The comments contained in this Forum post are my own, they may be somewhat controversial, and do not necessarily reflect the view or positions of KevinRoot Medical. In the past two posts I discussed “Back to Basic” orthotics as well as accommodative type orthotics. Now, I would like to take it one step further and discuss pre-fabricated or off the shelf generic foot supports.
It has always been a bone to pick with me that anything that can be stuck inside of a shoe for the purpose of correcting alignment or relieving symptoms and may be called “orthotic” or “orthosis’ or “orthotic device”. My belief is these terms should be reserved for devices that are prescribed or manufactured based on the needs of the particular individual for whom they are being provided. Terms such as insert, insole, support, arch support, sock liner, foot pad are all appropriate when describing a device that is generic, and whose attributes are based on limited parameters such as size, gender, activity, and self-determined diagnosis. A quick survey of the internet and social media reveals dubious claims such as “the only orthotic clinically proven to reduce foot pain” and “podiatrist recommended” and “lasts forever”. May the buyer beware.
Is there a place for prefabricated foot supports? Absolutely! I would encourage lower extremity clinicians familiarize themselves with at least a few of the seemingly endless variety of foot inserts available to the public, even going so far as to purchase several and give them a road test yourself. There are many instances when it might be preferable to try a relatively inexpensive OTC device before, or in lieu of, a custom foot orthotic. Patients often have financial limitations for which the expense of a custom orthotic is cost prohibitive, a rapidly growing child, for whom a device will be outgrown in a matter of months, a second pair for limited use, or a patient with a very mild biomechanical issue which may be alleviated with a simple fix.
A good practice would be to have a stock of two or three types of higher quality OTC inserts on hand in the clinic for dispensing as needed. Have familiarity with the supplier, and make sure they stand behind their products. I preferred working with companies that also supported my profession. Most patients appreciate the extra service and can be assured that they are receiving an effective supportive device that is recommended by their provider, and not misled by a random internet company. Many patients may eventually decide to have custom orthotic devices made at a later date.
