1. Aren’t All Orthotics Basically the Same?
I wish that were the case but it’s not.
There are huge differences in the quality of workmanship, research, casting techniques and providers who dispense foot orthoses.
It’s as frustrating for legitimate orthotics providers as it is for the public that the regulations surrounding foot orthoses are so loose.
2. Do you Make Orthotic Shoes?
Nope. There is no such thing as an “orthotic shoe”.
Somewhere along the line, through creative marketing, an orthotic company started to bundle prefabricated shoe inserts with footwear and re-label the package as “orthotic shoes” but that was just a deception to fool consumers and insurance companies.
The fact is that an orthotic is one thing and a shoe another. Simply putting an orthotic into a shoe does not make them become one.
3. Don’t Foot Orthotics Make my Foot dependent on using them?
Let me answer this with the example of a more common “device”.
If you have a visual problem that is corrected by wearing glasses, do you wear the glasses or avoid them because you become dependent on them?
If you have a biomechanical problem of the feet, wearing orthoses is like wearing glasses. They correct the problem while they’re in your footwear and the problem still exists when you remove them. So are you dependent or just using a corrective device?
4. Do You Treat Children using Orthoses?
It depends. Not usually until the age of 8 and even then the condition would need to be significant. If the child has a congenital problem and they are symptomatic, I may decide to use orthoses, otherwise I monitor the child until teenage hood and decide then.
5. Out with the Old…When to replace your orthotics.
There are no hard and fast rules about when foot orthoses need to be replaced. No two people wear out their shoes at the same rate and orthoses are much the same with replacement periods being as short as 1 year and as long as 5.
Long distance runners, those who work on their feet, those who may have gained 20 or more lbs of body weight and highly active people tend to flatten their orthoses more quickly.
The orthotics I use are uniquely designed to match each person’s body mass, which is the ingredient that keeps them comfortable and is also the factor that allows the plastic to “creep” (or drop) over time.
Here are a few indications that your orthotics need replacement:
It has been longer than 5 years. Many feet change over a 5-year period. So if you have some form of progressive change, then 5 years is a maximum.
If you experience a return of your original symptoms. In other words, the return of the pain in your heel or arch or knee after years of relief, may indicate a need for replacement.
The orthoses appear flatter than you remember them. It’s not uncommon for orthoses to flatten 1 cm in a year for those who are really active. That translates to an extra 1 cm of improper movement with each step.
6. How long will it take to get used to my Orthotics?
We discuss a “ break-in period” when you are first given your orthotics. This simply refers to the time it takes to wear the orthoses comfortably all day.
Interestingly, there is no single answer and it’s not possible to predict who will comfortably wear orthoses immediately and who will need several weeks of gradually increasing wear. There does not appear to be any correlation between gender or age or activity level or symptoms that helps to predict the “break-in” period.
A reasonable rule of thumb is that the orthoses should be comfortable for full-day wear around the 2-week mark. If it takes longer than 2 weeks, it would be wise to come back to the clinic. Minor modifications to the orthoses are sometimes necessary and usually allows for full day use.
7. “I have bunions. It must be because I wore the wrong shoes as a child.”
This is a statement that those who work in foot care have heard hundreds of times from people with lumps on their big toes.
Rest assured, it has nothing to do with your shoes and everything to do with poor foot biomechanics (the way your foot interacts with the ground).
Bunions are especially common in those who have very mobile flat arches where the muscle that pulls the big toe down into the ground is overpowered by the one the pulls the big toe towards the others.
Plenty of ladies who wear pointy-toed higher heels do not end up with bunions. By the same token, in cultures where people do not wear shoes at all, there are plenty who do have bunions. So clearly shoes cannot be to blame.