An orthotic is an innersole that is placed in your shoe. An orthotics’ role is to help redistribute force more evenly throughout your toes, feet and ankles.
I’ve found lately that most of my orthotic prescriptions are for conditions that other people and other health professionals probably wouldn’t know about. This has brought me to writing this blog to educate people about the intricacies of orthotics and feet. No two custom orthotics are the same just like no two feet are the same.
5 conditions you didn’t know orthotics are used for:
- Corns.
A corn is an area of compacted hard skin. Our body lays down hard skin as a way of protecting itself. Have a feel of your own feet and see if there are any lumps or bumps under the balls of your feet, the sides of the toes or maybe even the arches of your foot. If our body didn’t lay down corns and calluses then the pressure area would turn into a wound. These hard bits often get really sore for a lot of people. An orthotic can redistribute this force and reduce hard skin.
- 2) Nerve loss in the feet
Peripheral Neuropathy is when the nerve endings in your feet just aren’t working as well as what they should. This can happen in a number of conditions such as uncontrolled diabetes, chronic alcoholism, vitamin B12 deficiencies or auto-immune conditions to name a few. This can be really dangerous as any callus or blisters will go unnoticed and potentially turn to ulceration unless an orthotic helps to offload the feet correctly. In some foot types – particular people with a high arch it can actually lead to an increase in arch height and further pressure on the big toe joint and heel area causing further issues. An orthotic cannot FIX this problem but it can reduce pain, increase comfort and reduce the risk of falls and injury.
- 3) Ulcerations
Ulcers are a chronic prolonged break in the skin which take an extended period of time to heal. For some people, an ulcer WILL NOT heal unless the pressure is taken away. Imagine cutting the tip of your finger and then rubbing it continuously on the wall but expecting it to heal in a few days time – this is exactly what happens in your feet because you have ground reaction forces acting against the plantar surface of your feet – Remember the second line you read in this article? “An orthotic helps to redistribute pressure more evenly throughout the toes, feet and ankles.” The type of orthotic designed for ulcers and wounds is normally more flexible and has extra soft padding around the ulcer site for protection. There is no doubt that orthotics help increase wound healing times.
- 4) Flat foot
Yep, you read that right, I meant A flat foot. One flat foot. Orthotics have been debatably prescribed for a long time for ‘flat feet’ which will probably be continuously debated for another 50 years. But, the one thing that is not debatable, is when one foot is an ‘acquired flat foot’ and the other foot is a normal arch height. This person NEEDS AN ORTHOTIC. The reason I am so passionate about this is that I have seen too many patients lately with ulcers and corns under the collapsed flat foot arch. An acquired flat foot means that over a life-time the heel and arch have collapsed inwards causing a rupture of all the inside tendons and ligaments. It can happen in runners and people who have chronic severe ankle sprains. There is often a bony protuberance around the inside arch where all the pressure ends up going to – ouch! The orthotics can help slow the rate at which the arch continues to drop and can redistribute pressure so that the wound or corn goes away.
- 5) Ingrown toenails
Wait. What? An ingrown toenail and an orthotic? Surely the Podiatrist has lost it?? Keep reading…
When an ingrown toenail occurs repeatedly on the inside nail sulci of the big toe joint in conjunction with a severe bunion deformity then an orthotic is indicated (and it’s very common). The REASON the person is getting the ingrown toenail(s) is from the pressure of the second toe squashing against the big toe joint sulci and BAM it gets irritated and grows the wrong direction. An orthotic not only helps to straighten the toes but it helps to prevent the bunion joint getting worse and therefore the ingrown toenail getting worse. This works quite well with a little custom made interdigital toe wedge known as an ‘ottoform wedge’.
- 6) Bunions
Oh wait…I’ve passed the “5 conditions you didn’t know orthotics are prescribed for”. There’s more…This is one of my favourites so I’m going to write about it anyway.
A bunion is a ‘slow dislocation’ of the big toe joint on the inside of the ball of the foot. We know that this is a progressive deformity meaning IT GETS WORSE OVER TIME. This is inevitable. Often, a bunion is picked up when someone complains about a burning sensation on the balls of their feet or irritation on the tops of one of the patients little toes. The bunion joint itself doesn’t always cause pain. So, how does an orthotic help with bunions? An orthotic supports the arches of the feet and EVENLY DISTRIBUTES pressure across the balls of the feet (transverse arch). Reducing the pressure on the joint means reducing the rate at which the bunion continues to dislocate and progress. I’ve often found that the swelling within the joint reduces and therefore the actual size of the bunion also reduces. The ingrown toenails often go away when the alignment has been correct with an orthotic.
Okay, I feel so much better now that I’ve had my little educational session on feet, orthotics and Podiatrists. Please note that orthotics need to be used in conjunction with appropriate footwear. Exercises are also indicated with most orthotics.
Orthotics are not a terrible thing when prescribed correctly and carefully.
Orthotics are often a ‘conservative’ treatment modality implemented before surgery is considered.
If you have any questions then please don’t hesitate to contact me. I hope I have been able to give you an insight in to more intricate orthotic indication and prescription. If you are a health professional and want more information please don’t hesitate to reach out to me. If you are a patient and want more information then please don’t hesitate to send me an email at laura@thefootstudio.com.au or give me a buzz on 0413 288 698.