Why Custom Orthotics Should Come from a Podiatrist

You probably don’t think about it all too much (if ever), but your feet afford you the opportunity to do so much in life.

Sure, your lower limbs allow you to stand and walk—to say nothing of activities that require running and/or jumping—but you even need your feet and ankles when you operate the gas and brake pedals in your car.

As such, health issues and medical conditions that cause foot pain or take away functionality can be a big problem. But there’s good news:

Our practice provides an array of treatment options so you can find relief from painful symptoms and regain normal foot function—and an especially versatile tool we might use to treat your condition is a pair of custom orthotics.

Depending on the nature of your situation, this could be the right solution and all you need. Or perhaps it’s an essential component of a more comprehensive treatment plan that includes advanced, state-of-the-art options.

Either way, something important to keep in mind is this:

Custom orthotics should come from an actual podiatrist.

custom orthotics from a podiatrist

What are custom orthotics?

Custom orthotics are devices we use to modify and control foot motion, including pronation. Depending on your needs, we might prescribe a pair that either restricts or promotes foot rotation.

There are two general categories of orthotics—functional and accommodative.

In the case of orthotic therapy for pronation issues (more on this in a moment!), we will likely use functional ones to achieve our objectives. Functional orthotics are constructed from sturdier materials, which make them better able to restrict motion.

Accommodative orthotics are constructed from softer (yet still durable) materials. These can be prescribed to help provide additional cushion for areas of the foot that need it.

Knowing about these different kinds of orthotic devices is a good start as we look at how versatile they can be for treating a variety of lower limb conditions and injuries—but this isn’t the endpoint.

The biggest advantage of treating foot problems with orthotics is that we customize them to work specifically with your uniquely-structured feet and signature gait pattern.

Basically, no two sets of feet are completely identical. As a result of that (partially, at least), everyone has their own variance with regards to how we move when we walk. But custom orthotics can work within the bounds of these important factors and be adjusted to suit your needs. This is a major difference between the orthotics you get from a podiatrist at our office versus shoe inserts you can pick up at the store!

That isn’t to say those store-bought inserts don’t provide any value. If your shoes aren’t providing quite enough arch support—and yet you don’t need prescription orthotics—inserts could be the way to go. The same holds true if you spend a lot of time on your feet during the day and require some extra cushioning.

Just keep in mind:

Off-the-shelf shoe inserts are not capable of, or intended for, treating actual medical problems!

orthotic inserts

So why would we prescribe orthotics to a patient?

Well, a big reason for this is the fact orthotics can be used to treat—or be part of the treatment plan for—a wide range of medical conditions.

A commonality amongst many sources of foot pain is that they are caused in some way by either irregularities in foot structure or biomechanical processes, and in many instances the two (structure and movement) are related.

In the context of foot structure, one relevant area of variance from person to person is arch height.

Specific heights can vary greatly on a foot-by-foot basis, but there are essentially three different kinds of foot arches—medium, high, and low.

The most “normal” of the three is a medium height. Someone who has this kind of foot arch is likely going to pronate in a neutral, efficient manner and probably won’t have any issues from it.

Before we go further, let’s take a quick moment to get you up to speed on pronation.

What’s the deal with pronation?

Pronation is a completely natural process feet undergo with every step. Basically, this refers to a roughly fifteen-percent inward rotation that takes place starting with the heel strike of a landing foot and proceeding through the final push of the toes off the ground.

So why do we pronate? After all, do feet really need to rotate during the ground portion of a step?

In short – yes, they do.

See, this is a very important biomechanical process on account of the tremendous amounts of force we all place on our lower limbs.

The odds are pretty decent you aren’t aware of this, but when a foot lands and our weight shifts onto it, the actual force load is greater than how much we weigh. In fact, those forces can be as great as two times our bodyweight.

And that’s just when we walk! Running increases the forces to as much as four times our bodyweight with every step.

All of that force adds up, and especially when you consider the fact an average person takes 10,000 steps in an normal day. (Whereas that figure might be skewed a bit by those who take considerably more steps than others—like runners, military service-people, etc.—even less-active people still take thousands of steps daily.)

Pronation is one of the ways our bodies are able to handle all of the cumulative physical strain. It disperses the forces in a fairly equitable manner – and this serves to prevent any one area from receiving more than its fair share (and hold that thought for a second).

running stride

Arch height, pronation, and force loads, oh my!

Okay, now that we’ve covered pronation, it’s time to connect arch height, pronation patterns, and force loads, and then see how this all relates to orthotic devices!

We’ve already established that arches of medium height generally result in neutral pronation. When foot arches are either low or high, it impacts this process.

Low foot arches flatten quickly after the heel strikes the ground – but it still takes time before the toes are going to push off the ground. Until they do, the foot continues its inward rotation. This takes it beyond the ideal “fifteen percent” mark.

When a foot pronates excessively like that, we call it overpronation.

Conversely, high foot arches (cavus foot) start to flatten late in the process. As you might expect, this means they do not pronate nearly enough, and this is called supination.

Overpronation and supination might not sound like big issues—“The foot just rotates too much or not enough. What’s the big deal?”—but it’s important to remember the reason behind pronation – evenly distributing force loads.

Someone who overpronates ends up placing too much force on the inner edge of the foot, and especially the joint at the base of the big toe. With supination, too much force is placed on the outer edge of the foot.

And this is where orthotic therapy comes into play.

Depending on your specific case, we might prescribe a pair of custom devices to help your feet move in a more natural and efficient manner when you walk or run.

One final thought about custom orthotics

Something else that bears noting is the fact that we don’t prescribe orthotics for everyone who walks through our front door.

Yes, these are versatile medical devices that can be tremendously effective for many different foot and ankle conditions—but we take the time to assess every patient on a case-by-case basis and create individualized treatment plans.

As such, it’s entirely possible your plan doesn’t require orthotic therapy.

Naturally, this is something we will discuss together when you come to see us—which is exactly what you should do whenever you experience foot or ankle pain!

Remember, pain is not a normal state. This is actually an indication that your body is dealing with some kind of problem and likely needs help. We can provide that help, so give Austin Foot and Ankle Specialists a call today at (512) 328-8900 and give us the opportunity to put your pain to rest.

If it’s easier for you, please feel free to contact us online. You can either send us a message or make your appointment right now!
Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists
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