Custom Orthotic vs. OTC

These days many drugstores, shoe store or sporting goods retailers have shelves full of orthotics claiming to cure your foot problems.  Some stores even have machines to “measure” your feet claiming to give you a “custom” fit.  Specialty stores with celebrity endorsements and salespeople without medical training have been around for several years selling “custom-fit” inserts costing hundreds of dollars.

It is a common misconception that custom orthotics and store-bought inserts are the same thing. This is simply not the case. The key word in making the distinction is “custom.” The medical devices prescribed by a podiatrist are customized to accommodate your unique foot shape and work in conjunction with the biomechanics of your foot.  Mass-produced inserts found on retail store shelves rely on a “one size fits most” approach and may offer extra cushioning and some arch support, but these are not intended treat medical conditions.

Over-the-counter inserts are typically made of a flexible plastic, gel or rubber that lose their support once you stand on them.  The arches are structured to fit the masses and do not offer a custom support.  The size is determined by the size of your shoe and may not match the size or shape of your arch. While they offer nice cushioning and may feel comfortable initially, they do not address the underlying biomechanical problems that are causing pain.

Most custom orthotics are made of a semi-flexible polypropylene or a graphite composite laminated with additional cushioning material.  The shell material is custom molded to a cast or impression of your foot and does not collapse under the weight of your body.  These devices place your feet in optimal alignment to help your lower extremities function properly.  There are endless options for additions, modifications, support, and cushion for custom orthotics that a professionally trained practitioner will incorporate into your prescription device.

Custom orthotic devices are versatile and can be used to treat a wide range of foot and ankle conditions. There are essentially two classifications of custom orthotics:

• Functional orthotics are used to control abnormal motion. These can be effective in correcting faulty biomechanics and thereby treating discomfort in the feet, ankles, legs, knees, hips and lower back.
• Accommodative orthotics are designed to provide extra cushioning and support to specific, targeted areas of the foot. These are often used to care for diabetic foot ulcers, painful calluses, and other delicate foot conditions or issues.

The material an orthotic is constructed from can further define its intended function. Devices that are made out of rigid materials tend to fall into the functional category and often focus on controlling and restricting motion for the two major joints of the foot that are found beneath the ankle.  Soft materials provide additional cushioning and padding and can be worn under the sole of the foot, which further absorbs shock and relieves pressure from sensitive areas. Semi-rigid devices, which typically consist of a mix of rigid and soft materials, are often used in treating flexible low arched, as well as providing additional stability and support for sports or other physical activities.

It may be easier and less expensive to start with an over-the-counter insert, but an improperly fit device can sometimes do more harm than good.  If you have a foot problem that you think may benefit from orthotic support, contact Eagle-Summit Foot & Ankle for an appointment.