ORTHOTIC THERAPY:
WHAT IT TAKES-WHAT TO LOOK FOR

Are your orthotics working for you? Even when an orthotic initially fits properly, it may cause an immediate negative reaction. This can be perfectly normal. The key is to feel whether that reaction gets worse, stays the same or gets better.
 
Changing the way one walks, usually causes a ripple reaction throughout the lower extremity. Each muscle small and large has muscle memory.
 
Changing the alignment of all the muscles of the lower extremity can effect the entire musculo-skeletal structure in standing and gait; even a small amount can cause a reaction to that muscle memory on a day-to-day basis; after all, each muscle goes through contraction and relaxation hundreds and thousands of times a day (from the day you started walking). It knows what to expect from that movement for that task. Your alignment throughout your early development sets the stage for how your postural complex will age biomechanically.
 
You the patient need to take partial responsibility in determining if your orthotics are working for you. Here’s how:
You would do best to help your orthotic specialist and yourself by keeping a log daily and providing the following information:
 
Here’s the information I ask of my patients.

  1. How many hours worn EACH day?  What happens?
  2. Any level of comfort? (DO NOT relate this just to your symptoms and remember you need to think about each foot)
  3. Did one or both feet get sore (after how many hours?)
  4. Did it hurt?
  5. Which foot was most or least comfortable?

A couple of other things to think about are:

  1. How many hours worn comfortably?
  2. Any soreness, fatigue?
  3. Any new pain?

REMEMBER: Don’t judge the orthotic by your symptoms alone. Your level of pain, may mask the fact that the orthotics are fitting.   Think only of the “fit.”
 
Your orthotic specialist should be able to explain biomechanically what is happening, and make any adjustments if necessary. You can feel if those adjustments are working or not.
 
Because of the newer fluid technology orthotics (such as the Silicone Dynamic Orthotic—SDO) available it is easier to determine if L/R side is more or less comfortable than the other because they act more like “cushions” than a “traditional” orthotic. And by adding or reducing fluid you can soften or harden those cushions. To make it “fit”.

In addition L&R orthotics are interchangeable as they each match the way the foot walks, In this way you have a variety of “fits” of the orthotics for you to sample.
 
By doing this, the specialist and you can evaluate if the fit is on track to being best. Determining this most often takes 1-4 weeks..
 
THE FIT:

  1. The arch should feel the support, up to comfortably snug.
  2. It “must” be comfortable to wear (not in the sense of relieving your symptoms)
  3. You “must” feel stable on your feet when you are on the ground. not unsteady or shifted over to one side.

Then it’s just a matter of being able to wear them comfortably enough to be worn all day and even around the house. It still can take awhile to be able to wear a proper fitting orthotic all day, because of muscle memory reacting to the changes in the way they remember. This is part of your healing pain to be distinguished from an improperly fit orthotic.
 
When you understand what you should be expecting out of your orthotics after any corrections are made and if they helped or not, you can make better decisions concerning if your orthotics are working the way they should.