ATTENTION: Unfortunately, we longer provide the service of creating custom orthotics. The equipment we were using broke down and the manufacturer went out of business. We are still looking for a comparable system. Thank you for your understanding.
At the behest of many of my patients who didn’t know but now do, I offer custom orthotics in my office. I feel compelled, however, to educate you on what a good orthotic is and how you could benefit from it.
There are 3 different types of orthotics, generally speaking: non-custom, custom casted for the perfect stance, and custom evaluated for the perfect gait.
The first is the non-custom orthotic. These are the Dr. Scholl’s, SuperFeet or the kind from the Good Feet Store. Some can be a very good and beneficial product. Dr. Scholl’s are mostly just a padding to decrease shock absorption. SuperFeet and orthotics from the Good Feet Store are a lot more substantial and can
actually improve the way you walk or stand. The only issue I have with the Good Feet Store is the cost. You are paying custom prices (very expensive in my opinion) for non-custom or semi-custom orthotics. The semi is just because they have a wide selection for the salesperson to fit you as best as possible.
Custom orthotics created to mold the foot into the perfect stance is by far what most podiatrists use. They manipulate the foot and hold it in what is called taler neutral, basically, the ideal position of the foot. Then they make a cast which will be the mold to create the orthotic. Another method is to have you stand on a plaster or foam mold from which they create an orthotic. Typically, the orthotic is made of a hard plastic with no flexibility to keep the foot in the same position.
Either way, this method, in this doctor’s opinion, is outdated and shortsighted. The foot is designed to be flexible. When we walk, the perfect gait is for the heel to strike. Then, the arch flattens out while the foot pronates (flattens inward). Ideally, the flattening of the foot stretches the plantar fascia which creates a taut spring. When the pressure is released, the spring
pushes off the big toe to the next step. When you put in a piece of hard plastic, you negate the action of the foot. Essentially, you make your foot into a post. You take away the foot’s ability to absorb shock or act as a dynamic player while walking or running. The shock has to be absorbed by something. If the foot cannot absorb shock then it will certainly transfer to the knee, hip, or low back. Plus, it forces those other structures to compensate for the altered mechanics. Who cares if the foot is in a perfect position when you stand still? We are mobile creatures who need to move and function.
The best type of orhtotic and hence, the type I offer in my office, is the kind that corrects the gait. Often times, for various reasons, the foot doesn’t perform the way it should. It makes sense to me to help it work the way it was intended and designed. When we create an orthotic we take into consideration the stance and the gait. We have a digital plate that captures the pressure and the pattern of your stance and your gait. The goal is now to create a flexible and dynamic orthotic that will assist your foot in behaving the way it should.
Not everyone needs orthotics. Every time you add external devices there will be secondary and tertiary reactions. It is difficult to account for all of them. I have had plenty of patients who were wearing orthotics and complaining of all sorts of issues. I told them to take out the inserts and things resolved. My first course of action when someone asks for an orthotic is to discuss why. Sometimes just adjusting the foot will take care of the foot issue. I also like to look at value. If a patient can resolve their issues with non-custom orthotic for $35, then paying $150 for a custom pair might not seem worth it. That saying, if you need a custom pair of orthotics, they can be of tremendous benefit and can really preserve not only your foot but your knees, hips, and back, as well.
Post Script: Don’t let the price fool you. I could easily charge $300-600 for these orthotics (everyone else does). These are made by the same types of labs that do work for every doctor who works with orthotics. I keep my prices low because if people need them I want them to be able to afford them. Do I make much money from them? No. For now I am going to keep them at $150. I actually dropped them down from $200 because I switched to a direct lab and they only charge me around $100 per pair. If you want some, act quickly because the time it takes to gather the information is substantial and I will probably go back up to $200 again, soon (which is still a bargain).