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Science of Foot Orthotics


Customised Foot Orthotics (Prescription Shoe Insoles)

A proper foot orthotic (orthoses) is a custom-made shoe insole that is designed and lab-fabricated specifically to treat foot disorders, provide ailing feet with optimal structural support that relieves pain, and prevent foot deformities from worsening.

 

These prescription-only medical devices are prescribed by a Podiatrist only after they have obtained a clinical diagnosis through a comprehensive assessment.

 

They are classified as Class A (non-sterile) medical devices by the Singapore Health Science Authority (HSA), and under similar purview in many countries’ health and medical governing bodies.

 

They are individually contoured insoles used to treat a variety of postural problems of the human body, from ankle instability to shin splints to knee or back pain, simply by adjusting your natural alignment when stationary or in motion.

A functional orthotic might not immediately feel comfortable because an intended correction is unfamiliar to your body. For example, the correction may alter the feet and leg posture so as to correct your deviated gait pattern to avoid further distress or injury to specific parts of your body. Consequently, this may feel unnatural or uncomfortable as your body adjusts to the corrected gait pattern.

 

Each pair of foot orthotics is specifically designed for the individual it was made for; you should never try to use someone else’s pair of prescription orthotics as this may lead to gait problems and foot deformity. This is akin to using another person’s prescription glasses.

A brief history of foot orthotics

Before artificial surfaces such as concrete or tiles were developed, humans walked upon natural surfaces like grass and soil. These ground types were softer and conformed more to the shape of our feet. Today, despite the protection of footwear, our foot structures are instead forced to conform to the hard surfaces we encounter on a daily basis. Orthotics ensure that our feet receive the proper foot support needed for comfort and ideal posture.

 

Just as wheels evolved from simple wooden designs to modern air-filled tyres, our feet can also benefit from advancements in medical technology and knowledge. Orthotics are not a new idea, with the earliest known orthotics dating from over 2,000 years ago. However, the first modern orthotics were only jointly developed by doctors and podiatrists in the mid 19th century. Over time, the design and manufacture of foot orthotics has improved greatly due to our enhanced understanding of the foot and body as well as continued developments in device materials and concepts.

“The human foot is a masterpiece of engineering and a work of art” – Leonardo Da Vinci

 

Da Vinci was inspired in part by the design of the arches of our feet, which manage to support the weight of our upright body while conserving energy and redistributing physical stress forces. Because of this, maintaining a healthy foot arch is exceedingly important, and orthotic devices provide arch support that may not be naturally available.

Why are Foot Orthotics important?

Your orthotic devices are fabricated specifically for you and your needs. By conducting a comprehensive assessment of your musculoskeletal needs, natural biomechanics and lifestyle choices, podiatrists are able to prescribe a customised device that accommodates your daily activities while addressing abnormalities in your lower extremities.

 

Orthotics also exert biomechanical influences on the joints that they are not in direct contact with. For example, orthotic devices can be used to realign the knees and hips in order to improve gait patterns.

 

The impact of orthotic devices on our entire body cannot be underestimated.



Some of conditions that Prescription Shoe Insoles can help to alleviate include-

 

Flat Foot

Flat Feet are more prone to the ankles rolling inwards (over-pronation), causing pain in the feet, ankles, lower legs, hips or lower back. Prescription insoles address this by –

  • Providing support and stabilisation, keeping the ankles in optimal orientation
  • Reducing the strain on your arch and intrinsic foot muscles
  • Realigning the knees, hips, spine, and other parts of your body
  • Improving your walking/running gait for a better quality of life

High Arch

High arched feet tend to be more rigid and inflexible, reducing their ability to absorb shock. Customised orthotics are designed to help by –

  • Being contoured to your soles to increase contact area and reduce point pressures,
  • Altering weight distribution and reducing stress on your joints
  • Increasing shock absorption.

Custom orthotics can also be used to treat a variety of lower extremity conditions such as Plantar Fasciitis, Bunions, Achilles Tendonitis, or Knee, Hip and Back Pain.

What is the difference between retail insoles sold by commercial stores and custom foot orthotics prescribed by healthcare professionals?

 

In Singapore, custom foot orthotics are Class A medical devices. Despite their claims, insoles sold at retail outlets and chains are mass produced or made by non-clinicians, even when they claim to be customised for your needs. While customisation may have taken place, it is crucial that your insoles are customised by a clinical foot specialist, as customisation performed by a non-professional is more likely to cause harm than good.

 

Podiatrists are certified clinical specialists who are specially trained to prescribe and design custom foot orthotics. Unlike insole retailers, podiatrists prescribe based on a comprehensive diagnosis of a patient’s musculoskeletal problems. Besides being experts in the science of human anatomy and biomechanics, podiatrists also possess years of experience in both hospitals and clinics treating patients presenting with a variety of foot conditions.

 

Retail “corrective insoles” may seem comfortable at first, but they do nothing to treat a person’s conditions in the long run. In some cases, unsuitable retail insoles may even worsen a patient’s condition. It is a common sight at our practice to see patients who have bought non-medical so-called “custom insoles” at retail shops complaining of its inability to ‘fix’ their problems.

Why are Podiatrists the Specialists for Foot Orthotics?

Foot orthotics were developed by podiatrists and doctors over a century ago, and it continues to be a major area of study for the podiatry profession. Podiatrists specialise in utilising orthotics to painlessly treat a variety of lower limb conditions.

 

Providing a patient with an orthotic device is only the first step in an ongoing process of patient care. Reviews with a podiatrist are required to establish whether the prescribed orthotics are achieving the desired treatment outcomes. Patients and their needs will continue to evolve and change, while the orthotics will require adjustments over time. Maintaining detailed records of progress allows podiatrists to provide timely and accurate care for their patients, an approach that retail insole shops cannot possibly match.

 

Podiatrists are also experts in shoe evaluation and shoe selection, allowing them to make personalised recommendations for footwear best suited for a patient’s specific lower extremity conditions. Our podiatrists also recognise the modern Singaporean’s need to complement function with aesthetics and can refer you to suitable shoe stores that carry ergonomic shoes for business or casual wear.

ECPC Podiatrist Team | East Coast Podiatry

What methods & technologies do podiatrists use for prescribing customised shoe insoles?

A full biomechanics assessment is undertaken to diagnose all causes of a patient’s lower limb abnormality.

 

Weight bearing and non-weight bearing examinations are undertaken to assess the patient’s static and dynamic posture and function.

 

Multiple 3D scanning methods are used to produce accurate measurements and a complete image of your feet contouring in all aspects. This will form the base template for your custom orthotics.

 

Our Podiatrists will handcraft the base 3D orthotic template, making modifications to correct a patient’s specific biomechanical deficit. Once the design is complete, we send the specifications to an accredited orthotics lab in Australia where the customised foot orthotics will be produced.

 

Our custom foot orthotics are a pillar of our commitment to patient care. We guarantee your orthotics from material defects and design mistakes, and will spare no expense at ensuring quality.  Our process also includes regular follow-up appointments reserved for you to monitor the long-term treatment outcome with your orthotic devices.