Custom Foot Orthotics

“Encyclopaedia Biomechanica” is published quarterly by Kawartha Total Foot Care Centre. It features helpful information on different aspects of your body’s biomechanics (how your muscles and joints work together to help you move) and gait (how you walk), the kinds of problems that can occur, and how feet affect your whole body from the ground up.

There are a lot of people out there claiming to offer “custom” orthotics. There is that guy who visits the gym with his pressure mat, people at an information booth in the mall, a very professional looking set-up and compelling sales pitch at a trade show, the woman who visits your work place and “does everyone’s insoles,” and the health professionals whose primary focus is not feet but offer “orthotics” as a sideline business to generate additional income.

Unfortunately, orthotics are poorly regulated right now. There is no legal definition of what a custom orthotic is, how it should be made, and anyone can lawfully dispense one. This is not the case for most biomedical devices. Hearing aids, glasses, even compression stockings have tighter restrictions than orthotics.

Who should you choose as your orthotics provider?

Orthotics may be poorly regulated, but Chiropodists / Podiatrists have a regulatory body; the College of Chiropodists of Ontario. This regulatory body has defined what a true custom orthotic is, how it must be made, and what examinations are done to determine the design of the device. Members of the College of Chiropodists of Ontario are the ONLY regulated health professionals whose legal scope of practice includes treatment with orthotic devices.

Our regulations are your protection, and insurance companies have caught on. Most companies have limited their coverage to restrict reimbursements for only true custom orthotics from a member of the College of Chiropodists.

What kind of training is needed to properly provide an orthotic?

Some providers you meet will have been trained briefly by their employer. Others will have taken a “course” as short as an hour — or no course at all! Chiropodists undertake an exhaustive nine semester post-undergraduate podiatric medical program that includes extensive training on biomechanics and orthotics, and how they play a role in treating foot pain, corns and calluses, sports injuries, arthritis changes, and progressive deformities like bunions and hammer toes. We don’t just learn how to “cast” for an orthotic, we learn how to design that orthotic to address your individual problem, and we have the overall knowledge of your foot health to ensure optimal results.

How do I know if I have a truly custom orthotic?

A custom orthotic is made using a three dimensional model of your own foot in a special position called suspended subtalar joint neutral. To achieve this, your foot must be cast using a laser imaging unit or plaster (not a foam box) by a practitioner with the requisite knowledge and skills. If there was no three dimensional capture of your arch, your orthotic is not custom. This includes “walk-on” computerized pressure pads, which by virtue of the technology, may seem impressive but provide only a two dimensional image of your foot and use a “library” or standard sizing system to create the closest match to your foot profile.

Why shouldn’t I shop around for the best price?

Orthotics are “Buyer Beware.” Most of the time, you get exactly what you pay for. If your orthotic wasn’t made properly, it will likely not fully address your problem. It might make things a bit better, and it can make things worse. If you are in pain, it may not allow your injury to heal. If it is not properly designed, it may cause injury. Some just don’t last long, break or bottom out quickly. If they can discount the cost, they are likely purchasing a ‘cheaper’ device. If you have diabetes and your provider doesn’t have the comprehensive foot knowledge of your chiropodist / podistrist, it might even cause an ulceration!

Until the orthotics industry is cleaned up and legally restricted to properly qualified practitioners only, consumers will continue to have to research their orthotics providers. In the end, it’s up to you to make the right step. After all, you wouldn’t see a dentist for a problem with your eyes. Your good foot health is tremendously important, and you can rest assured that when you put your feet in the hands of a chiropodist you’re seeing a skilled, highly trained, and legally regulated foot specialist. Your good foot health is our “sole” interest.