FOOT PAIN & PODIATRY ONLINE FOOT PAIN - FOOT ORTHOTICS WHAT ARE FOOT ORTHOTICS From a podiatry standpoint, foot orthotics are used to treat foot pain and certain foot problems caused by the incorrect positioning of the foot while standing, walking and/or srunning.  The functional orthotic is designed to hold the foot straight with the leg with your foot is on the ground and the other foot is passing by during walking and running. This position is called the neutral position and it is the same position that that Podiatrist should cast you in in making the orthotic.   Podiatric doctors must spend considerable amounts of time while studying to become a foot specialists on biomechanics of the foot and specifically how to realign the foot using a foot orthotic.  For the patient, not only does most insurance companies cover the cost of a foot orthotic, if medically necessary, but almost 90% of the time the devices require no further adjustment by the doctor.  If you need to get foot orthotics, go to a Podiatrist first and not last.  In getting foot orthotics from a Podiatrist, make sure you ask the doctor about follow-up.  The answer you should hear from the doctor is that follow-up is included and the device will be replaced with a new one if it turns out to be not working correctly after repeated adjustments.  In addition, make sure that the doctor examines your feet from a biomechanical standpoint so the best orthotic can be made for you based on your unique anatomical design. In getting an foot orthotic made, only get a device made from the Podiatrist and not a back office assistant or by the guy in the white coat at the county fair.  The orthotic should be made by a slipper cast of each foot that is taken with the patient sitting and the foot correctly set in place by the doctor.  If the doctor wants you to place your foot into a foam mold, tell the doctor you only what the cast taken of your foot or you do not want foot orthotics made by the doctor.  Placing the feet into foam boxes produces an very inaccurate device and you probably will end up going to another Podiatrist unhappy and your feet still not improved. As a patient you must understand that there is no regulation of foot orthotics and any one can say they are an expert and sell insoles trying to make out the devices are the same as the devises you get from a Podiatrist.  The fact is that unless the device is a functional device from a cast of your foot, the usual outcome will be that you purchased an expensive pad for your shoe when a pair of $8 silicone insoles from the drug store would have worked just the same. TYPE OF ORTHOTIC CONSIDERATIONS: There are two types of orthotics generally, those the fit in athletic size shoes and those that go into lady's dress shoes.  In considering orthotics for athletic and dress types, there are many to choose from in each category.  There are different covers that go on top of the hard shell of the device and different extensions that extend beyond the end of the orthotic.  The most successful method is to end the top cover where the device ends and to use a separate pad to cushion the ball of the foot. This way, the device can be moved from shoe to shoe and the toe box can be of different sizes and the devices will still drop in effortlessly.  For a new athletic shoe, cut the pad that is removable about a half inch in front of where the heel part of the orthotic ends.  This will allow the device to rest on the bottom of the shoe and will help the device to work more effectively.  The concept is that the device keeps the inside of the foot from rolling to the ground and thus preventing the foot from pronating or flattening out. Lady's dress foot orthotics are much thinner and narrower than athletic devices and as such, do not have the same amount of support of an athletic orthotic.  However, dress shoe orthotics are helpful enough that they are worth using if dress shoes have to be used most of the time for long periods of walking and standing.  Generally, dress devices are only used when the patient plans to use the devices more than just the occasional night our or going to church on Sundays.  Dress orthotics do not work in athletic shoes and same is true for using athletic devices in dress shoes. Before deciding which type of devices is best for your situation, discuss the activity you plan to use the device for and your job description with the Podiatrist prior to having the doctor casting you for orthotics.  Copyright © 1999 PLACENTIA-LINDA FOOT AND ANKLE GROUP Podiatry Associates. All rights reserved.