The Art & Science of Prescription Foot Orthotics

When writing about a topic such as foot orthotics, the first question that needs to be answered from a functional health perspective is: "Why do I need foot orthotics?"  The simple yet affirmative answer is that your feet are a complex structure of bones, ligaments, muscles and tendons that support the balance of your body.  From there....any alteration functionally or structurally in your feet will have an effect on the rest of your body.  Custom foot orthotics can effectively treat foot pain caused by conditions such as plantar fasciitis, bunions, metatarsalgia, diabetes and arthritis but also importantly prevent foot issues from causing other problems in the rest of your body by altering the way you stand, walk or run.  The way you move as a result of the biomechanics of your feet....directly affects your ankles, knees, hips, get the idea.

In my office I often hear that patients prescribed foot orthotics in the past stopped wearing them because they were just too uncomfortable.  Now this seems highly counterintuitive to me as it should to you.  Wasn't the idea to prescribe the foot orthotics in the first place to mitigate, not cause discomfort?  It is important to highlight here that to correctly prescribe custom foot orthotics, the doctor not only needs to correctly diagnose the biomechanical foot issue, but also the effects caused on the rest of the body.  A common mistake is that practitioner's focus only on correcting the foot anomaly and do not pay enough attention to the fact that patients have to wear and be on these corrective devices daily.  This daily wear requires correction of foot biomechanics and structure combined with comfort and shock absorption which directly will have a positive effect on the rest of the body.  Proper custom prescription foot orthotics strike this fine balance between "correction" and "comfort".  Without appreciation of the vast implications of correctly prescribing a custom foot orthotic to a patient, errors are for example made in the magnitude of foot correction and orthotic rigidity leading to poor patient compliance in using the devices and consequently poor patient outcomes in the treatment of their condition(s).

The correlation of patient information including: foot biomechanical/structural diagnosis, other body/joint issues, age, weight, footwear used, activities undertaken, type of footwear worn daily etc. is the fundamental prerequisite in the prescription process.  The responsibility of correlating all of these factors accurately and completely rests on the prescribing practitioner.  If this fundamental is achieved, it will lead to the production of the best fitting, most corrective and comfortable foot orthotics.  The key take home point here is foot orthotics are meant to increase correction and comfort.....end stop!  As I always say to my patients, in very quick time, you shouldn't even notice that there are orthotics in your shoes -you should however notice when they are not there!

Our Office’s Comprehensive 6 Step Process:

1.  Clinical History:  A clinical history of the patient is conducted to take into account all health and lifestyle factors contributing to your health issue.

2. Foot Examination:  An examination of your feet in a non-weight-bearing position to assess the overall condition of your feet (ie. callus patterns, bunions, bone alignment, the integrity of the arches, areas of pain or discomfort).

3.  Weight-Bearing Gait Assessment:  This part of the exam allows the practitioner to assess the patient while standing as well as in the different phases of the gait(walking) cycle. Foot and body biomechanics can be identified that are contributing to the patient’s condition and overall health.

4.  OH1 3D Casting –  Walking Digital Gait Scan:   A digital 3-dimensional impression is made of the patient’s feet as well as a digital gait (walking) scan is conducted. This technical data provides the laboratory of a concise picture of your feet in both a static and dynamic state.

5. Integration:  The findings of the first 4 phases of the Process are integrated and assessed by our office and the professional technicians at the orthotics laboratory to produce a custom foot orthotics best suited to our patient’s specifications.6.  Fitting and Reassessment:  Once the orthotics arrive at the office Dr. Badyal will fit them into your shoes and ensure that all specifications have been met.

If you have questions about custom foot orthotics; or just want to know more, get in touch with Dr. Raminder Badyal - Vancouver Chiropractor & Custom Foot Orthotics.

Dr. Raminder Badyal
Dr. Raminder Badyal
Vancouver chiropractor
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