How do I know if my orthotic is working?

Foot orthotics are easy, no? You get casted, it gets built, you put it in your shoe and you’re good to go, right? Wrong!

Orthotics or “Orthotic Therapy” as we call it is an ongoing process. If an orthotic is doing it’s job, your foot should change (for the better) and your prescription should become less. and less….Until you no longer need them… At least in an ideal world.

Remember, orthotics are designed to help you adapt to your environment better. Unlike a footbed, they should change the biomechanical function of your foot. A lot should go into getting fit for an orthotic, otherwise they can actually cause some of the problems they are purported to fix!

First of all, there should be a history of you and whatever is going on, with an inventory of all your past injuries. Sometimes there is a pattern that can be recognized and gives your provider clues as to what may be going on with you.

Next you should have a thorough examination of your lower kinetic chain, including the feet, ankles, knees, hips and low back. This should include range of motion, muscle strength, muscle recruitment patterns and joint function, along with reflexes, sensation and balance or proprioception. This gives us a benchmark and defines weaknesses and strengths.

Now there should be an analysis of your gait, preferably with stop motion video which allows us to slow down movements and assess subtle abnormalities that may not be visible during normal speeds of movement. If you are there for cycling orthotics, then a video of your stroke pattern is made. Sometimes, footage of your skiing technique can be helpful as well.

At this point, it should be obvious to both you and your orthotic provider whether or not an orthotic is needed. If so, a non weight bearing cast in terminal stance phase (This is a specific position of your ankle and foot) should be performed. This is usually followed by the prescription of appropriate stretches and exercises, specific to your condition. Shoe recommendations should also be given, since different foot types require different footwear characteristics. This will be good news for the ladies who like many shoes. Most guys just want the pain to stop and won’t care what they look like, as long as they are not pink!

Now you have an idea of what goes into (or should go into) building the perfect orthotic for you. Ask lots of questions of whoever is building them for you and make sure they are answered to your satisfaction. They should be a stepping stone to your recovery and  not a crutch for you to depend on. 

Telling it like it is, we are… The Gait Guys

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