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Doctors of
podiatric medicine prescribe orthotics as a conservative approach to
many foot problems or as a method of control after certain types of foot
surgery.
Orthotics are available in various types of materials and many shapes.
All types of orthotics are designed to improve foot function and
minimize stress that could ultimately cause foot deformity and
pain.
Types of Orthotics
Foot orthotics fall into three major categories: those that primarily attempt to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.
Rigid Orthotics
A rigid orthotic device is designed to control function and may be made of a firm material such as plastic or carbon fiber. It is used primarily for walking or dress shoes. It is generally patterned from a plaster of paris mold of the individual foot. The finished device normally extends along the sole of the heel to the ball or toes of the foot. It is worn mostly in closed shoes with a heel height under two inches. Minimal alteration in shoe size is necessary.
Rigid orthotics are primarily designed to control motion in two major foot joints, which lie directly below the ankle joint. This type of orthotic device is long lasting, does not change shape, and is usually difficult to break. Strains, aches, and pains in the legs, thighs, and lower back may be due to abnormal function of the foot, or a slight difference in the length of the legs. In these cases, orthotics may improve or eliminate these symptoms.
Soft Orthotics
The soft orthotic device helps to absorb shock, increase balance, and take pressure off uncomfortable or sore spots on the foot. It is usually made of soft, compressible materials, and may be molded by the action of the foot in walking or patterned over a plaster impression of the foot. This orthotic
device is also worn against the sole of the foot and it usually extends from the heel past the ball of the foot to include the toes.
The advantage of any soft orthotic device is that it may be easily adjusted to changing weight-bearing forces. The disadvantage is that it must be periodically replaced or
refurbished as it wears down. It is particularly effective for arthritic and grossly deformed feet where there is a loss of protective fatty tissue on the side of the foot. It is also widely used in the care of the diabetic foot. The soft orthotic is usually bulkier than the rigid orthotic and it may require extra room in shoes, or prescription footwear.
Semirigid Orthotics
The semirigid orthotic device provides for dynamic balance of the foot
during walking or participating in sports. This orthotic is an aid to the athlete. Each sport presents different demands on the feet and body, and each sport orthotic needs to be constructed with the sport and the athlete taken into consideration. This functional dynamic orthotic helps guide the foot through proper functions, allowing the muscles and tendons to perform more efficiently. The classic, semirigid orthotic is made of layers of soft
material reinforced with more rigid materials.
Orthotics for Children
Orthotic devices are effective in the treatment of children with foot deformities. Most podiatric physicians recommend that children with such deformities be placed in orthotics soon after they start walking. In this situation, the orthotic device serves to stabilize the foot. The orthotic devices can be placed directly into a standard shoe or an athletic shoe. Orthotic devices for children usually need to be replaced when the child's foot has grown two sizes.
The length of time a child needs orthotics will vary, depending on the degree of the deformity and when the initial intervention is
made.
A podiatrist
will determine if a child is in need of orthotics. Fallen arches, flat
feet, are one situation in which a podiatric physician may prescribe
orthotics for children. To check your child's feet for fallen arches,
follow these simple instructions:
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Position
yourself in front of the child, with the child's feet at your
eyelevel.
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With the
child standing, feet hip width apart, observe the soles of the feet
on the inner sides; a child with flat feet will have soles that
touch the ground with no concave curve where the normal arch should
be and the ankles will tilt inward. A child without flat feet will
have a concave curve where the normal arch should be.
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If you
discover symptoms of flat feet in your child, it is advisable to
have the child examined by a podiatric physician for diagnosis and
treatment.
Other Types of Orthotics
Various other orthotics may be used for multidirectional sports or edge-control sports by casting the foot within the ski boot, ice skate boot, or inline skate boot. Combinations of
semi-flexible material and soft material are used to accommodate painful areas for specific problems.
Research has shown that back problems can be caused by a foot imbalance. Your podiatric physician will evaluate the lower extremity as a whole to provide for appropriate orthotic control for foot problems.
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