What is a custom orthotic and what kind of conditions does it treat?

Custom orthotics are medical devices prescribed by a foot and ankle surgeon. These are different from shoe inserts and arch supports that you may purchase online or over the counter. Custom orthotics can be used to accommodate or offload a prominent area on your foot. This can be helpful for inflammatory conditions such as plantar fasciitis and bursitis, painful calluses beneath bony prominences and ulcers commonly associated with Diabetes. They can also help with foot function to improve stability in conditions of tendonitis, fasciitis, and a flatfoot deformity. Custom orthotics can help support and align the foot and lower extremities as well.


Custom orthotics can help with pain and support following foot and ankle surgery to help achieve an optimal result. Orthotics may also help delay the need for surgery, particularly in a child where growth plates must be allowed proper time to mature. It is important how the foot shape or mold is captured, whether it be via laser scan, foam box or making a plaster cast.


Conditions that are commonly treated with an orthotic are:

            Plantar fasciitis (heel pain)

            Bursitis (inflammation of a weight bearing surface)

            Adult and pediatric flat foot

            Posterior tibial tendon dysfunction (PTTD : early onset flatfoot)

            Achilles tendonitis

            Apophysitis (inflammation of the heel growth plate in children)

                        Metatarsalgia (forefoot pain from weak bone/loss of fat pad)

                        Post surgical correction of flatfoot / reconstructive surgery

                        Post surgical amputation with plastizote filler


What are the advantages of a custom orthotic versus an over the counter purchase?


            One of the major advantages to a custom orthotic is the process in which it is made from your board-certified foot and ankle surgeon. Your consultation, exam, x-rays, and additional tests help your doctor in the diagnosis and how to treat you conservatively. The interaction of that consultation will help your doctor make the best product for your specific needs.

            Additional advantages of a custom orthotic device include:

                        excellent materials, long lasting to reduce additional purchase

                        multiple design options for varying shoe types

                        simple process with satisfaction guarantee (30 days)

                        customer / patient satisfaction

                        sport specific styles: running, cycling, golf, football, baseball

                        diagnosis specific styles: plantar fasciitis, flatfoot, pttd, apophysitis


How do I know if I need a custom orthotic?

            Simple! Here is an algorithm to help you achieve your goals. We will use plantar fasciitis as an example, but many foot and ankle conditions will apply to this algorithm.

How do I get my own custom orthotic and do I need one for each foot?

            Simple! Make an appointment with your board-certified foot and ankle surgeon for a consultation. If custom orthotics are recommended, an impression of both feet may be made that day with a laser, foam box material, or plaster casting, this is typically surgeon preference and makes no impact on your final product. The custom prescription will be filled out by your surgeon, addressing any specific needs or biomechanical deformity you may have. Expect your custom orthotic within 2-3 weeks.

            Your next appointment will include fitting your orthotics properly into shoes and trimming the top cover material for your shoes. It is recommended to bring several shoe types to your visit to ensure accurate fit into multiple shoes prior to trimming the top cover material.

            Finally, the question “do I need an orthotic for both feet if only one foot hurts?” is a common one yet valid question to ask. The answer is YES! When prescribing an orthotic, symmetry and balance is important and yet prevention of the condition on the opposite side is also a concern.  The orthotic prescription is done in pairs for that purpose.

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