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Orthotics - Differentiating Functional Foot Orthoses from Other Types of 'Custom Orthoses'

What are foot orthoses?

Good question! Foot orthotics are referred to by many names. Some common names used to describe foot orthoses and related products are arch supports, shoe inserts, orthotics, orthoses, custom orthotics or orthoses, prefabricated orthotics or orthoses, just to name a few! Needless to say, this can all be very confusing to patients or consumers who are interested in understanding prescription and non-prescription foot care products and devices.

Foot orthosis defined:

The most accurate definition: A foot orthosis is a device that is used to brace, support, or protect the foot or a part of the foot.

The term orthosis is the singular form and means one orthotic device whereas the term orthoses is plural and means more than one orthotic device. While the preceding definition of a foot orthosis is simple and concise, one can use an adjective to add further meaning. For example, an orthosis made specifically for sports activity might be called a sports orthosis or might be a sport specific device such as a ski orthosis.

Categories of foot orthoses:

There are many types of foot orthoses and there are different ways that we can attempt to categorize them. It is somewhat difficult to categorize foot orthoses due to variations in orthotic device design and manufacturing.

One method of categorizing foot orthoses is to divide them into groups according to prescription and non-prescription foot orthoses. Non-prescription foot orthoses are often referred to as “over-the-counter” devices and may be obtained with or without the assistance of a licensed healthcare professional. Non-prescription orthoses are sometimes custom made but are typically pre-manufactured.

Prescription foot orthoses are prescribed by a licensed healthcare professional and are not available without a prescription. Prescription foot orthoses are typically custom made but there are some varieties that are pre-manufactured and not custom made.

Another way to categorize foot orthoses is by their method of manufacture. Foot orthoses may be custom or non-custom made. Custom foot orthoses are individually made, and are typically manufactured using the patient’s own foot anatomy by creating a model of the foot (a cast, impression, impression foam, scanner, etc.). The anatomical model serves as the foundation of the form used to produce the orthosis.

Non-custom foot orthoses are manufactured using predetermined shapes or pre-made models, or are made by injection molding or computer milling. Non-custom foot orthoses are not made from the patients own foot anatomy and are more generic or general in shape.

Types of prescription foot orthoses: There are basically three types of prescription foot orthoses. The two most common types of prescription foot orthoses are accommodative orthoses and functional orthoses.

Accommodative orthosis: An accommodative orthosis is a device that is designed to pad and protect the foot or a part of the foot. An accommodative orthosis supplements the foot’s natural padding and may be designed to reduce pressure by accommodation, in certain areas.

Functional orthosis: A functional orthosis is a device that is designed to influence the position and/or motion of the foot through the application of biomechanical principles. A functional orthosis is the most biomechanically advanced type of foot orthosis and is only available by prescription. It influences the position or motion of the foot altering the forces acting on the foot. A functional orthosis requires a significant degree of expertise to prescribe and manufacture.

Prescribing accommodative or functional orthoses should be done by a podiatrist or other qualified healthcare professional who has been educated and properly trained in their use. Dr. Donela has had extensive training and experience in this area of his practice. He has worked closely with a well-known and reputable prescription foot orthotic laboratory for the past 25 years.


What is the process?
After performing a complete biomechanical evaluation,Dr. Donela obtains a 3 dimensional negative impression of each foot. A detailed prescription is written, specific to each patient's diagnosis and condition.

Once the negative casts are received at the laboratory in California, numerous hands-on techniques are employed to create the custom orthotic specific to the Doctor's prescription.


Do you need an orthosis and if so, what type of orthosis is best for you?
There is no simple answer to this question. In some cases, a simple over-the-counter orthosis may be all that is required to relieve minor pain or foot fatigue. On the other hand, minor symptoms may be an indication of a more serious medical problem that may require a doctor’s attention. To compound matters, some diseases or conditions have an asymptomatic stage in which pain can be absent or may be intermittent even when the condition is progressive. In such cases, early intervention can be very important. The best way to determine if you need an orthosis is to consult your podiatrist or a qualified health care professional.

An orthosis is an orthosis, or is it?
Foot orthoses and related devices are available from a variety of different sources these days. Custom and non-custom foot orthoses, arch supports, and shoe inserts may be obtained at retail establishments, via the internet, or from professional healthcare providers. There can be major differences between foot orthoses from different sources, so finding a specialist who is qualified in biomechanics and foot orthotic therapy is very important. A prescription foot orthosis is a medical device that should only be provided after an appropriate biomechanical examination. A biomechanical examination enables a practitioner to understand the patient’s individual needs so that a proper foot orthosis can be prescribed.

The process of prescribing a prescription foot orthosis requires a qualified practitioner. There are many variables which influence the prescription process. Careful consideration of the patient’s individual biomechanics, medical condition, health history, and other needs must be done in order to develop a treatment plan and the proper orthotic prescription. The value of the services of a qualified practitioner should be recognized by patients when considering the need for foot orthotic therapy. A qualified medical practitioner is important component in achieve favorable outcomes with foot orthoses.

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