and modifying it in multiple ways to provide the intended support.

What are they used for?

Orthotics can be used for a variety of diagnoses. For something like plantar fasciitis, posterior tibial tendonitis, Achilles tendonitis - all the issues related to the rear part of the foot. They also can be beneficial for issues related to the front of the foot. Which include Morton’s neuroma, and hallux limitus. In addition, orthotics can be used as a preventative device to provide support for some individuals that have a flatter or higher arch and perform specific activities, for example, sports, or activities that involve a long time on your feet. 

What is the difference between orthotics, insoles, and inserts?

We have to differentiate between the specific devices we are talking about.  Customed orthotics are designed by a podiatrist or a medical practitioner. They are customed to the patient’s foot using a laser devise or traditionally using a plastic cast. They accommodate for any specific lump, bump, and contour of the patient’s foot. Orthotics can be adjusted and manipulated in infinite ways, so we can account for neuromas at the front of the foot, for limitations in joint range of motion, and for high or low arches. We can control the internal or external rotation of the heel bone. And all of these are related to certain pathologies, so we can do that with a device that is made in a factory which is why custom orthotics have a lot more flexibility.

Over-the-counter insoles are designed for the general public based on a standardized cast indicated for a limited amount of conditions. They are not specific to the patient’s foot. They may be slightly larger or slightly smaller. They may have an arch that is not in the correct position when compared to certain patients' feet.

And there are also inserts, which are essentially a spacer to fit between your foot and the shoe. They are removable and don’t provide a biomechanical correction that an orthotic or over-the-counter insole would provide.

Do orthotics fit any shoe?

Custom-made orthotics can fit any footwear, designed in multiple ways. They can be made for high profile shoes or low profile and can be adjusted to any type of footwear from dress shoes to sneakers and casual shoes. They can also be specific to certain sports. For example, we can design orthotics that can fit into ski boots or into ice hockey skates - options are endless based on the indication. 

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