Foot
Orthotic Arch Supports
What do they do? Comfort, Control and Support!
The control of abnormal foot conditions is of paramount importance. Ankle-foot mal-alignment may result in secondary ankle, leg or spinal injuries. Patient assessment will lead to diagnosis and an individualised treatment program.
Some pathologies fail to respond to other treatment modalities or surgery, because they are caused by a bio-mechanical mal-alignment of the foot, requiring an Orthotic Arch Support to re-balance and re-align the feet and correct lower leg posture. A redistribution of weight from painful areas can also be achieved. This acts to reduce pain from conditions such as heel spurs, plantar fasciitis or metatarsalgia, as well as controlling foot deformities such as pes planus (flat feet). Orthotic arch supports are frequently used in conjunction with other treatments such as physiotherapy or surgery to achieve the best outcomes, addressing the longer term causes - not just the symptoms - of pain. Within recent years the success of Orthotics has become more widely known to treat common foot, ankle and knee complaints. Some of these pathologies include:
- Flat Feet
- Plantar Fasciitis
- Ankle Instability
- Pronation / Supination
- Patella Tracking Probs
- Shin Splints
- Heel Pain
- Heel Spurs
- Knock Knees
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- Arch Pain
- Metatarsalgia
- Leg Length Difference
- Severes Disease
- MortonŐs Neuroma
- Arthritic / Diabetic Feet
- Aching Knees
- Tendonitis
- Pigeon Toes
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Features of Orthotics
The basic functions of a Foot Orthotic can be segmented into six main categories:
1. Heel Wedges
Incorporated into the heel of the Orthotic, the wedges act to align the calcaneus and mid-foot into the midline, thus decreasing strain on joints, ligaments and tendons.
2. Redistribution Of Weight
Loads are spread over a wider area to reduce localised forces in one area of the foot. “Relief areas” can also be created to transfer weight away from sensitive or painful areas, such as from heel spurs or the forefoot.
(Heel spur encircled by foam for instant relief)
3. Metatarsal Domes & Platforms
Relieve pressure from specific metatarsal heads or the entire transverse arch of the 2nd, 3rd and 4th metatarsal heads. This modification is incorporated during the orthotic manufacture.
(plantar view of foot showing met. dome)
4. Heel Raises
A raise of up to 15mm can be incorporated into an Orthotic to allow for leg length differences. This acts to level the pelvis and align the spine.
5. Shock Absorption
Quality materials are used to provide not only comfort, but also to reduce joint reaction forces - especially for high impact sports and the elderly. “Semi-rigid” Orthotics are great in this regard.
6. Medial Longitudinal Arch
The medial longitudinal arch may be raised in order to help with foot alignment and to control conditions such as plantar fasciitis & pronation.
Various types of Foot Orthoses are as follows:
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O1 - Custom Made Foot Orthotics: Semi-Rigid
Presciption
- Flat Feet
Plantar Fasciitis
Pronation
Heel Spurs
Severes Disease
Shin Splints
Arthritic / Diabetic Feet
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O3 - Custom Made Foot Orthotics: Rigid
Presciption
- Severe Pronation / Supination
- Severe Flat Feet
- Unstable Gait
- Created to fit in womens dress shoes
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O4 - Carbon Fibre Rocker Orthotics Arch Supports
Presciption
- Painful Hallux Rigidis
- Extreme Metatarsalgia
- Stress Fractures of Metatarsals
- Tarso-Metatarsal Joint Osteoarthritis
- Post-op Metatarsal Osteotomy
- Immobilisation of Toe Fractures in Shoes
- Hallux Amputation
Description A thin carbon-fibre plate with a small forefoot rocker to allow easy toe-off (simulates toe extension at toe-off phase of gait). May be fitted with a soft orthotic for extra support and comfort.
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O5 - Heel Raise
Presciption
- Pelvic Tilt
- Leg Length Discrepancy < 15mm
- Achilles Tendonitis
- Post Hip Replacement Surgery
Description A heel raise is placed inside shoe to balance leg lengths and align the pelvis, and can also be incorporated in an orthotic for other conditions.
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O6 - Silicone Heel Pad
Presciption
- Severes Disease
- Heel Pain
- Plantar Fasciitis
- Achilles Tendonitis
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O7 - Temporary / Off-The-Shelf Orthotics
Presciption
- Diagnostic tool or for short term pathologies
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O9 - Inter-digital Wedge
Presciption
- Toe Deviations
- Inter-Digital Corns
- Hallux Valgus
- Relief on Distal Phalanx
Description A custom mould silicone wedge acting to separate and align single or multiple toes.
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OF2 - Orthopaedic footwear has improved enormously in function and appearance over the past few years. The importance of client comfort and appearance is paramount. The shoe must support the feet, but also relieve pressure from problem areas such as bunions. Even the most deformed and awkward feet can now be accommodated in great looking styles. Many people with diabetes (peripheral neuropathy), arthritis and trauma benefit from proper fitting shoes. Orthopaedic Shoes can be made for many different purposes:
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Footwear for Orthoses
Presciption
People wearing:
- Foot Orthotics
- Ankle-Foot Orthotics
- Knee-Ankle-Foot Orthotics
- Calipers
Description People who wear orthoses should not need to wear a larger (longer) shoe, but often extra depth or width is required to accommodate these orthoses. Shoes can be made-to-measure or custom made in these instances.
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Footwear for Bunions
Presciption
Description For bunions and Tailor’s bunions a shoe with a wide, deep toe box is suggested, as most pain is caused by footwear pressure. For decreased hallux extension (Hallux Rigidis), use a rocker sole.
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Footwear for Leg Length Difference
Presciption
- Leg Length Difference > 20mm (e.g. Post Hip Replacement Surgery)
Description Shoes can be built up to equalise leg lengths. This acts to align the pelvis, decreasing the chance of spinal or hip problems and creating a more fluid gait pattern.
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Footwear for Hammer Toes / Toe Deformities
Presciption
- Hammer Toes
- Various Toe Deformities
Description A deep toe box is suggested to clear the top of the inter-phalangeal joints and reduce pressure and corns / calluses. An orthotic with a metatarsal dome can aid less severe cases.
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Footwear for Impact Absorbtion
Presciption
- Soreness of Joints
- Severe Osteoarthritic Feet
Description Soft foam-based soles can reduce ground reaction forces, combined with orthotic arch supports.
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Footwear with Sole Flares
Presciption
- Unstable Gait
- Pronation (Valgus Ankle)
- Supination (Varus Ankle)
Description The sole of the shoe is modified and reinforced to control abnormal gait or deformities in the medio-lateral plane. Severe cases require an A.F.O. (p. 11)
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Footwear with Rocker Soles
Presciption
- Ankle Arthrodesis
- Metatarsalgia
- Stiffened / Painful Hallux or Amputated Hallux
Description To decrease forces on the metatarsal heads and toe extension at toe-off phase of gait. The forefoot of the sole is rounded, providing a rolling effect for the shoe.
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OF3 - Cast Boot
Presciption
- Worn Over Casts
- Stable Metatarsal Fractures
- Stable Phalanx Fractures
- Post Surgery
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