Orthotics FAQs


What is an orthotic?

An orthotic is a shoe insert often referred to as an arch support. An orthotic does lend support to arches, however, it does much more than that. An orthotic reorients the angle of your foot relative to the ground.

Why use an orthotic?

Some people require the angle of the heel bones to be realigned to prevent the 
arches from flattening.  This is often referred to as pronation or flat feet.  For others, 
the root of their symptoms is the heel bone turning out into supination. angle of our
feet effects the alignment of our joints, from toes to head.  

These include the bones in our feet plus, those in the ankles, knees, hips, back, and finally the neck and shoulders.  When the position of the bones are affected, the soft tissues associated with them are also affected.  Soft tissues include muscles, tendons, ligaments, joint capsules, and fascia. 

When the bones and soft tissue are aligned properly, they function better and will help to support better posture and movement.  This in turn can help decrease pain, contribute to improved coordination and strength, and can prevent progression of existing misalignments.  Thus, orthotics may address problems within the foot and/or throughout the rest of the musculoskeletal system.

Why have a custom orthotic?

Custom orthotics are appropriate for someone whose needs are beyond the capability of a factory orthotic.  It is possible to purchase orthotics from a variety of sources.  Some are factory made and can be found in shoe or drug stores.  In addition, 
podiatrists, physical therapists, and orthotic companies all may provide some version of an orthotic.  As with many consumer 
products, quality can vary. 

If you are a person who has a rather simple and straightforward issue, purchasing a factory made insert may help. It is important to have an evaluation to determine if the symptoms you are experiencing will be alleviated by an orthotic, and if so, which type.  It is possible for the wrong orthotic to be insufficient in the help it provides, worsen symptoms 
or create new problems.

If I have had a problem for years, aren’t my muscles imbalanced, and if so will orthotics help?

Orthotics are most often immediately helpful.  It is possible to maximize the benefit from orthotics with specific exercises, stretching, or acupuncture, as well as understanding any contributing factors.

What happens when I make an appointment with you for an orthotic?

A physical therapy evaluation is necessary.  The evaluation may be provided to you by your physical therapist or by me.  If you have not had an evaluation, time for that is scheduled and can be accomplished in the same appointment for the orthotic 
fabrication, or in a separate appointment.  The orthotics are created at the time of your visit.  Measurements are taken, a dense foam is cut to size, heated to conform to your foot, and posts are added and ground down.

What is a post?

A post refers to a thickened part of the orthotic which changes the angle of your foot relative to the floor.

Will the orthotic fit in my shoes?

When orthotics are fabricated, they are done so relative to the surface of the floor. Many of us have uneven wear on the soles of our older shoes.  If this wear is significant, it will alter the angle of the orthotic and therefore it’s appropriate effectiveness. I would then recommend a new sneaker, or for a shoe, if appropriate, an outer sole replacement. I try to make the orthotics as thin as possible and most can fit into a sneaker when the original insert that comes with the sneaker is removed.  

At times, a larger correction is required and a new form of shoe will need to be purchased. For women’s shoes, often a new style will be required. High heels are a challenge for orthotics.  There are shoe companies online that specialize in shoes with a deeper seat and have the removable insert to allow for an orthotic. One particularly helpful company is Footsmart.com

How long is an appointment to fabricate the orthotic?

An appointment can take as long as 2 hours.  There are frequent short breaks when neither your attention nor participation is required.

Does insurance pay for the orthotics?

In my experience, most insurance companies do not, however, I would encourage you to check with yours.

What makes your orthotics different from others who fabricate custom orthotics?

One difference is the material. I make orthotics out of dense foam, which is comfortable to wear in general, and the changes it makes to your foot position can be adapted to in a short period of time.  Another more important difference is where I am willing to post. There is a debate in the orthotic community about posting only at the heel versus also posting at the ball of the foot.  When I evaluate someone for orthotics, if I see it necessary to post the ball of the foot I will.  

Most orthotic companies do not do this, and as far as I know no factory made ones do.  While making orthotics over the last 15 years, I have found that posting only the heel has been adequate for many corrections; however, there is a percentage of those who no matter how we have tweaked the rear foot post the orthotics were inadequate.  Now, fabricating them myself in my office, I find including the forefoot in the design maximizes the effectiveness and changes the symptoms people have been experiencing.