Do Orthotics work?

At Footcare Scotland, we specialise in the treatment of foot, ankle and lower limb musculoskeletal injuries.  We use orthotics to help manage a wide variety of painful conditions.

We believe that orthotics should only ever form part of a successful treatment plan.  We also utilise education, rehabilitation, activity modification, injection therapy and footwear modification to ensure that we can get you back to your chosen activity as quickly and safely as possible.

How do orthotics work?

Historically we have been led to believe that orthotics re-align or correct the skeleton, whether that be at the level of the foot or as far up as the hips or back.  Unfortunately, there is no evidence to support the argument that orthotics realign your skeleton.  Their actual action is much more complicated.  There are a few different theories as to how orthoses work.  The theory that I subscribe to is that they alter kinetics.  Simply put, they modify or change the forces and stresses that are placed upon certain tissues, dependant on how they are designed.

What’s the difference between off-the-shelf and custom-made orthotics?

While off the shelf devices, like the ones you buy online have a place, I don’t think that we can compare them to a device that has been specifically prescribed by an experienced practitioner for your particular problem.

When it comes to prescribing foot orthoses, there are lots of things to consider.  The diagnosis, activity levels, footwear, weight, occupation, goals…. Then there are the design variables, of which there are hundreds of combinations.  We consider material choice, stiffness, shell geometry, top cover and additions.  Your Podiatrist should be able to clearly explain your diagnosis, what role orthotics will have in your treatment plan and what they are designed to do for your specific problem.

Custom made orthotics

Custom foot orthoses should be unique to you and your presenting complaint. We work closely with a leading Scottish based orthotics lab and utilise state of the art 3D scanning and 3D printing to produce our custom made devices.  Each pair are carefully designed and manufactured for precision and comfort.  Depending on the materials that are chosen, custom orthotics will normally have a useful lifespan of at least 5 years.

Off the shelf orthotics

We also use lots of different types of off-the-shelf orthoses in clinic.  When using an off the shelf device, the design and materials should be carefully chosen to give the best chance of a positive outcome.  Using off the shelf orthotics doesn't give us the same control over the design of the device and they tend not to have the same lifespan as a custom device.  However, they can be a good option when orthotics are only needed in the short term or when a cheaper option is required.

Do orthotics work?

We often see patients in clinic who have been given foot orthoses that have failed to work for them.  This could be down to many factors.  Maybe orthotic therapy wasn’t the correct intervention or treatment in the first place.  Maybe the patient wasn’t compliant with wearing the orthotics as advised.  Or maybe, orthotic therapy was the appropriate treatment, but the orthotics supplied were not the correct prescription or design. When we are discussing orthotic therapy with our clients, there are many things we consider.  Firstly, we must have a clear working diagnosis of the problem.  Without a clear diagnosis, we cannot begin to consider planning your treatment and we certainly cannot think about prescribing orthotics. With a clear diagnosis, good clinical reasoning and well-designed orthoses, you are likely to have a positive outcome.

We have successfully treated hundreds of patients using orthotics, here are just a few examples: