Foot pain is one of the most common reasons that patients seek orthopedic medical attention. It is no wonder; this complex structure of 26 bones and their corresponding joints takes at least a million steps a year. In our society, much of this is done on hard surfaces.

The subject of orthotics is complex but there are some basic principles and examples that should give you an appreciation of their benefit. First of all, orthotics can be prefabricated (such as the Dr. Scholl’s products) or custom molded. The prefabricated (off the shelf) device gives added shock absorption but fails to control excessive motion and breaks down rather quickly. They are cheaper but tend to loose their benefit within 2 to 3 months versus custom orthotics that can last up to 2 years.

Custom molded orthotics are made specifically for each individual patient’s foot. They can be done with plaster molds, standing foot impressions, and, most recently, with the use of a computer. At Orthopedic Physician Associates, we have gone to the use of the computerized foot analysis. This gives us the advantage of looking at the dynamics of your foot through the whole gait cycle while walking. All methods prior to this have taken a static mold. Plaster molds, for instance, are usually done with the patient sitting and as such are very limited in their accuracy of representing what forces actually go on while walking.

Orthotics achieve foot comfort by changing the way forces act on the foot. If we look at two different foot types, the benefits become quite clear. In the flatfoot, there is a great deal of motion and some collapse of the arch with each step. This creates fatigue of the soft tissue structures and makes flatfooted individuals prone to conditions like tendinitis. Orthotics help to control motion and collapse in these patients. Individuals with a high arch foot usually have a much more rigid foot structure but have limited contact with the ground. This creates areas of pinpoint pressure and the entire body weight is distributed through a relatively small part of the entire surface area of the foot. Consequently, a patient with a high arch is going to be prone to calluses, pressure points, and even stress fractures in an impact exercise program. Orthotics help these people by distributing body weight through a greater surface area and decreasing the shear stress (sliding in the shoe) of the foot in the shoe.

At Orthopedic Physician Associates, the cost of a completed pair of orthotics is $446.00, which includes a gait analysis. We use a product made by Footmaxx Corporation, which guarantees the orthotics for a period of 45 days. If, for any reason, the patient is dissatisfied with the orthotics, they can be modified or returned for a full refund. Because the patient’s gait analysis is in a computer, additional pairs of orthotics can be fabricated without the patient's even coming back into the office. The cost for additional pairs is $165.00 for each pair. You can also get your old OPA Footmaxx orthotic refurbished for $50 per pair.

One more thing you should know about orthotics is they have become somewhat specific to the type of shoe wear you are wearing. For instance, most sport shoes have a prefabricated insole that should be removed and replaced with a full-length custom orthotic. Dress shoes, on the other hand, need a ¾ length dress orthotic to give support to the arch and still allow room for the toes in the shoe. Sandals can also be done with a Footmaxx custom insole.