Off-the-Shelf vs. Custom-Made Foot Orthotics

What Are Foot Orthotics?

Foot orthotics are shoe inserts designed to support the foot and correct imbalances. It helps improve foot posture and treats certain foot and ankle problems. Podiatrists may prescribe foot orthoses for individuals with foot or leg conditions affecting their health and function. Athletes may also use foot orthoses to correct foot issues that affect their performance. Those individuals at increased risk of developing calluses may use foot orthoses, which help redistribute body weight pressure across the feet.

In Which Conditions Are Orthotics Used?

Foot orthotics are beneficial in the following conditions:

• Flat Feet - Arch supports and in-shoe foot orthotics are the primary conservative treatment options for flat feet.

• Bursitis - It is the irritation or inflammation of a bursa (fluid-filled small sac that acts as a cushion between the bones and tendons) that results in pain. Supporting the foot arch and heel with orthosis can relieve pain.

• Neuroma - Morton's Neuroma is characterized by the thickening of tissues around a nerve that leads to the toes. Metatarsal pads can be added to the shoes, or custom shoe inserts can be used.

• Foot Injuries - Orthosis can be used to prevent foot injuries during sports activities.

• Corns and Calluses - When corns and calluses are present, the foot is not aligned properly. As a result, during walking, greater pressure is exerted on certain food regions, which can result in the recurrence of calluses. Using foot orthotics in such cases aligns the foot correctly and prevents recurrence.

• Plantar Fasciitis - It is a condition in which the plantar fascia (tissue that acts as a connection between the heel and toes) is affected. In such cases, an orthotic provides arch support and reduces pain.

• Bunions - Bunions are bony projections in the region of the first toe joint. Orthotics slow the progression of the condition and reduce pain.

What Are the Different Foot Orthotics?

Foot orthotics are mainly of three types -

• Over-the-counter foot orthotics or off-the-shelf foot orthotics.

• Custom-made or prescription orthotics.

• “Kiosk-generated” foot orthotics.

Over-the-counter or off-the-shelf foot orthotics are the ones that are widely available and are chosen based on the condition and shoe size. These range from silicone or rubber heel cups to cork inserts. Some are flat, while others have a medial arch build-up. Some contain fluid-filled sacs or magnets.

“Kiosk-generated” foot orthotics are based on the foot scan. A particular orthotic is recommended based on the foot problem and foot scan. These are useful in lower back pain, heel pain, foot discomfort, etc.

In the case of custom-made or prescription orthotics, the podiatrists consider the patient’s health history, medical history, height, weight, activity level, etc. The best material for the patient and the level of flexibility of the orthosis are determined, and a mold impression of the foot is taken. They are used for personalized correction of biomechanical issues. They provide longer-term symptom relief and a more predictable response.

What Are the Advantages and Disadvantages of Off The Shelf and Custom Made Foot Orthotics?

Comparison of the advantages and disadvantages of Off-the-Shelf and Custom-Made Foot orthotics

The Advantages of Custom-Made Foot Orthotics Are:

• Aids in pain reduction by improving gait and reducing ligament and muscle strain.

• Provides support for the connective tissues and reduces muscle fatigue.

• Provides support to individuals with weight issues.

• Helps increase mobility by reducing the discomfort experienced due to foot issues.

• Support those in strength training, high endurance sports, and active individuals.

• Meets the individual’s unique needs.

The Disadvantages of Custom-made Foot Orthotics Are:

• When considering custom-made orthotics, cost is the most important factor. Custom-made orthotics are expensive. Furthermore, it is not a one-time purchase. As one age, the size of the feet changes, meaning the orthotics should also be changed.

• The delivery time for custom-made orthotics is longer. It may take weeks to fabricate custom-made orthotics, which can be a painful wait for some.

• According to some physicians, custom-made orthotics may sometimes result in harm with prolonged use by providing more support than is necessary and weakening the foot, ankle, and knee.

The Advantages of Off-the-Shelf Orthotics Are:

• Off-the-shelf orthotics are less expensive compared to custom-made ones. Multiple pairs can be bought,

• as these fit more than one shoe type. The cost depends on the material used and the retail markup.

• Over-the-counter orthotics are easily and conveniently available in most stores. Unlike custom orthotics, these are produced in mass and easily available in pharmacies, retail stores, and grocery stores.

• They are found to be successful in correcting minor biomechanical abnormalities.

The Disadvantages of Off-the-Shelf Orthotics Are:

• Does not fit all foot types. But in some cases, it can be trimmed to fit.

• Have a shorter life span when compared to custom-made ones.

• Can also be used for mild to moderate biomechanical issues; more significant issues require other options.

What Are the Steps Involved in Fabricating Custom Made Orthotics?

Compared to off-shelf foot orthotics, the fabrication of custom-made orthotics involves many steps that make it more costly but, at the same time, gives more individualized results.

The different processes involved in the fabrication of custom-made orthoses are:

• Firstly, a biomechanical assessment is done to evaluate the function of the foot and legs and to determine joint movement and flexibility. The podiatrist conducts a detailed examination of the legs, ankle, knee, foot, and type of gait.

• The appropriate orthosis is selected depending on the foot's condition and lifestyle needs.

• The foot impression is made using a cast. These are mostly non-weight-bearing foot molds. With the patient sitting, the foot care specialist wraps the patient’s feet with plaster strips. After the plaster hardens, the strip is removed, leaving behind an accurate impression.

• It can also be made from a three-dimensional foot scan.

• A custom-fitting orthosis is made based on the unique structure of one’s feet.

Conclusion

Though custom-made foot orthotics are mostly considered the gold standard, recent studies suggest that off-shelf and custom-made have almost the same effectiveness. The choice of orthotics for each varies, and as a general rule, off-shelf ones are a temporary, affordable option for short-term foot problems, and custom-made ones are better for long-term support in cases of more complex foot issues. The purchase of such orthotics can greatly enhance one's comfort in daily life.