Buying a foot orthosis is no easy matter. Should you buy an orthotic in a shop? Orshould you consult a podiatrist and opt for a custom-made model? To find out, we spoke to podiatrist Dr Alexandre Morel. His detailed explanations outline the major differences between custom-made orthotics and those bought in a shop.
What’s the biggest difference between a custom-made orthotic and one bought in a shop?
Firstly, there is the degree of conformity with the patient’s foot. A made-to-measure orthotic is made from a mould of the foot obtained when the foot is in a position deemed adequate by the treating podiatrist. It offers more personalised control based on the patient’s needs. The prefabricated orthotic, on the other hand, has a ‘standard’ shape, without moulding or custom adaptation. It is sold with the promise of being suitable for all types of feet, which is a bit utopian. In some cases, it may be suitable, but only for feet with no major problems.
Can an orthotic prescribed by a podiatrist treat all podiatric conditions?
Yes, as long as the conditions treated are associated with poor foot posture and not caused by a specific external trauma. Let’s take the example of a patient who has a bad fall. He subsequently develops heel pain, which develops into plantar fasciitis or ‘Lenoir’s thorn’. Given the traumatic nature of the injury, it would be advisable to opt for anti-inflammatory therapy in conjunction with temporary partial immobilisation of the foot. For example, a cortisone infiltration could be performed if necessary, in addition to a bandage to support the plantar arch. The injury would then be reassessed, and custom-made foot orthoses could be a good long-term option if the injury persists.
Is a custom-made foot orthotic best suited to correct a podiatric condition or to relieve its symptoms?
This depends mainly on the patient’s age. In the case of children, we often have the opportunity to treat and correct.
In the case of adults, treatment is more geared towards relieving and stabilising poor biomechanical foot posture. But we cannot talk about definitive correction. For example, if I see a young patient with a major postural problem with their foot (they walk inwards or have a flat foot), I’m often lucky enough to be able to correct the growth of their foot by rectifying its axis. However, if an adult patient comes to see me, I will mainly be able to relieve their symptoms, but I will not be able to correct their foot. Even if I manage to stabilise the posture, the effect will not be permanent. Once the orthoses have been removed, the axis of the foot will slowly but surely return to its original position, attracting the same pain as before.
Can an in-store orthotic offer the same level of comfort as a custom-made model?
Unfortunately, this is rarely the case, especially if the patient suffers from a major problem. As the prefabricated orthotic often does not fit the patient’s foot exactly, it can create pressure points and cause additional pain. A custom-made orthotic, on the other hand, can offer both a good level of comfort and a treatment dimension for the patient.
Under what conditions is it not advisable to choose a prefabricated orthosis?
If the patient is suffering from an acute or severe podiatric condition, I strongly advise against starting treatment with orthotics bought in a shop. If the condition requires adequate stabilisation of the feet, custom-made foot orthotics will offer a much greater degree of control than prefabricated orthotics or insoles. This will enable the patient to get back on his or her feet more quickly, while preventing as far as possible any recurrence of the initial pain.