Orthotic Prescription

Orthotic Prescription


Foot biomechanics research has evolved since the 1980s and has proved an extremely useful addition to sports science and medicine. Orthotic therapy is a precise science that provides accurate diagnosis and resolution of problems associated with the lower limbs and feet. An orthotic prescription can restore a range of motion and functional efficiency that has been impacted by injury, genetics or other factors.

What is an orthotic device?

The feet are the point of contact with the ground, and are subjected to powerful impact forces that can cause or aggravate injury. An orthotic device is a rigid or semi-rigid insert, often made from polypropylene, that provides comfortable and efficient movement of the foot from heel to toe.

Orthotic prescription versus off-the-shelf shoe inserts

Prescription orthotic devices are extremely durable, long-lasting and manufactured to conform to exact specifications. They provide the maximum benefit for every individual situation. Off-the-shelf devices, on the other hand, are often bulky and soft, providing the benefit of cushioning some impact without addressing underlying foot or posture problems.

Although fairly comfortable, off-the-shelf orthotic devices generally only fit into roomy shoes and aren’t suited to be worn with dress shoes or other tight fitting footwear. This in turn can exacerbate problems with feet, due to the variable forces from wearing a range of footwear, without adequate foot protection. These soft devices, usually made from foam, don’t provide much assistance with forefoot to rearfoot motion or control.

Orthotic prescription examination

There are several important steps a sports podiatrist will take, in order to evaluate the patient’s condition prior to manufacturing an orthotic device.

  • Motion testing
  • Muscle testing
  • Quantifying the performance of lower extremities
  • Identifying abnormalities
  • Identifying limitations
  • Determining weight-bearing and non-weight-bearing functions

A functional orthotic should provide comfort, assist with alignment and help alleviate injury symptoms. The examination and testing will investigate tight or weak muscle groups and biomechanical problems that cause injury. Once the thorough examination is complete, the orthotic prescription is sent to a laboratory for manufacture. Details will include the specific materials to be used along with any additions to the orthotic device as prescribed.

Personalised orthotic prescription

The feet support a huge range of weight-bearing stresses and impacts. Every activity or sport entails specific movements, and there are variations even within individual sports. Orthotic devices are manufactured with this in mind. For example, sports people performing repetitive motions in distance running, may be more suited to a rigid device, whereas stop-start sports people playing tennis or soccer will often benefit more from a flexible, compliant orthotic device.

An orthotic device should help eliminate pain, improve muscle performance, normalise pressure in all areas of the foot, improve motion and timing, and even stimulate accurate perceptive feedback to the brain.

When all is said and done, we are all individuals and will benefit from personalised treatment. A consultation with a podiatrist specialising in sports medicine will educate and inform the patient, regarding the full spectrum of orthotic devices available, along with other treatments that can improve the prevailing condition.