What are Custom Orthotics?

What are Custom Orthotics?

What Are Custom Orthotics?

Definition:
Custom orthotics are prescription medical devices designed to support, align, prevent, or correct deformities or improve the function of the foot.

Types:

  • Rigid: Made from firm materials for structural correction.

  • Semi-rigid: Combines support with flexibility.

  • Soft: Cushioned, for pressure relief and shock absorption.

2.  Indications for Custom Orthotics

Common Conditions:

  • Plantar fasciitis

  • Flat feet (pes planus)

  • Overpronation or supination

  • Achilles tendinopathy

  • Patellofemoral pain syndrome

  • SI joint dysfunction

  • Diabetic foot ulcers

  • Leg length discrepancy

Red flags for referral:

  • Chronic pain not improving with rehab

  • Significant biomechanical abnormalities

  • Recurrent stress injuries

3. Biomechanical Assessment

What to assess:

  • Static posture (standing)

  • Dynamic gait (walking/running)

  • Footwear analysis

  • Range of motion (ankle, subtalar joint, 1st MTP)

  • Muscle strength (intrinsics, posterior tibialis, etc.)

Tools:

  • Gait observation

  • Pressure plate / foot scanner

  • Functional tests (e.g., single leg balance, squat)

4. Understanding Orthotic Design

Components:

  • Shell (main body)

  • Posting (forefoot/rearfoot angles)

  • Topcover (comfort layer)

  • Extensions or lifts

Materials Matter:

  • EVA: lightweight, shock absorbing

  • Polypropylene: durable, rigid

  • Foam/cork: cushioning and moldability

5. 🤝 Physio-Podiatry-Orthotist Collaboration

  • When to refer (e.g., diagnostic uncertainty, complex cases)

  • What information to provide (diagnosis, goals, activity level)

  • How to interpret reports and recommendations

6. 🧩 Orthotics in Rehab

  • Introduce orthotics gradually (break-in schedule)

  • Combine with:

    • Foot intrinsic strengthening

    • Manual therapy and joint mobilization

    • Neuromuscular re-education

    • Gait retraining

  • Reassess after 4–6 weeks

7. 📊 Evaluating Outcomes

Patient feedback:

  • Pain reduction (VAS, NPRS)

  • Comfort and function in ADLs and sport

Objective measures:

  • Gait changes (stride length, foot placement)

  • Functional improvements (6MWT, SLS, hop tests)

8. Addressing Common Myths

  • “Orthotics weaken the feet” – Only if used without a strengthening plan.

  • “They work instantly” – Most require a 2–4 week adaptation period.

  • “One pair fits all” – Customisation is key for long-term results.

If you would like to speak to our friendly team about referring a client or to book an appointment, contact us on (02) 8710 4183 for more information.