Custom orthotics inserts are roughly the same thing. Inserts are the orthotics. Being custom made they have to be:
Why do we need custom made orthotics inserts anyway? Lists reasons why you should and should have orthotics in the first place.
They also tend to have a huge quality range. Sometimes they are really good and sometimes they are really bad. Here are some tips:
There are multiple different ways to make orthotics and they all dependent upon the confidence and effectiveness of whoever is making them. For use we used the "foam box" method. We liked it and we were comfortable with the results it produced. If we moved onto something else our confidence would reduce and possibly the end product.
Is any one better than the other?
They all have their pluses and minuses but they depend upon the person creating them unfortunately. The main thing is that the output- the actual orthotic, is what you need.
So we have found some really horrendous orthotics that should never have been created. They caused more pain for the patient because they didn't take into consideration the actual patient and what they were going to do with them. So for example, a postal worker was given rock solid orthotics which caused so much pain that the patient hobbled into the clinic with these things in their shoes. We removed them and created more cushioning devices which gave an equal benefit to the foot. The patient was pain free.
The following are the main ways to create custom orthotics inserts:
Casting is what is shown the the picture. What happens is a Plaster of Paris cast (or wax cast) is taken of the foot when it is in a certain position. It is removed and filled with plaster, then that is removed and an orthotic is created against that mold.
I never liked it because I could never get them right (dimples would show, I would press too hard in some areas or not enough in others, and creating the mold was difficult).
Some people have got it down to an art form and have produced good works but I just found it cumbersome, messy for the patient and takes time to do. Also for me, you don't weight bare on the cast- it is done when the patient is not pressing down on the foot. Which I didn't get.
This is where the patient walks over the mat and the computer picks up the foot in certain a position highlighting where it is lacking or applying extra weight. This technique is similar to one where a patient stands on a mat and the computer pushes up little posts to the foot.
I like the post version because you can adjust the foot and the posts move into the position that you have created- then the orthotic can be made through the computer to a machine which cuts out a mold which the orthotic can be made from.
Pressure sensors are OK but I find they tend to show what the foot looks like in motion not really stating why the foot is in that position. So if you stand upon the mat and then your foot gets adjusted you should be able to see pressure reducing or increasing?
Ahh the foam box. This was our favorite to manufacture custom orthotics inserts. Roughly the same technique as the casting method but with this one you put the foot into the foam box in a fixed way and then the patient stands on the box. The mold can then be taken of the foot impression.
We found that it was a good method of creating orthotics, but that was us. It was a cheap, reliable and easily adaptable to each patient
Custom orthotics are not a golden bullet. They won't cure the issue especially if you have a boney problem, but they allow the issue to calm down, make the patient feel comfortable and heal.
Therefore custom orthotics inserts should only be used by people who actually have a problem for which the orthotic can help with- then they will help. When used poorly they can make the issue worse or give the patient a false sense of hope.
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