A patient came to visit me not long ago with concerns about her pain. She knew she had flat feet, but her feet didn't hurt. She suffered from chronic hip pain. After numerous cortisone injections, anti-inflammatories, and physical therapy, she was told by several surgeons that it was time for surgery. She instead came to seek my opinion about the possibility of how her feet might affect her hip. She had heard about orthotics and, in a last-ditch effort, decided to see what they were all about. At this point, she figured she had nothing to lose! I made her first pair and her hip pain resolved! What's up with that?
There are 26 bones, 33 joints and over 100 ligaments, muscles and tendons in the foot.
Your feet are like a finely tuned clock with all its components working in synchronicity. This synchronicity is the foundation of biomechanics, how our bodies move through space. When all parts are working optimally, they support and balance the weight of the entire body. Considering that walking alone puts up to 1.5 times one's body weight on the feet with running adding up to 3 times your body weight, maintaining this synchronicity is a big deal!
Feet that are out of alignment can lead to complex problems that can affect the function of other parts of the body, including the knees, hips, and back. Muscles attempt to compensate for the imbalances and can become fatigued or injured as a result. Pain and joint related problems are often seen secondary to this biomechanical misalignment. Give it long enough and many of these misalignments end up needing surgical correction! There are many unfortunate instances where my surgical patients tell me they saw their foot deformities forming but figured they couldn’t do much about it until it needed surgery! Though I am dedicated to fixing what needs to be fixed, I am just as passionate about doing what I can to help prevent the need for surgery! This is just the sort of thing functional orthotics can help with!
Here are the 5 most common questions I get about orthotics:
1. What is a functional orthotic?
Functional orthotics are customized biodynamic devices that are meant to replace the factory inserts in your shoes. It places your feet in the best position as they move through the phases of gait from heel strike through propulsion. Think of your body as you would a house. You build your house on the best foundation to support it so the house does not suffer structural problems. An orthotic as the best foundation your body or your “house”.
2. How are orthotics different that an arch support?
An arch support is simply an insert that supports the arch. If you are getting something from a store that comes out of a box or brought to you from a store’s stock room and is dispensed according to your shoe size/ foot shape, then it really is just an over-the-counter insert. It may be better than the factory insert that came with the shoe, but it does not and should not be compared to true functional orthotics as they do not truly correct foot function.
Orthotics are custom ordered by your podiatrist. They are ordered with specifications made to address the needs of your feet, considering your foot type, any pathologies you may have and how your feet function as a whole. A pair of functional orthotics are as specific to your feet as prescriptive eye wear is to your eyes! As eyes may have different prescriptions, your feet may as well. Orthotics address the needs of your feet individually. In doing so, they improve and optimize how your feet and, overall, how your body functions.
3. Do I need an orthotic?
Between 70 and 85 percent of all people have biomechanical imperfections. Many of these people can function, though not optimally, without issues and do not necessarily need orthotics. Here is a guideline of patients who would benefit from functional orthotics:
If you have a history of foot or ankle injury. Stabilizing your feet with orthotics have shown to help prevent re-injury.
If you have a family history of bad feet like I do, orthotics can help slow down the development and progression of foot deformities.
If you have pain in your lower extremity, hips, knees or back, orthotics will improve body positioning, overall alignment and biomechanics.
If you have no current pains and you exercise on a regular basis, orthotics help your feet and body move most efficiently throughout activity by reducing muscle and joint fatigue to enhance performance.
If you are overweight, orthotics can help to more evenly re-distribute the pressures and stresses placed on your bones, muscles, ligaments, tendons and joints to delay their deterioration.
If you are standing on your feet most of the day, functional orthotics can help alleviate the stresses imposed on all joints by maintaining alignment at the “foundation” level.
Basically, functional orthotics allows the muscles, tendons, and bones of the feet and lower legs to function at their highest potential. When appropriately fabricated, orthotics can decrease pain, not only in the foot, but in other parts of the body such as the knee, hip, and lower back. By eliminating the need for one's muscles to compensate for imbalances, orthotics can reduce fatigue and promote efficient muscle function to enhance performance. By increasing the stability in unstable joints, it is possible for functional orthotics to help prevent early foot deformities from developing into potential problems in the future.
4. How long do orthotics last?
Orthotics come in an array of styles, materials and shapes and specifications. The rate of wear and failure varies depending on the type of orthotics chosen, how often they are worn, what type of exercise you are involved in, your weight, your occupation (desk job vs. on your feet), and more. The determination of when to replace orthotics is best made by your podiatrist who best knows your feet!
5. How do I get orthotics?
The best place to start is where my last paragraph ended, with your podiatrist! If you don't have one, you can start here at Foot and Ankle Associates of North Texas (FAANT)! We will gladly tailor your orthotics to your specific needs! In many cases there is orthotic coverage through your insurance. We will determine your benefits before we start the process of making your orthotics.
I can't make claims that orthotics help in every situation, relieve everyone's pain or even prevent everyone's surgery. I can certainly tell you, however, that with 20 years of experience to pull from, they are a "FAANT"-tastic option and one of the best investments you can make for your feet and your body!