Foot orthoses

Foot orthoses, commonly called orthotics, are specially designed shoe inserts that help support the feet and improve foot posture. People who have chronic foot or leg problems that interfere with the health and functioning of their feet may be prescribed orthoses by their podiatrist. For example, someone prone to calluses can have the pressure of their body weight redistributed across their feet with the aid of custom-fitted shoe inserts. Athletes may also wear orthoses to help correct foot problems that could hinder their performance.

These prescription shoe inserts are either ‘off the shelf’ or made from scratch using a plaster cast or computer-aided digital picture of the patient’s foot.

Foot conditions treated with orthotics

Some of the foot and lower limb problems that can be successfully treated in the long term with orthoses include:

• corns and calluses
• foot ulceration
• tendonitis
• recurrent ankle sprains
• recurrent stress fractures of foot and leg bones
• heel pain
• front-of-knee pain (patellofemoral syndrome)
• some hip and low back pains (particularly those made worse by long periods of walking or standing.

Orthotics are individually designed

Orthoses are designed to address the person’s particular foot problems. The various types of orthoses can include:

• functional foot (customised kinetic) orthoses – to offer all the features below, including postural adjustment
• prefabricated orthoses – these devices can be customised by a podiatrist to provide relief for a specific problem
• cushioning orthoses – to offer extra shock absorption to the foot
• pressure relief orthoses – to remove pressure spots (that could be responsible for complaints such as corns or calluses) by redistributing the person’s body weight across the sole of the foot.

Prescribing orthotics

When prescribing your orthoses, your podiatrist will consider various factors, including:

• existing foot problems (such as corns and calluses)
• foot structure and function
• biomechanical considerations, including posture and walking pattern
• type of footwear commonly worn
• occupation (such as whether your job involves standing up for long periods of time)
• lifestyle factors (such as preferred sports).

Foot assessment for orthotics

If foot orthoses are considered necessary, a comprehensive understanding of your foot function will be required. This may be done by examining your foot, including the range of motion of your foot joints, the strength of the muscles in your feet, and the position of the bones in your feet when you stand. Your walking pattern will be assessed in detail (on a flat surface, a treadmill, or or by repeating the activity that triggers your pain).

Long-term treatment with orthotics

Orthoses will usually be prescribed with other therapies, such as a program of stretching and strengthening exercises to improve your posture and alignment. These exercises are generally developed by the podiatrist in consultation with you and started at the time of orthotic prescription.

Other physical therapies may include:

• ultrasound
• mobilisation
• manipulation
• taping and strapping.

For people with diabetic foot ulcers, wound cleaning and dressings are provided, as well as pressure-relieving orthoses to improve the rate of healing.

You may need to visit your podiatrist after your orthoses are fitted to make sure they are working properly. In some cases, small adjustments to the shoe inserts are needed. Your podiatrist will devise an ongoing treatment plan to help you manage your foot problems in the long term.

Where to get help

• Podiatrist
• Australian Podiatry Association (Vic) - to find a podiatrist in your area please call Tel. (03) 9895 4444.