Key Takeaways:
- Orthotics are medical devices worn in shoes to support or correct the alignment of the feet, ankles, knees, hips, and lower back. They can treat various conditions and reduce foot and lower limb pain.
- Regular orthotic reviews are important, just like with other medical devices, to ensure they are still effective and suitable for the individual. Factors such as sizing, materials, cushioning, top covers, and changes in footwear can affect the performance of orthotics.
- Feet can change size due to factors like growth (in children), trauma, pregnancy, and age-related conditions. It is crucial to assess and accommodate these changes to ensure orthotics fit properly.
- Different materials are used in orthotics, with some being rigid and sturdy (such as polypropylene) and others more elastic and comfortable (such as ethylene-vinyl acetate). EVA can be heat-moulded and modified to provide proper correction and comfort.
- Orthotics may require adjustments or replacements due to compression of materials, wear and tear of top covers, changes in footwear, or the occurrence of additional injuries. Orthotic reviews allow for necessary modifications and ensure ongoing foot care.
You’ve been to a podiatrist for your pain – whether it’s foot pain, lower limb pain, knee, hip or back pain – and they have prescribed orthotics for you.
All seems to be going well, you’ve worn them in and your pain has gone. Mission accomplished!
So why has your podiatrist asked you to come back for an orthotic review?
First, let’s have a bit of a refresher on what orthotics are.
Orthotics are medical devices worn in your shoes to help to support or correct the alignment of your feet, ankles, knees, hips and lower back.
The structure and function of your feet can significantly impact the entire kinetic chain from the feet to the lower back.
Orthotics can be used to treat a wide range of conditions from stubborn corns and calluses, plantar fasciitis, flat feet, repeated ankle sprains, achilles tendinopathy, foot deformities, shin splints, knee pain and hip bursitis.
Orthotic shoe insets are designed to support the structures on your foot and ankle to allow them to work effectively and efficiently.
There are multiple different types of orthotics that range in various aspects from the degree of correction to the material they are made out of. Orthotics can also be pre-fabricated, semi-custom or custom foot orthotics.
They are not able to change the structure of your feet, rather they provide support and correction where you need it most, and thus reduce foot pain and lower limb pain and discomfort..
The great thing about wearing orthotics, particularly custom orthotics, is that they can be tailored specifically for your needs, allowing them to be incredibly versatile.
This does mean that what worked for your neighbour or your friend might not be what is best for you!
A comprehensive understanding of how the lower limbs function is required to properly prescribe orthotics, meaning that podiatrists are the best fit for the job.
We can perform a thorough biomechanical assessment to determine why you are in pain, what structures are affected, any potential future injuries or pain and what type of orthotic would be best for you.
Why is an orthotic review needed?
Just like any other medical device like hearing aids or braces, regular reviews are important to ensure that your shoe orthotics are still doing their thing and are right for you.
There are a number of reasons why we review orthotics, here are some of them:
Sizing
Most people are surprised to know that during our lifetime, our feet will change size due to various factors.
Obviously, children’s feet change as they grow and during growth spurts, they can change quite rapidly.
The last bone to ossify/harden in the feet is the navicular and this occurs at the age of 7. From this age, our feet continue to grow until we are 20-21 years of age when we consider them to be ‘fully grown’.
However, there are a few instances where our feet will change size in adulthood. These include:
■ Trauma to the feet, which may have altered the structure of the foot. This may include fractures or tears of the soft tissue, significant injuries such as a crushing injury or due to surgery.
■ Pregnancy is another instance where the feet can change size, often becoming slightly bigger. During pregnancy, the ovaries and placenta produce a hormone called relaxin in preparation for childbirth. It works to help to relax the structures of the pelvis, however it can also relax the ligaments elsewhere in the body, particularly in the feet.
■ As we age, our bodies change significantly. Various bone and soft tissue conditions can affect the structure and alignment of our body, particularly our feet. Conditions such as osteoarthritis and rheumatoid arthritis can alter the structure of the feet. As we age, the soft tissue within our body atrophies, meaning it becomes weaker and degenerates. This can cause the ligaments to become lax, thus increasing the size of your feet!
Materials
Orthotics can be made with a large variety of materials and this will depend on the type of orthotic and how much correction or support is required.
There are often various materials that make up an orthotics, all of which
Orthotic material:
Some podiatry clinics use a material called polypropylene, which is a thermoplastic material. It is quite hard and can be a little difficult to modify once it has been made, making it quite rigid and sturdy.
For some patients, this material works well but for others, it feels very hard underneath the feet and they cannot adjust to them properly or easily.
The material that we use here at Watsonia Podiatry is called EVA, which is ethylene-vinyl acetate. It has more elastic properties and moulds to the feet, often making it far more comfortable and allows patients to adjust to them easily.
Over time, EVA can compress due to the forces that our bodyweight places through it. In saying that, it is far more easily modified and can be reinforced over time relatively easily.
EVA is able to be heat moulded and correction can be either increased or decreased by heat moulding the material, grinding through different parts of the device or adding correction using various different materials. This means that we can increase the longevity of the devices and ensure that they are still doing their job properly!
Apertures/cushioning:
For some conditions such as rheumatoid arthritis, painful corns and calluses and heel pain, we will often use a softer material built within the orthotic to provide cushioning. Over time, these can compress and no longer provide enough support. These may need to be replaced.
Top covers:
There are dozens of top covers available for orthotics. These can range from waterproof covers, thin covers, soft spongey covers etc.
Your podiatrist will pick the most appropriate top cover for you depending on the type of orthotic you have and what activity you are doing most whilst wearing them.
Over time, they can wear down or become damaged, so it is important that we review them regularly and replace them if needed to help keep them as comfortable as possible.
Footwear
Very few people wear exactly the same shoes all the time and over the years, we tend to change what we wear. This may affect how well your orthotics fit in your shoes.
We are able to make small adjustments to make this transition easier for you!
Other injuries
Whilst orthotics can be used to help prevent future injuries, life sometimes has other ideas!
The orthotics that we use at Watsonia Podiatry are able to be modified and adjusted to accommodate any other injuries that you may sustain along the way.
Do you have orthotics?
So if you have had your orthotics for a while or need something to be altered, it might be time for you to have an orthotic review.
Give call us on (03) 9432 2689 or book online for a consultation with one of our podiatrists where we can assess how well your orthotics are currently working and that your feet are being taken care of!
