Orthoses and Pedorthics

What is Orthosis

An orthosis (or orthotic) is an apparatus that supports, aligns, prevents, protects or corrects deformities, or improves function for a section of the body. Most orthoses, like a back or knee brace, "wrap” or cradle the body area they're intended to help. A foot orthosis, however, is unique. While its goal – improvement – is what every orthosis aims for, a foot or a foot-and-ankle orthosis can't be "worn” like other orthoses. A foot or foot-and-ankle orthosis can only achieve its goal when working in conjunction with the appropriate shoe.

Pedorthics (peh-DOR-thiks) is the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. Without a proper shoe, a foot orthotic can't do its job. With an appropriate shoe and orthosis, the foot can get the treatment the doctor prescribes.

What Does a Foot Orthosis Look Like?

Appearance depends on the job the orthosis is expected to perform. The orthosis can be short or long, thin or thick, made of one material or make of several materials combined. It can be rigid, semi-rigid or flexible, and it can come in a variety of colors.

Why Does a Foot Orthosis Depend on the Shoe?

The shoe holds the orthosis in the proper place on the foot. Shoes play a major role in maximizing or minimizing the value of an orthosis. Because an orthosis takes up room that would otherwise be available for the foot, not all shoe types are suitable for an orthosis. Many of today's shoes are manufactured with a removable inlay, which is the "bed” on which the foot rests. When the inlay is removed, there is typically sufficient room to replace it with an orthosis.

Types of Orthoses

A foot or foot-and-ankle orthosis works to compensate for factors that lessen the foot's ability to function normally. Because it performs inside the shoe, the orthosis is invisible to everyone except the wearer. There are basically two types of foot orthoses: pre-fabricated devices, and custom-fabricated ones.

Pre-fabricated orthotic products are mass-produced and easily available in pharmacies, supermarkets, shoe and athletic stores, as retain items or by prescription. Custom-fabricated devices, which are created for an individual, most frequently address health issues, and are prescribed by a healthcare provider to help deal with one or more specific conditions.

Custom-fabricated foot orthosis or foot-and-ankle orthosis is intended to fit a particular foot, for a particular purpose. Custom foot orthoses and foot-and-ankle orthoses come in two categories: customized, which means mass-produced with features that will adapt to one person, and custom-made, which means created especially for one person and made from a cast of that person's foot. Both kinds work properly only for that one person.

When is a Footwear Prescription Needed?

People often begin to wear pre-fabricated orthotics for comfort reasons. Generally, a prescription is not needed to relieve minor aches or pains. When a medical condition – such as injury, arthritis, diabetes, or poor circulation – is present in the foot, a pedorthic prescription is in order. Any health care provider qualified to prescribe can write a pedorthic prescription.

Where do People Take Pedorthic Prescriptions?

The credentialed pedorthist is the member of the health care team who focuses on footwear as a therapeutic device. Credentialed pedorthists concentrate on how footwear – which includes shoes, orthoses and other devices – can prevent further damage, relieve pressures, redistribute weight and accommodate or correct medical conditions. Working from a doctor's prescription, the credentialed pedorthist can made or modify shoes, fabricate an appropriate foot orthosis and fit the devices to the patient in a way that allows footwear to achieve the doctor's desired result.

To accomplish its prescribed goal, a foot orthosis must partner with a shoe. Maintenance of both the shoe and the orthosis is important. The credentialed pedorthist can monitor each component's continuing effectiveness, and alert both patient and doctor when a need for change approaches.

Is Orthotic Lifespan Important?

Orthotic materials are chosen based on the individual's level of activity, age, physical condition and foot structure. Because those factors will change, so will the person's orthotic needs.
Durability of materials is a consideration in orthosis fabrication, because the orthotic must remain strong enough to do its job. However, the "lifespan” of an orthosis should be measured not by when it "wears out” but by how long it meets the foot's changing needs. A softer protective orthosis will not last as long – by design – as a rigid or semi-rigid corrective device.

Appropriateness is far more important. Selecting materials which have both the required strength and the necessary sensitivity to the patient demands knowledge and experience.

Patients may be eligible through health insurance for partial or full reimbursement for footwear prescribed to accommodate or alleviate medical conditions.
This page contains generalized information. Use of specific words within this generalized framework is not intended either to reflect or to contradict technical pedorthic definitions. Nothing in this brochure should be interpreted as a substitute for professional consultation.

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