Orthotics and Your Feet

Orthotics are devices which fit into the shoe to aid the foot. "Functional orthotics" are rigid and designed to control motion and correct the function of the foot. Individuals with flatfeet, tendonitis, plantar fasciitis, certain foot deformities, knee, hip and back problems may benefit from functional orthotics. "Accommodative orthotics" are soft and designed to reduce pressure and prevent excess friction. Diabetics and those with a loss of sensation or circulation in their feet will benefit from accommodative orthotics. Both types of orthotics are custom made by taking a mold of the foot.

Functional Orthotics

The goal of the functional orthotic is to improve the mechanics of the foot, control the abnormal motion in the foot, decrease the pain in the foot, ankle, knee, hip or back and to add support. The orthotic should make standing, walking, jogging or running more comfortable. The orthotic must be rigid to help control the motion in the foot and add support. If the orthotic is soft, the weight of the body would collapse the device and it would no longer function.

Abnormal motion is typically in the form of pronation. Pronation is the rolling in of the foot and collapse of the arch. The motion starts at the rearfoot, or heel area. When the heel turns in, it allows the arch to collapse. This puts undue stress on the ligaments and tendons in the arch area and contributes to the development of tendonitis, plantar fasciitis, bunions and hammertoes. The functional orthotic helps to control the abnormal motion in the rearfoot. This is accomplished by taking a mold of the foot in its neutral position. The neutral position is the position the foot should be in when walking. When standing, the over-pronated foot is in the uncorrected position. The mold of the foot should be taken with the patient sitting so the foot can be placed in the neutral position.

The molds are sent to a lab and scanned into a computer. A reverse image is produced and the computer generates an image of the foot in neutral position. The computer adjusts the image based on the corrections recommended by your podiatrist. A model of the foot is then cut out, in some cases out of wood. The orthotic material is pressed over the foot model and the orthotic is created. The most common material is polypropylene, but other materials, such as graphite are used. In some cases, hand-made molds are created out of plaster. This was the classic way orthotics were made until newer technology made the process much less labor intensive.

Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results from functional orthotics. This includes 17% who felt the orthotics "cured" their pain. Less than 10% had no relief. The most commonly treated condition in the study was a painful heel. Over 20% of patients surveyed were treated for a painful heel and 20% were treated for a painful arch. Fourteen percent of the individuals were using orthotics for flatfeet. Other conditions treated with orthotics were knee, hip and back pain, foot arthritis, bunions and high arches. Tendonitis was not specifically evaluated.

Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to orthotics. The plantar fascia is a ligament type structure on the bottom of the foot which helps to hold up the arch. When the foot collapses, the weight of the body stresses the ligament and results in tearing and inflammation. This results in plantar fasciitis. These individuals typically respond well to orthotics in combination with other treatments. Certain types of tendonitis respond well to orthotics and other types require orthotics. Posterior tibial tendonitis is the tearing and inflammation of the tendon that helps to hold up the arch. When this tendon is overstressed by arch collapse it cannot heal. Orthotics are essential in the treatment of this condition.

Individuals with high arches may require orthotics as well, but they do not respond as well. Orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not "cure" the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended. If the foot is stable and does not require support, the bunion, hammertoe, neuroma, tendonitis or even plantar fasciitis may not require custom made orthotics for treatment. These individuals may do well with a pre-fabricated orthotic.

Accommodative Orthotics

Diabetics can develop numbness and loss of circulation in the feet. This numbness and circulation loss puts them at risk for developing open sores on the feet called ulcerations. To help prevent excess rub and friction in certain areas on the feet, accommodative orthotics are recommended. Diabetics who do not have numbness or circulation loss (as diagnosed by their doctor) do not need to have accommodative orthotics. If the foot has a deformity, like a bunion or hammertoe, then accommodative orthotics are necessary.

Accommodative orthotics are made from many different types of material. Some are made of a foam type material, others made from cork and others have covers ranging from soft spongy material to leather. The type of material depends on the type of foot. Many accommodative orthotics, made for diabetics, have two or more layers that form around the foot once they are worn. Three pairs are dispensed every year and they are replaced every 4 months. Other materials are longer lasting. A mold of the foot is taken by stepping into a foam box. In this case, it is important to take the mold standing, so that the orthotic can be made to form around the foot.

The Cost

Many insurance companies cover orthotics for certain diagnoses. The most commonly covered diagnoses are plantar fasciitis (heel and arch pain), flatfeet and diabetes. Many insurance companies cover the orthotics at 80%. This means the patient is responsible for 20% of the cost unless they have a secondary insurance. If the deductible has not been met, then the amount is applied to the deductible and the patient must pay the full amount. Orthotics are not cheap. They range from $250 to $600.

Medicare covers orthotics for diabetics with neuropathy (numbness of the feet). Medicare does not cover orthotics for any other type of foot problem. Secondary insurance will not cover orthotics if Medicare does not cover them.

Podiatrists most commonly prescribe orthotics, but pedorthotists, orthotists, physical therapists and sometimes orthopedists will also provide orthotics.

Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com. For more information on prefabricated orthotics visit http://www.northcoastfootcare.com.

---

3 Facts Everyone Should Know About Stem Cells

Cord BloodCord Blood is the blood that remains in the... Read More

Protect Yourself Against the Flu Vaccine!

The vaccine industry insists that their vaccines against the flu... Read More

Why R.I.C.E.?

What is R.I.C.E. and why do you need it? One... Read More

Catch The Wave

There has never been a better opportunity for chiropractic medicine?and... Read More

7 Tips to Immediately Reduce Rotator Cuff Pain

1. Support the affected arm during activities of daily living.... Read More

Death by Fluoride

A wee bit of fluoride makes teeth and dentists happy,... Read More

Robotic Future of Hospitals; Pandemic Prevention and Bio-Terrorist Attack

There is a huge concern in the medical industry that... Read More

4 Reasons Why You Should Use Canadian Pharmacies

Let's face it: purchasing prescription drugs in the U.S. can... Read More

A Closer Look at Lower Back Pain Relief

As many as 8 out of 10 adults will experience... Read More

Integrative Medicine And Its Future

The NBC National News, quoted the Washington Post in March... Read More

How To Locate An Alcohol Rehabilitation Center In California

Alcohol rehab in California refers to the centers that help... Read More

VIOXX Lawsuits

Vioxx is a prescription medication that has been used primarily... Read More

A Guide to Arthritis Pain Relief

In a recent survey on pain conducted by the Stanford... Read More

Chronic Head, Facial, Or Neck Pain That Won?t Go Away - Could It Be TMJ?

I stumbled across TMJ when I needed treat a literal... Read More

Contact Lenses and Eye Glasses, How is Your Vision?

Notice friends getting contact lenses and pulling out eye glasses?"What... Read More

When Your John Doe Is Homeless

The patient, known only as John Doe, was difficult to... Read More

Resperate or RESPeRATE - this device controls blood pressure however you spell it!

Resperate is natural and powerful and it puts you in... Read More

Arizona Drug Rehab: Finding Help in Arizona

The state of Arizona has one of the worst drug... Read More

You Are Getting Very Sleepy....The Truth about Hypnosis

A hypnotic "trance" is not something that is foreign to... Read More

Pharmaceuticals: The Next Frontier in America?s War on Drugs

America's war on drugs, which has been fought in the... Read More

Lunesta Tolerance

Lunesta is a newly released sleeping pill. Marketed as a... Read More

Are You Suffering From Addiction?

Many researchers believe that addiction is a behavior that can... Read More

Heart Disease: The Dangers Of Coronary Heart Attack And How To Avoid It

What is a coronary heart attack?Are you at the risk... Read More

Bextra, Vioxx and Side Effects ? Do You Need Aa Lawyer?

The recent withdrawals of the prescription medications Vioxx and Bextra... Read More

Over The Counter Drugs: How To Safely Choose The Right Medication

What Medication Can Cure Me?1. Am I expecting a cure?... Read More

CT and MRI Scans in Neurological Practice: A Quick Overview

Before computed tomographic (CT) scans became available in the 1970s,... Read More

A Very Medical Miracle

Madeline Mann once weighed less can a can of soda... Read More

Why Modern Medicine is the Greatest Threat to Health

There is the underlying assumption that modernity translates into better... Read More

Whats a Good Arthritis Medicine for Me, Doctor?

Pain is the body's warning signal that something is wrong.... Read More

Celebrex Side Effects Lawsuit Lawyer

The Food and Drug administration urges people to stop taking... Read More

How to Find a Drug Rehab in Florida?

When you're in need, the quickest way is the best:... Read More

Propulsid Litigation Lawyer Says: Unnecessary Drug Killed 80 People

Propulsid was a popular nighttime heartburn drug before it was... Read More

Medical Billing PDA: 21st Century Convenience for Medical Practices

Medical Billing PDAOne of the first things I notice about... Read More