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Orthotics and Heel Pain

The plantar fascia is a flat broad ligament that acts as a strut, orginating at the base of the heel and extending across the bottom of the foot to attach at the bases of the toe joints. It is narrower at the heel and widens as it goes forward.

The plantar fascia is very strong in terms of tensile strength (pulling strength) but is prone to damage when twisted either excessively or repetitively, AKA torsional strain. Too much pronation (inward rolling) of the foot or too much supination (outward rolling) is what can cause such twisting of the fascia. That is a bit of an oversimplification because when the back of the foot rolls in, the front of the foot rolls out in response.

Orthotics are devices which change the mechanics or function of the foot. There is not a rule or strict definition of an orthotic so vendors can apply the label “orthotic” to almost anything one can place in a shoe, from insoles to arch supports.

There are three broad categories of foot orthotics, prefabricated or OTC orthotics, customized orthotics and custom orthotics.

1) Prefabricated or OTC orthotics: Inserts that are mass produced and sold by shoe size. They primarily act as arch supports and can be helpful in reducing overpronation. Some of our favorite brands are Powerstep, Superfeet, Sole and Redithotics. The cost of prefabricated orthotics ranges from about $15 to $50 and can be found at retail outlets and occasionally at medical provider's offices. There are some types of prefabricated orthotics being marketed as “custom” at retail outlets for substantially higher prices so “buyer beware.”

2) Customized orthotics: These are prefabricated orthotics that have been molded, modified or changed by a healthcare professional to make them work better. 

3) Custom orthotics: This refers to orthotics that are provided by a healthcare professional, often a podiatrist. The podiatrist first performs a biomechanical exam of the feet and legs to determine the optimal prescription, then, takes a mold of the foot while holding it in a semi-corrected position. Keep in mind that such a mold cannot be made by having the patient standing because the foot will tend to go to the position that is causing problems.

For a more detailed explanation of foot orthotics visit our website: http://www.footorthotics.pro



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