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Sunday, April 3, 2011

Custom Orthotic Devices and Shoe Inserts: They Do Not Coexist

When using a custom orthotic device, it is generally very important to remove the insert that comes with the shoe. Not only are there crowding issues, but the form of the shoe insert can effect the position of the orthotic device within the shoe. Thus, it can either help or hinder the orthotic device from doing it's job. The photo above illustrates this principle. My patient was complaining of 4th toe pain. When I looked at his shoe inserts you could see the 4th toe was overhanging the front edge, thus getting irritated. Had he bought the shoe too short? The solution was found at looking at how the orthotic devices were sitting in the shoe. The photo above shows the orthotic is being pushed forward by the heel cup of the shoe insert. If you push the orthotic forward, the whole foot will go forward, and the length of the toe will not be exact.
Here again you get a full view of the orthotic device sitting forward in the heel cup which would push the whole foot forward. To hedge my bet, I also taught the patient power lacing and gave some tongue pads to hold him back into the shoe heel counter better. I had him replace the shoe insert with a flat spenco insole.


1 comment:

  1. No question; just posting the shoes that I have found work with my athletic custom orthotic devices. It was a huge search for 2 years but the list is as follows: tennis shoes are the best, but almost as good are merrill clogs with removable footbeds (summer and winter styles are available), ugg ultimate boot short (removable footbed)and I have one dress boot (after trying on about 25 or so). The only sandle I have been able to wear with dresses is the Mephisto Helen. If I need to wear a dress in the winter, I tape my feet, using the low-dye method. Hope this helps someone, because it took me a long time to figure this out.


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.