Sports Medicine: The Facts about Orthotics

Alameda sports medicine Podiatry

Alameda runner sports medicine

Sports enthusiasts since the early 1970’s have been turning to the little plastic devices that have helped revolutionize the field of sports medicine. The functional foot orthotic (as it is technically known) emerged during those early years as an alternative method of treating sports injuries without surgery. The elite athletes and sports figures of the day were frustrated with the orthopedic community’s inability to adequately treat the introduction of lower extremity injuries and other problems they had experienced. After introduction of the functional foot orthotic, injuries and pain seemingly remotely connected to the foot were being successfully treated by sports podiatrists.  Fourty years later, most respected experts have embraced the modern orthotic.  In retrospect, the birth of the functional foot orthotic marked one of the first facets in the preventative medicine movement once marginalized and now mainstream.

What are Functional Foot Orthoses?

The Greek word “ortho” means straight, upright and correct. The modem foot orthotic is a readily transferable, custom device made for the foot which insures that the body moves correctly through the various phases of walking, running and other sports. Orthotics perform this feat by gently but consistently placing the foot in the optimum position each time the foot strikes the ground. By balancing the foot underneath the body, the orthotic effectively changes the manner in which the bones and muscles of the extremity function during gait. The body, now balanced above the root, is in its most efficient position at all times. Visualize the functional orthotic in this way, the orthotic is to your feet as the contact lens is to your eyes. Or another example, imagine how important the foundation is when building a house (we all know about the Tower of Pisa). Orthotics can take various forms and be made from a variety of materials. Generally, the thin, thermoplastic material is formed around a plaster impression of your foot. The foot is held upright and the joints are gently manipulated and “locked” in the neutral and stable position by the podiatrist. These impressions are then sent to the laboratory where the orthotic is molded directly from a plaster or wooden model of your foot. The individual, custom devices are then adjusted and modified by your podiatrist so they can be comfortably worn in your shoes.  The plaster impression of your foot is critical and this is what clearly separates the true, functional foot orthoses from all others. The so-called orthotics/arch supports purchased over-the-counter, diagnosed by a computerized drugstore machines, or made in shoe stores, sports shops and some doctors’ offices are not true, functional orthotics unless they use the plaster suspension technique. Clearly, stepping in foam, sand or on a two-dimensional “computerized” pressure pad will not correct or balance the foot but merely capture the foot “as is.”

How do you know if Functional Foot Orthotics are for you?

How do you know if orthotics are for you? One way of course is upon recommendation from your sports podiatrist or other qualified physician, Another is through self assessment. The over-the-counter or quasi-custom types capture the foot “as is,” however, they may help if your pain is minor and short term. Experience has shown this route to be effective about 35% of the time.  Generally speaking, if you are one of the many people who tend to have structural problems such as flat feet, high arches, bow-legs, knock-knees, arthritis or have deformities, such as bunions, you should consider orthotics even in the absence of pain. Orthotics would also be a consideration if you have a family history of foot problems or a personal history of tendinitis, bursitis, heel/arch problems, repetitive strains and shin splints. Even some knee, hip and low back problems can be helped by these devices. High impact sports activities such as running, basketball, football, soccer, baseball, volleyball, racquetball, tennis, some aerobics, long distance hiking, skiing may also require orthotics in the injury prone athlete. We have not covered orthotics for children, a whole separate article, but suffice it to say that there are indications with one clear advantage – not only can foot function be improved but permanent structural changes can be achieved. Minimalist Running Shoes/barefoot running will also be covered in a future post. If you need guidance with self assessment or have any questions regarding orthotics, please feel free to call our office at 510-521-3410. Good Luck and Happy Trails.  ~ Dr. Jeffrey J Niccoli   Board-Certified, Alameda Family Podiatry Group and Bay Area Sports Medicine Clinic. Serving  Bay Area patients from San Francisco, Oakland, Fremont, and Alameda

Did You Know?  It takes at least 23 individual steps to make a fully custom orthotic. Click the link below to enjoy the video called “The Making Of An Orthotic”


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