Orthotics

Different Types of Orthoses

There are two major types of orthoses: custom and prefabricated.

In general, prefabricated orthoses are formed based on a “normal” anatomic model and are usually obtained over the counter. This type of ortho-sis is typically mass manufactured and is therefore cheaper than custom orthotics.

Custom orthoses are typically fit to a specific patient by an allied health professional, such as an orthotist. These are typically formed using a mold and then are made specifically for the patient. In general, these are more expensive and are often favored by athletes.

Orthoses for the feet are the most common class of orthotics. Because of the weight bearing associated with most forms of work and sports, foot orthotics are extremely popular. These range from over-the-counter “shoe inserts” to custom orthotics molded to the foot. Some orthotics are made simply to provide comfort, while others are formed to help with correction of structural abnormalities.

Orthotics are generally either “soft” or “rigid.” Rigid orthotics are formed to maintain the body part (typically the foot) in proper position. An example of this type of orthotic is an ankle-foot orthotic (AFO), which is prescribed for patients who suffer from foot drop as a result of a stroke or other injury to the peroneal nerve. Soft orthotics are used for cushioning and can be used in a variety of medical conditions, such as plantar fasciitis [Page 1008]or diabetes; these are also sometimes called “accommodative” orthotics.

Developments in Orthotics

Over the past two decades, there has been a movement in sports toward helping keep the foot in what is thought to be the most anatomically correct position. Particular attention is paid to maintenance of the arch of the foot, as well as maintaining the foot in a subtalar neutral position (the normal position of the foot when walking) as much as possible. This development has resulted in the formation of semirigid and calibrated orthotic devices. Semirigid orthotics are made of a mixture of soft and rigid materials and are used to correct abnormalities such as flat feet (pes planus) and inward rolling of the foot (overpronation), and these are very popular among athletes. Calibrated orthotics also take into account other factors such as body weight and flexibility to provide greater levels of support.

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