Orthotic Devices

Orthotics, or orthoses are insoles molded from a plaster cast of the patient’s foot. They are prescribed by podiatrists for conditions like fallen arches or structural foot problems. Orthotics are usually categorized as rigid, soft, or semi-rigid:

• Rigid Orthotics. Rigid orthotics control motion in two major foot joints directly below the ankle. They are often used to prevent excessive pronation (the turning in of the foot). They help people who are very overweight or have uneven leg lengths. They must be used with caution, as unlikely, but possible complications from use of rigid orthotics are sesamoiditis or benign tumors that form from pinched nerves.
• Soft Orthotics. Soft orthotics are made from a lightweight material to absorb shock, improve balance, and remove pressure from painful areas. They help people with diabetes or arthritis. They need to be replaced periodically, and because they are bulkier than rigid orthotics, they may require larger shoes.
• Semi-Rigid Orthotics. Semi-rigid orthotics are designed to provide balance, often for a specific sport. They are typically made of layers of leather and cork reinforced by silastic.

Insoles

Before seeking prescription orthotics, people with less severe problems should consider testing the lower-priced over-the-counter insoles.

An insole is a flat cushioned insert that is placed inside the shoe. They reduce shock, provide arch and heel support, and absorb moisture and odor.

Insoles can be purchased in athletic and drug stores. Shoe stores that specialize in foot problems often sell customized, but more expensive, insoles. In general, over-the-counter insoles offer enough support for most people’s foot problems. Most well-known brands of athletic shoes have built-in insoles.

Dr. Scholl’s is a popular and well-known insole, many others are also available. They are composed of various materials, such as cork, leather, plastic foams, and rubber. Very beneficial insoles are now made from viscoelastic polymers (e.g., Sorbothane, Airplus, Spenco, Dr. Scholl’s Massaging Gel, and others), which are gel-like materials that act both as liquids and solids. NCISM does not promote or discourage any particular brand.

Heel cushions are helpful for people with shortened Achilles tendons. They are inserted inside the shoes, like insoles. They should be at least 1/8 inch thick, but not more than 1/4 inch thick.