Professional Rehabilitation & Occupational Physical Therapy

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Pro
Physical Therapy

199 Whitney Avenue
New Haven, CT 06511

Phone: 203-789-8873

Shoe Orthotics

Orthotics are orthopedic devices placed in your shoe to help prevent and reduce painful conditions in the foot and lower extremity.  Custom orthotics are made from a variety of materials molded to the shape of your foot.  This will ensure a proper fit.  Modifications can be made to the orthotic to balance the forces on the foot therefore reducing abnormal stress.  The insert is placed into your shoe and this help control or correct mal alignments in the foot.

The foot and ankle is a complex network of bones, joints, tendons and ligaments.  It is the foundation in which we function on.  Like any foundation if it becomes out of balance, stresses or overloads can occur eventually leading to failure.  In the body this may lead to painful conditions in the foot, ankle, knee and even up into the lower back. 

If you have one of these conditions, you may benefit from using orthotics:

Achilles Tendonitis
Ankle Injuries
Arch Pain
Bunions
Charcot Foot
Flatfeet
Foot Pain
Heel Pain
High Arch
Knee Pain
Low Back Pain
Metatarsalgia
Morton’s Neuroma
Osteoarthritis
Plantar Fascitis
Sesamoiditis
Shin Splints
Tendonitis in the       Foot/Ankle

Types of Orthotics

Orthotics can be broken into three groups based on the properties of the materials: Rigid, Soft & Semi-rigid.

Rigid orthotics applies to the name itself. Materials such as acrylic or graphite do not move, give or flex in any manner.  Rigid orthotics are the most difficult, and expensive to work with.  They are unforgiving.  Once the fabrication is complete, there is very little room for adjusting the shell itself.  Any adjustment must be attempted extrinsically.  In many cases, the lab will cast correct during the fabrication process to allow for the unforgiving nature of the material.  Rigid orthotics are time consuming and, in many cases, the patient has difficulty getting accustomed to the hard nature of the material.  Many patients will become frustrated and discontinue the use of the device; leading to failure. 

Soft orthotics are used mostly for shock absorption purposes.  They are inexpensive and serve a small portion of the patients who require orthotic intervention.  This type of orthotic purchased at a shoe store or pharmacy as an over-the- counter type of device.    Generally, they are not effective for the patient who needs a true supportive or corrective orthotic device.

Semi rigid orthotics are by far, the best choice.  This is the only type of orthotic fabricated at ProPT, they are fabricated in house, they are inexpensive and easy to use, and provides the best treatment outcome.  This material allows for direct molding to the patient’s foot.  It eliminates the need to cast mold the patient, which in turn reduces the supply expense and the time it takes to fabricate the orthotic. The beauty of this type of material is the flexibility it allows the foot, while providing the appropriate support.  The patient is more likely to tolerate this material than most others, and only a very small percentage of the patients (less than 5%), have returned with the complaint that they were unable to tolerate the device.  The break-in period is generally short (1 – 3 days).  This material allows easy adjustments; add posting, wedging and make adjustments to the arch, if needed. 

Controlling excessive motion and allowing flexibility for activities is the prime advantage of semirigid orthotics.  The only down side with semirigid orthotics is the thickness that is inherent in the material.  This will, at times, limit the type of shoe the patient will be able to wear.   Most patients who are in pain are willing to make that sacrifice.  In most cases, they will acclimate without too much change in life style.  If you are unwilling to make the changes needed in the correct footwear, orthotics may not work for you.   

Instruction Sheet

If you are not accustomed to wearing orthotics, you should gradually increase the amount of time when you start wearing your orthotics.  It is recommended you start by wearing your orthotics for 2 hours the first day.  Evaluate how your foot feels the following day. 

If you don’t experience any discomfort in the arch of your foot or any anywhere else, you may increase the time by 2 hours each day until you can tolerate a full day.  It may take longer in some cases for some people.  It will generally take about 2 weeks to fully accommodate to the orthotic. 

If you are experiencing unusual discomfort or pain you should stop wearing your orthotic and contact our office at 315-6780.  If you are diabetic it is very important you check feet after each wear during the break in period for any skin breakdown or irritation.  If you experience this you should stop using your orthotics immediately and contact the office as soon as possible.  In some cases, an adjustment may be required to achieve the best fit for you. 

Frequently Asked Questions:

Will the orthotic fit in my regular shoe?
In most cases, an orthotic will fit well in a tie shoe, sneaker or boot.  The laces allows you to loosen up your shoe enough to accommodate the orthotic.  The typical orthotic does not fit well in slip on shoes, loafers or dress shoes.  If your daily life requires you to wear dress shoes, there are dress shoe orthotics available.  Please call our office for further information.

Will I have to get bigger shoes?
In most cases you do not have to start buying larger size shoes.  In some cases you may remove the original insert from the shoe to allow for a better fit if your shoe feels too tight when you first place the orthotic in your shoe.  It is recommended that if your shoes are old and worn down, you start off with your orthotics in a new pair of shoes. 

When will I get them?
The technique used at ProPT reduces the time needed to fabricate your orthotic and since they are made onsite, your orthotics will be ready the same day they are molded.

How long will it take?
The process generally takes 25 to 30 minutes from start to finish.

Does my insurance company pay for them?
Generally insurance companies do not pay for orthotics.  You may have a particular addendum or rider as part of your plan which does cover orthotics.  You may call your insurance carrier and inquire about coverage.  Medicare does not cover orthotics.  Since your orthotic will be ready on the day you come, full payment is required when you receive your orthotic. 

How long will they last?
You can expect your orthotics to last for about 2 years.  In some cases they will last longer depending on the use.  If you feel you like your orthotics are not supporting your foot as well as they were when you first received them, it may time for a new pair.  When your foot perspires a lot, the top cover may need to be re-glued if it starts to pull away from the shell. This can happen after you have been wearing them for awhile.  There is no charge for alterations done to your orthotics. There is no special care needed for your orthotics you may occasionally wipe them down with mild soapy water. 

Do I have to come back for a follow up visit?
You only have to come back in for a follow up visit if your orthotic does not feel good in your shoe or if you are having increased pain.  Sometimes the orthotic may need to be adjusted.  There is no charge for modification or alteration to the orthotic.

Will I feel relief right away?
You may feel some immediate relief after putting in your orthotics.  However, more commonly patients have been experiencing pain for an extended period of time and may not feel relief right away.  Orthotics can be adjunct to any treatment and may take a period of time to have relief.  If you have an acutely painful problem, it may take between 4 and 6 weeks to have a noticeable difference.

What should I expect to feel?
When you first start walking with your orthotics you should feel a bit of a lift under the arch of your foot.  This is normal.  This pressure under the arch will dissipate after you get used to wearing your new orthotic.

What should I bring to first visit?
You should bring any shoe you would like to try and wear with the orthotic.  You will have the opportunity to see how the orthotics fit while you are in the office.  This may make it easier to adjust and modify.

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