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Shoe inserts and custom prescription orthotics

Shoe inserts are any kind of non-prescription foot support designed to be worn inside a shoe. Pre-packaged arch supports are shoe inserts. Unless the device has been prescribed by a doctor and crafted for your specific foot, it is a shoe insert, not a custom orthotic device.

Shoe inserts can be very helpful for a variety of foot ailments, such as flat arches and foot and leg pain. They can cushion your feet, provide comfort, and support your arches; they can counteract and correct biomechanical foot problems or cure long-standing foot issues.

The most common types of shoe inserts are:

  • Arch supports: some people have high arches while others have low arches or flat feet. Arch supports can have a “bumped up” appearance designed to support your foot's natural arch.
  • Insoles: insoles slip into our shoes to provide extra cushioning and supports. Insoles are often made of gel foam or plastic.
  • Foot cushions: Do your shoes rub against your toes or your heels? Foot cushions come in many different shapes and sizes and provide a barrier between your foot and the shoe.
  • Heel liners: Heel liners, sometimes called heel pads or heel cups, provide extra cushion in the heel region. They are especially useful for patients who have foot pain caused by age-related thinning of the heel's natural fat pad.

Choosing an over the counter shoe insert

Selecting a shoe insert from the wide variety of devices on the market can be overwhelming. Here are some tips to help you find the one that best fits your needs:

  • Consider your health, do you have diabetes or problems with circulation. Diabetes and poor circulation increase your chance of foot ulcers and infections so schedule an appointment with your podiatrist. They can help you find a solution that won’t cause any other problems.
  • Think about the purpose, are you planning to run a marathon or do you just need a little extra arch support in your work shoes?
  • Look for a product that fits your planned level of activity.
  • Bring your shoes. For an insert to be effective it has to fit in your shoes. So bring your sneakers, dress shoes, or work boots – whatever you plan to wear with your inserts. Look for an insert that will fit the contours of your shoes.
  • If at all possible, slip the insert into your shoe and try it out. Walk around a little. How does it feel? Don’t assume the feelings of pressure will go away with continued wear.

What are prescription orthotics?

Custom orthotics are specially made devices designed to support and comfort your feet. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet, ankles, and leg. The orthotic is made to accommodate your unique foot structure and problems.

Prescription orthotics are divided into two categories:

  • Functional orthotics are designed to control abnormal motion. They can be used to treat foot pain caused by abnormal motion. They can also be used to treat injuries such as shin splints and tendonitis. Functional orthotics are usually created from a semi-rigid material such as plastic or graphite.
  • Accommodating orthotics are softer and are meant to provide additional cushioning and support. They can be used to treat diabetic foot ulcers, calluses on the bottom of the foot, and other painful conditions.

Podiatrists use orthotics to treat conditions such as plantar fasciitis, bursitis, tendonitis, diabetic foot ulcers, and foot, ankle and heel pain. Clinical research studies have shown that podiatrist-prescribed orthotics decreased foot ulcers and improve function.

Orthotics typically cost more than shoe inserts, but the addition cost is usually worth it. Unlike shoe inserts, orthotics are molded to fit each individual foot, so that you can be sure the orthotics fit and do what they are supposed to do. Prescription orthotics are also made of higher-quality material and meant to last for many years when cared for properly. Insurance often helps pay for prescription orthotics.

If you are simply looking for more cushioning or extra support, you may wish to try an over-the-counter shoe insert first. If you have serious pain or discomfort, schedule and appointment with your podiatrist. Today’s podiatrists are specifically trained to evaluate the biomechanics of the lower extremity.

Your podiatrist will examine your feet and how you walk. He or she will listen carefully to your complaints and concerns, and assess the moving function of your lower extremities.

The information gathered during the examine will help your podiatrist determine if shoe inserts may be helpful or if you need prescription orthotics. If orthotics are needed, your podiatrist will capture a three-dimensional image of your foot. These images, as well as any measurements obtained, are used to create a set of unique foot supports that will provide your foot movement and allow you to function more normally. 

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