Orthotics

What are orthotics?

Orthotics are devices you wear to relieve pain associated with various foot and ankle conditions. They include everything from shoe inserts and ankle braces to custom devices. Your foot and ankle specialist (podiatrist) may recommend you try an over-the-counter orthotic device if you have mild symptoms related to your condition. If symptoms persist or worsen, they may prescribe a more advanced option, like custom orthotics. Orthotics can help prevent or delay the need for more invasive treatment, like surgery.

Other names for orthotics include:

• Ankle foot orthotics.
• Orthoses.

What foot problems require orthotics?

Your foot and ankle specialist may recommend orthotics for any of the following foot and ankle conditions:

• Bunions (hallux valgus).
• Corns and calluses.
• High arch feet.
• Flat feet.
• Foot tendonitis.
• Forefoot pain (metatarsalgia).
• Hammertoes.
• Morton’s neuroma.
• Plantar fasciitis.
• Patellofemoral pain syndrome (runner’s knee).
• Sprained ankle.
• Stiff big toe (hallux rigidus).

What are signs you need orthotics?

Signs that you may need orthotics include:

• You have foot pain and swelling during and after everyday usual activities, like walking and standing.
• You have sharp heel pain, especially first thing in the morning, which may indicate plantar fasciitis.
• You have flat feet or high arches that cause foot pain or inward rolling of your foot (overpronation).
• You have balance issues or falls due to collapsed arches.
• The wear and tear on your shoes is uneven.
• You’ve had a recent lower leg injury that affects the way you walk (gait abnormalities).
• You have foot complications from diabetes.

What does an orthotic do?

Your foot and ankle specialist may recommend orthotic devices for several reasons. Orthotics:

• Align and support your feet and ankles.
• Prevent and treat foot deformities.
• Improve the overall functioning of your foot and ankle.

For example, you can insert an arch support on the inside of your shoe to help support a flat foot. Supporting flat feet can help prevent foot tendonitis. Or you may use a heel cushion to help absorb the impact and relieve stress when you walk on your heel.

What are the different types of orthotics?

Orthotics range from simple inserts you can buy at your local drugstore to custom-made devices that a podiatrist creates especially for your foot.

• Foot pads: Foot pads are small cushions you place at the bottom of your shoe to make a barrier between your foot and your shoe. They come in many different shapes and sizes, including bunion pads, circle or “doughnut” pads and metatarsal pads.
• Heel liners: Heel liners, or heel inserts, provide extra support by cushioning your heel. Also called heel pads or heel cups, you can use them for age-related thinning of your heels’ natural fat pads. They can also increase the heel height of the shoe to aid in the reduction of pain in the arch, Achilles tendon or plantar fascia.
• Arch supports: Arch supports provide support for your foot’s natural arch. They typically have a “bumped-up” look to them and can help people with flat feet or high arches.
• Insoles: You slip insoles, or shoe inserts, into your shoes to provide extra support and cushioning. They’re made in a variety of materials, including foam, plastic and gel, and create a solid foundation for your feet to stand on. Insoles may be soft or firm and come in different shapes and sizes.
• Ankle braces: You put on ankle braces before you put your foot in a shoe. Providers recommend ankle braces for a variety of foot and ankle conditions, including tendonitis.

Custom orthotics

Custom orthotics are specially made devices that your provider designs to cushion and support your feet. You can get some custom orthotics as full-shoe inserts. Others are available that support just your heels.

Your provider will craft a pair of prescription orthotics that precisely match the contours of your feet. They’ll design them to work with the way your feet and ankles move. To construct your custom orthotics, your provider will either make a plaster mold of your feet, have you step in a foam box that takes an impression of your foot or use a computerized foot analysis to create a 3D image of them.

There are two main kinds of custom orthotics:

• Functional: Functional orthotics are made of a semi-rigid material like graphite, carbon fiber or plastic. They help reduce pain and discomfort by controlling the way your foot moves. You may also use this type of orthotic to treat injuries like shin splints.
• Accommodative: Accommodative orthotics are made of flexible, soft materials. This lets them mold to the shape of your feet and provide support and cushioning. This type of orthotic is helpful for treating health conditions like diabetes-related foot ulcers.

Custom orthotics are more expensive than shoe inserts you can buy at the store. But they last much longer and provide better cushioning and support for your feet.

What are the potential benefits of orthotics?

Foot and ankle specialists use orthotics to help reduce the symptoms that a number of different health conditions can cause. Orthotics can help align and support your feet and ankles. They can also help prevent and treat foot deformities and other conditions involving your feet. Many people say that orthotics help improve the overall functioning of their feet and ankles.

Do orthotics really help flat feet?

Research on the effectiveness of orthotics for the treatment of flat feet in adults shows that there’s a lack of evidence in the available studies. None of the studies that researchers examined showed a clear indication that orthoses work for flat feet. But studies indicate that the use of inserts doesn’t cause any harm either.

How long do I have to wear orthotics?

Orthotics creates a change in the biomechanics of your feet. Your healthcare provider will recommend that you give it some time to allow your feet to adjust to this change. It can take up to one month for your feet to adjust to your orthotics.

Orthotics don’t treat your foot or ankle condition but rather, manage your symptoms. If you find orthotics that work for you, your provider will likely recommend that you use them permanently. If you stop using them, your foot or ankle symptoms may return or get worse.

How long do orthotics last?

Prescription orthotics can last for years, but this varies based on several factors, including:

• Material: The type of material your orthotics are constructed from will affect their durability. If your orthotics are made of a rigid material like plastic, they may last longer.
• Activities: If you participate in high-impact activities like running, your custom orthotics may break down quicker and you may need to replace them more frequently.
• Weight: If you’ve experienced significant weight loss or weight gain, you may need to replace your orthotics sooner rather than later.
• Care: If you properly care for your orthotics, they can last longer. Make sure to clean them often and avoid extreme temperatures (hot or cold).

When should I call my healthcare provider?

If you want some extra support or cushioning for your feet, you may want to try a store-bought shoe insert. These over-the-counter options work well for minor pain and swelling due to mild conditions. Purchase one with a firm arch that doesn’t easily give.

But if you’re experiencing severe pain or discomfort, you should see a foot and ankle specialist. A podiatrist will talk to you about your symptoms and perform a physical exam of your feet and ankles. They’ll diagnose any conditions you may have and prescribe treatment, which may include the use of a custom orthotic.

A note from Cleveland Clinic

Do you have an annoying pain in your foot that’s been bugging you for a while? A store-bought orthotic device may help with your pain and discomfort. But if your pain is severe or nagging, it may be time to see a foot and ankle specialist. A podiatrist can take a look at your foot and see what’s been going on. They may recommend a custom orthotic to help permanently get you back on your feet — literally.