All Orthoses are NOT created equal
Many different kinds of in-shoe devices are referred to as “orthoses”. You’ll see orthoses in television commercials, stands at customer shows and in a growing number of retail shops. Arch supports and insoles sold in pharmacies, sports and shoe shops are increasingly referred to as “orthotics”.
Then there are the orthoses that podiatrists and related professionals prescribe for their patients. For most consumers, telling the difference between the various types of orthoses (and making an informed decision) is a challenge. Recognising slick sales “spin” and separating it from the facts can be an even bigger challenge.
Following is some information that may help. There are three common types of foot orthoses: Custom, Customised, and Off-the-Shelf.
Custom Foot orthoses are prescription medical devices, designed to adjust and control the functions of the foot and its alignment with the lower leg.
They are used to treat/prevent injury-causing motions including excessive pronation (collapsing in) and supination (rolling out) and make standing, walking and running more efficient. Some custom orthoses are designed to redistribute pressure on the bottoms of your feet alleviating pain from corns, calluses or bony prominences.
Genuine, custom foot orthoses are made by starting with a thorough exam by a qualified health care professional, followed by the taking of impressions using plaster or an impression foam material, followed by the completion of a detailed prescription form. Your casts and prescription are then sent to a professional Lab where your orthoses are made by technicians with appropriate training and qualifications.
Customised devices are relatively new in the market and can be difficult to distinguish from genuine custom ones. They are commonly a product of computerized force platform systems that capture and display pressure information and are typically made by adding components to a pre-manufactured insole. Unfortunately, they are often marketed as “custom” and sold at similar prices. One way to tell the difference between custom and customised is if a plaster cast or foam impression is not taken of your feet, you won’t be getting genuine custom orthoses.
Walking or standing on a force platform form with a colourful graphic display is an excellent way to evaluate some aspects of foot function and pressure distribution. In qualified hands, force platforms can be useful diagnostic tools but they are incapable of capturing true, three-dimensional volumetric impressions of your feet. Beware of the slick sales “spin” - if there is no cast, it can’t be custom.
Off-the-Shelf devices are most commonly found in retail pharmacies, sports and shoe shops as well as some specialty shops. Some foot health care professionals recommend them for minor foot problems. They rarely cost more than £15.00 - £40.00 and the better quality ones can provide a good measure of arch support and cushioning.
If you are having foot and/or leg problems and want to know if orthoses are right for you (and if so, what kind) start by consulting your local podiatrist. Getting orthoses that are right for you begins with a thorough examination by a qualified podiatrist. You won’t find these people on television, in the shopping centre or at a consumer show. Minor foot problems can often be treated with an inexpensive off-the-shelf insole and/or proper footwear selection and fitting advice. More pronounced/persistent problems usually require a more precise, custom orthotic solution.
