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In this day of increasing awareness and education regarding our own health, people are seeking alternatives to conventional medical intervention for a multitude of ailments. Foot pain is no exception.

There are numerous problems that affect our feet and many more solutions. The most important factor for treatment is to use the most appropriate treatment plan for each individual case. The use of foot orthotics (also known as inserts or orthoses) may be a part of the treatment plan for some sore feet. However, before jumping into foot orthotics, it is essential to ensure that the mechanics or physical structure is part of the problem.Assessment

When foot pain strikes, the first step in the treatment plan is to consult a medical doctor to have the problem properly diagnosed. The physician will conduct any necessary tests in order to establish the diagnosis, and then a treatment plan can be established. Treatment plans may include: rest, medication, physical therapy, surgery, appropriate footwear and/or foot orthotics. The physician may refer the client for assessment for orthotics.

Once the referral or prescription is obtained from the physician, an appointment with the Certified Orthotist(C.O.) is required for an assessment. During the assessment, the C.O. will first take a detailed history of the client's case including diagnosis, previous treatments, injuries, related surgeries, family history, daily activities and foot wear. Then the C.O. will look carefully at the client's gait (walking pattern) and standing positions. This is followed by an examination of the foot structure. Any abnormalities, boney structure, swelling, deformities and discolourations will be noted. After the assessment, the appropriateness of orthotic use will be discussed. Other factors that may be significant for the individual client will also be discussed including characteristics of proper footwear.

If it is decided to proceed with foot orthotics, there are two routes: over the counter insole or custom made foot orthotics. Over the counter Foot orthoses castinginsoles can be purchased in pharmacies and some shoe stores and may be appropriate in some cases. Custom made orthotics are made to the individual foot, usually from plaster impressions. The foot is casted with Plaster of Paris to produce molds and the molds are taken to the laboratory to use in the manufacturing of the foot orthotics. The foot orthotics are fabricated from a variety of materials, again depending on the individual client. In general, a softer material is used for cushioning and protection such as for a person with rheumatoid arthritis or diabetes mellitus. A firmer material is used for a foot orthotic that will control motion and foot position for pathologies such as plantar fasciitis or tibialis posterior tendonitis.

Once the foot orthotics are made, they need to be fit into the appropriate footwear. The C.O. will make sure that the orthotics fit well into the shoe and is comfortable for the client. The client should walk to allow the C.O. to reanalyze the gait. The foot orthotics may need minor adjustments to improve function and/or comfort. The fitting appointment should be followed-up after two to three weeks with a check-up to assess comfort and determine efficacy of the devices. If there are any ongoing issues or problems the clients should be encouraged to return for adjustments.

Click here to arrange an appointment in our Mississauga or Guelph locations for a free assessment.

The provision of foot orthotics is not controlled or monitored by The Ministry of Health. Since there is a large number of people with foot pain and few regulations, there are many people who provide foot orthotics. However, not all providers are created equal, and therefore it is the patients' responsibility to educate themselves and to take an active role in their own treatment plan.

Ask plenty of questions such as:

Where are the orthotics made and by whom?

Orthotics that are made in a lab across the country often take time to receive. Ask for a provider that uses their own lab or a lab close by. There are many high quality facilities that have patient assessments and manufacturing labs in the same location. Make sure that a qualified technician is manufacturing the devices (eg. Registered Orthotic Technician or R.T.O.(c))

Where are adjustments made and who makes them?

Often after the orthotics are fit into your shoe, minor adjustments may be required to accommodate for your shoe. Your provider should be able to do that in a matter of minutes while you wait.

Are they custom made or prefabricated?

In some cases a ready made orthotic is appropriate and can be fit quickly and less expensively than a custom made orthotic ($50 vs. $500.00). Make sure that if you are paying for a custom made device, you are receiving a custom made device.

How long do orthotics last?

Foot orthotics do not last forever. With normal wear the average orthotic, on the average person will last three to five years. However, with diseases such as Diabetes Mellitus and Rheumatoid Arthritis, changes in the feet and gait may occur which would necessitate more frequent renewal of the orthotics. Also people who are more active, heavier or not careful with the orthotics may need new ones sooner than the average person.

Foot orthoses what should you expect from Custom Orthotic Design Group


I just wanted to let you know - for the first time in months and months - I am able to go for a long, long walk - because my feet are not killing me anymore!!! I am not limping at work any more either!!! Thanks so much - I feel great! Even walking 8 blocks back to the car after the last appointment with them in my shoes - I could have done a tap dance all the way - the change was so drastic!
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When I saw Jim, it was for two appointments for braces he put in my shoes (that he had made recommendations about). I could walk and keep shoes on all day and I was not walking off balance. He was amazing. He took time to talk to me and explain things. My husband had gone to Jim for years for foot orthotics . I would recommend Jim to anyone.
- Ms L.M. -
I am so greatful that the heel lift for my right shoe has been so helpful. I am in less pain when I walk, I can now stand straighter, on both legs at the same time when I stand still. I should have done it a lot sooner!
- Ms. D.T -
I am a person with polio in my left leg. I 've been using Custom Orthotic Design Group Ltd. for many years. Their service is great and friendly, they know what they are doing. I am really happy with their services.
- Mr. K.N. -
Custom Orthotics has always stood behind their product. They have always treated me with kindness and dignity. Whenever there is an issue, they have repaired it right away. Friendliness is their top priority. The product is 10/10. I can't say enough and I find there is never any negative comments. I have been with Custom Orthotics since 1998.
- Mr. F.H. -
The whole process was very positive, Custom Orthotic Design Group answered all of my questions and responded to my concerns in a professional pleasant manner. I highly recommend that anyone requiring any form of custom made orthotic from a simple shoe insert to a sophisticated support such as my CROW walker consider Custom Orthotic Design Group.
- Mr. MB -
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