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Our knowledge of biomechanics has taught us that, by establishing the optimal functional position of the feet and lower extremities, the entire skeletal complex is permitted to function in an optimally efficient fashion. If there is a biomechanical fault, the body compensates, or adjusts, by either rolling the foot into excessive pronation or supination. When that occurs, abnormal forces are created in the foot and leg, causing potential problems. These problems may include shin splints, plantar fasciitis (heel spur syndrome), metatarsalgia, interdigital neuromas, Achilles tendinitis, posterior tibial dysfunction and/or patellofemoral pain.
Medications, exercise and/or rest often do not resolve the primary symptoms, and custom foot orthotics may be required to treat the underlying cause of the problem. Maintaining a subtalar neutral position of the foot with custom orthotics is often the best long-term solution to these problems. An over-the-counter type of arch support simply makes the arch weightbearing, which is neither desirable nor well tolerated, and may cause other compensatory problems. A custom orthotic specifically “raises the ground” to the rear or forefoot to provide improved neutral positioning and alleviation of symptoms.
Many times patients receive temporary orthotic management to not only provide immediate treatment, but to evaluate the potential effectiveness of long-term orthotic management. If custom orthotics are indicated, the therapist makes a neutral position plaster cast of the foot to “capture” the deformity. These casts are sent to a laboratory where the permanent orthotics are fabricated based on the cast and specific instructions from the therapist/physician.