There are basically two types of orthotics that a podiatrist will prescribe, functional and accommodative.
The Accommodative Orthotic:
The purpose is to cushion and relieve pressure. Often prescribed for the diabetic foot. The diabetic foot is prone to ulcerations from pressure points and calluses. They are also used to relieve foot pain coming from a multitude of causes, heel pain, plantar fasciitis, metatarsal pain in the ball of the foot, etc. Since they are made from a mold of your foot they can be made to control foot functions also. Take for example: a person walks on the inside of their foot (pronates), the orthotic can be made to adjust the heel strike allowing for a better weight distribution. The accommodative orthotic is also designed to absorb shock. This helps with pain reduction in the foot, ankles, knees and back. These custom orthotics tend to be softer and thicker since they are made to absorb shock. They are often made of foams and rubber materials. Since they tend to be thicker, roomy shoes must be worn, such as sneakers. Many times a Therapeutic Shoe is advised because they are wider and deeper just for this purpose. The last thing you need is a diabetic rubbing his/her toe against the shoe, forming a blister. The accommodative insert is usually full length and is meant to replace the original shoe insert.
The Functional Foot Orthotic:
This custom orthotic is used to alter the gate of an individual by adjusting the way the foot hits and rolls across the ground. In doing this a person’s walking gait is altered. The functional orthotic is made to apply arch support for flat footed and high arched feet. They are made to correct over pronation and over supination. They are made to relieve pain in areas such as the heel, the arch, the front foot pad, toes, ankles, knees back etc. and specific problems, hammer toe, curly toe, Morton’s toe, plantar fasciitis, etc. Functional Orthotics tend to be made of more rigid materials (thermoplastics, polypropylene, composite fiber) and are typically thinner. They can be rigid, semi rigid depending on their purpose, such as walking or running. The functional orthotic will likely take more time to feel comfortable and usually require a break in period. Take for example a person has been flat footed their whole life and now arch support is applied, it will most likely hurt at first.
A store bought insert can be purchased for as little as $20.00 where as a custom insert can cost upwards of $300.00. Typically a manufactured charges $85.00 to the doctor and they mark it up to the patient. Most doctors say they have great success rates with patients. How are they made? They are made from a mold of your feet, newer methods include laser imaging of the mold, with a C&C machine carving out the shoe insert to an exact copy of your foot. This is all overseen by a Licensed Pedorthist, a person who is trained at making Orthotics. The Pedorthist will make sure that the insert lies in a way that will change the walking gait.
Why are inserts becoming so popular?
If you talk to someone over 50 they probably played in a sport and did not have any foot padding less than a shoe insert. I recently talked to someone who is 57 and he played basketball through college. When asked about shoe inserts he reported, “When I played in the 60’s and 70’s we had two choices, “Converse white or black, high top or low top.” I have always had foot pain, I wish they had some kind of insert to help.” So you have a twofold buying spree, baby boomers who want to remain active are feeling the pain and parents who see there are ways to correct their children’s feet at an early age. Many people are also taking their health into their own hands because of the rising cost health insurance. One person stated, “I went to the doctor and received a $350.00 shoe insert which my health insurance didn’t cover. I loved the way they worked but was reluctant to buy another pair because of the cost. Then I found out I could order them online and save $200.00. The only knowledge I needed was to explain the purpose of what I wanted. Inserts for walking with flat feet, which they already knew from the imprint of my foot mold.”