There are many different types of “orthotics” available to us.
From inserts sold over the counter at the chemist, to intricate braces made up by orthotists.
Orthotics come in many different shapes and sizes depending on which podiatrist you see, what you need and which lab they come from. To save us going too deep I’m going to highlight the main type of Custom Foot Orthoses we use;
- Custom foot orthoses- polypropylene and 3D printed
- Custom EVA orthoses- foam/soft orthoses
- Prefabricated- “off the shelf”
- Richie Brace
Custom foot orthoses (poly and 3D):
These are by far the most common device we use. We take a 3D scan of your foot in its ‘neutral’ position. Ie not rolled in, not rolled out, flexed nor extended. This is the position that forms the foundation of our orthotic prescription.
We write a prescription based on your needs and the lab uses this information to design a device customised to your foot, work/sport requirements and foot biomechanics to get the best result.
We either use a polypropylene (plastic material), which is milled from a block or 3D printed Enviropoly material, which is printed from the ground up with a 3D printer.
Both materials can be fashioned in different thicknesses, shapes and sizes to give control (firmness) or flexibility if necessary.
Traditionally, these devices have been really firm. The accuracy of 3D scanning, combined with the higher quality materials has allowed us to use thinner materials to get the same result. This improves comfort and means the device doesn’t have to be really thick to last longer.
They work great for unloading sore structures, dispersing plantar pressures and positioning your foot to work most efficiently.
Custom foot orthoses (EVA/foam)
These devices are milled from a EVA/foam block. They work fantastic for managing PRESSURE related injuries. For example, corns, wounds, sesamoiditis when we want to DEFLECT pressure. They can also be great for injuries like heel pain, when a firmer device hasn’t been tolerated.
They are nice and soft, but they rely on bulk to achieve their control. This can make fitting them to casual shoes more tricky. They also wear out a bit quicker than a poly/3D device.
They are still a great option when we want something softer.
Prefabricated (off the shelf)
These are arch supports that can be heated and moulded. They come in a standard level of control through the arch and have no support at the heel or the front of the foot.
In some cases, they can be handy in unloading the arch. For example; a patient has walked on the beach barefoot and has a mild arch strain. They can be used in shoes for a few weeks to unload the arch so you don’t have to tape so often.
They are cheaper and also wear out pretty quick. I like them when I need support NOW for an injury that is caused by training error, not foot mechanics.
Richie Brace
These fancy gadgets control complex and chronic conditions of the foot and ankle. They have been important in ‘non-operative’ management of these conditions since it was designed in 1996 by Doug Richie.
We use them for conditions like severe tibialis posterior tendinopathy (adult acquired flat foot), drop foot as well as neurological conditions like Charcot- Marie Tooth (CMT).
They are light-weight and have different designs and configurations based on the condition. They also have an in-built custom orthotic built into them.
Your podiatrist will WORK WITH YOU to decide which device best suits you and your needs.
Darby, Podiatrist