Saanich Physiotherapy Blog

Would you benefit from Orthotics?- Here is what the research tells us.

Would you benefit from Orthotics?- Here is what the research tells us.


Custom molded Orthotic devices like these are frequently used to treat various conditions of the foot and ankle. They are

often very effective in relieving common lower extremity complaints.

Orthotic devices may be recommended for several reasons, including:

•aligning and supporting the foot or ankle

•preventing, correcting or accommodating foot deformities

•improving the overall function of the foot or ankle


Heel Insert

For example, a wedge inserted into the inner (medial) side of the sole of a shoe can be used to help support a flatfoot,thus reducing the risk of tendinitis.

An ankle-foot brace can help relieve the pain of rheumatoid arthritis in the heel or ankle.

A heel flare can be used to increase support and help prevent ankle sprains. Heel cushions can help absorb impact and relieve stress on the heel and ankle when you walk or run.

The type of orthosis recommended will depend on your symptoms, the underlying cause for those symptoms, and the shape of your feet. In some cases, your physio prescribe an insert or pad; in other cases, modifications to your shoes may be necessary.


Custom versus off the shelf Orthotics


Although custom orthoses are considerably more expensive than off-the-shelf devices, they last much longer and provide moresupport or correction. In some cases, however, an over-the-counter device can be just as effective, particularly when combined with a stretching and exercise program. In the past, plaster molds of the foot were used to construct the custom-made orthosis. The casting method remains the most research based way to produce orthotics.


The info below shows which orthotic devices are commonly recommended for various foot conditions. Consult your physiotherapist before buying or using an orthotic device on your own; if you select the wrong type of device, you could change the mechanics of your gait and cause problems instead of curing them.


Diagnosis Recommended Orthotic Device


Bunions and/or bunionettes:

Shoes with a wide toe box; soft, seamless uppers, stretchy shoes; “bunion shield” type pad


Corns and calluses:

If located on or between the toes, a toe separator may be helpful.

Cavus foot: (rigid high arch)

Soft orthotic cushions to distribute pressures evenly


Flatfoot (adult):

No device needed if there are no symptoms or pain. If there is pain or aching, a semirigid insert or long arch pad, inner heel wedge or extended heel counter may help.


Flatfoot (child):

No special orthotic device or shoe treatment is indicated. Most infants have flatfeet, and 97 percent will grow out of it.


Stiff big toe :(hallux rigidus)

Full-length prefabricated stiff insert, Morton extension inlay, or rocker bottom sole Hammer toe or claw toe Shoes with a wide or deep toe box to accommodate the deformity; toe crest

Forefoot pain (metatarsalgia):

Wide shoes, pads or bars under the bones of the forefoot (metatarsals)

Limb length deformity:

Custom-made full-contact orthosis


Morton neuroma:

Shoes with a wide toe box, metatarsal pad positioned over the neuroma

Neuropathic ulceration: (such as with diabetes)

Full-contact cushioned orthosis, extra-deep or custom shoes, rocker bottom sole to reduce pressure on foot


Plantar fasciitis (heel pain or heel spur):

Prefabricated heel insert made of silicone, rubber or felt

Runner’s painful knee:

Full-length, soft, prefabricated sport orthotic inlay to reduce stress and turning inward of the foot.



Information Sourced from the American Academy of Orthopedic Surgeons.

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