03/02/2022
Answers to some of your Orthotic Questions.
Orthotic inserts have been gaining in popularity and usage since the mid 1980’s. They are used for a large variety of condition such as: Plantar Fascitis, heel spurs, calluses, bunions, forefoot pain, knee pain, sports injuries, low back pain, and a myriad of other conditions.
So how it is so many conditions respond to orthotics a seemingly simplistic device ? I’ll try to simplify the answer as best I can.
Orthotics alter the mechanism of gait by supporting the foot in its best mechanical position. Each joint in the Kinetic chain of the lower limb is dependent on the joints above and below the one we are examining. If any joint in that chain doesn’t have the correct range of motion, the ones above and below start to compensate by being locked up, or hyper mobile.
Pronation and supination are needed for tibial rotation on the femur, tibial rotation is needed for eversion and antiversion for the hips, eversion and antiversion of the hips is required for neutation and counter neutation of the illia. And so on. When any of these natural motions is effected, you cause issues with the joints above and below the area of mechanical deficiency.
Suffice it to say in my experience, orthotics are very helpful for a large segment of the population and seem to effect positive changes on a wide variety of conditions.
The next debate is what type of orthotics should I wear ? Soft, semi rigid or rigid ones and what determines the choice that’s right for you. This decision should be driven by several factors, what activities will you use the orthotics for, what type of shoes will they be used in, and your body weight.
The goal of orthotics in my professional opinion is to have you in your shoes in sub-talar neutral. This is the best position to support normal mechanics above and below the ankle.
Many practitioners make their orthotics as follows: The patient sits in a chair, a cast is made of the patients non weight bearing foot, the cast is cut off, sent to a factory, sealed and filled with a solid material, that solid “Model of your foot” then has a solid orthotic made to fit it, which is then returned to you to be placed inside your shoe.
To simplify that to it’s most absurd…. When we stand up, our foot widens SO a weight bearing foot is not the same shape as a weight bearing one.
The above process is, make a mold of the non weight bearing foot, send that to a place where they make a mold of the mold of the non weight bearing foot, then make a mold of a mold of the non weight bearing foot and return the mold of the mold of the mold of the non weight bearing foot to the patient. Mmmm sounds Comfy doesn’t it ? There is notoriously low patient compliance their orthotics any wonder why ?
So are Orthotics right for you, the only way of knowing is to try them. I can say that they do help a wide variety of conditions with a great percentage of my patients reporting success in treating their symptoms.
Hope that helped you if you are trying to decide if they are right for you !
As always you can reach Dr. Camp by telephone if you have any further questions, and thanks for reading.