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Saturday, April 10, 2010

Foot Orthotic Devices: General Principles

There are many types of foot orthotic devices for the consumer. They fall into 5 categories based on the needs of the patient. These 5 categories are:

1. Corrective (or Controlling)
2. Stabilizing (or Balancing)
3. Shock Absorbing (or Cushioning) as seen above
4. Accommodative (or Weight Transferring)
5. Combination (or Multi-Functional)

How is the correct orthotic device ordered or purchased? The orthotic device that you are prescribed, or that you purchase in a store, may or may not help you if it is not the correct type. At its best, the correct orthotic device will successfully make the necessary change in mechanics, but it may still be crucial to work on all the other aspects of rehabilitation (anti-inflammatory, flexibility, strengthening, etc.) in order to relieve all your symptoms. It is important that the doctor/therapist prescribing the orthotic device be familiar with the many different types of orthotic devices available. It is also important for the patient/customer to be somewhat clear on what type of orthotic device is needed. And, unfortunately, the type of orthotic device required today may change in the future with different sports, different symptoms, different shoe types, and different age (the onslaught of time rages!!). You need to be willing to change to a different type of orthotic device if your symptoms are not improving with the present pair of orthotics, and if there is another type available that may help you. Don’t be afraid to ask if a change to another type of orthotic device may help. Sometimes, practitioners don’t like discussing this type of change due to the added cost to you.

Corrective or Controlling Orthotic Devices do what they say---correct or control excessive pronation or supination (the inward collapse of the arch, or the outside roll of the ankle, respectively). This type of orthotic device produces the most dramatic change in function, and may take the most time to get used to wearing.

Stabilizing or Balancing Orthotic Devices normally do not change foot position much, but the patient/customer feels more centered, more balanced.

Shock Absorbing or Cushioning Orthotic Devices take the stress out of the pounding of heel impact. Runner’s versions need to have equal cushion at the heel and forefoot. These can dramatically reduce the stresses which cause or aggravate stress fractures, joint pains (knee and hip), and heel pain.

Accommodative or Weight Transferring Orthotic Devices try to transfer weight from a painful area to a non-painful area. These orthotic devices have probably been around the longest of all orthotic devices prescribed by podiatrists. Way before I was born. If you have heel pain, you need an orthotic device that transfers weight into the arch.

Combination or Multi-Functional Orthotic Devices are probably the most prescribed type of orthotic device. The prescribing practitioner attempts to accomplish multiple tasks with one type of orthotic device. This is why there are so many types of orthotic devices out there. When you really study them, most primarily do one of the 4 basic functions really well, and then 1 to 3 of the other functions somewhat or not at all. A good practitioner will try to get the most out of Orthotic therapy. This means that the practitioner tries to combine different functions into each orthotic device on a routine basis.

Hopefully this post helped you understand some of the basics of Orthotic therapy. When discussing with a physician, therapist, or store salesperson, try to understand what the orthotic device is going to do. Ask yourself these questions:

1. Do I need a corrective device to change my foot positioning?
2. Do I need to feel more centered and stable?
3. Do I need cushion/shock absorption as I walk or run?
4. Do I need to transfer weight from a painful area to a non-painful area?
5. Do I need a multi-purpose orthotic device with many functions to help me?

Perhaps you will need several orthotic versions since your activities, shoe gear, etc. vary so much. There will be many more posts regarding orthotic devices in the future.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.