Orthotics or orthoses are shoe inserts that are intended to adjust an abnormal or irregular walking pattern. Orthoses are not really or just "arch supports," though they are often described that way. They perform functions that make standing, walking, and running more comfortable and efficient, by correcting the angles at which the foot strikes a surface. Doctors of podiatric medicine prescribe the use of orthic devices as a conservative approach to many foot problems and their use is a very successful practical treatment method.

Orthoses take various forms and are constructed of various materials. All types are concerned with improving foot function and minimizing stress forces that could lead to foot deformity and pain. Foot orthoses fall into three broad categories: those that primarily attempt to change foot function, those that are primarily protective in nature, and those that combine functional control with protection. Corresponding to the three types of orthotics are the three general materials that are used in constructing orthotic devices.

Rigid devices are designed to control function and are often made of a thin material such as a plastic or fiberglass. This type is primarily used for walking or in dress shoes. Soft orthotic devices help to absorb shock, increase balance and take pressure off uncomfortable or sore spots on the foot. Usually made of compressible materials this type of device is used to treat arthritic and diabetic foot deformities. Semi-rigid devices provide for dynamic balance of the foot while walking or participating in sports.

Orthotics are a true performance enhancing aid to many athletes. Each sport has its own demand and each sport orthosis needs to be constructed appropriately with the sport and the athlete taken into consideration. The semi-rigid orthotic has become the most commonly prescribed device due to the advances in materials being used and its versatility.

As in life itself orthotic devices are only as good as the environment they exist in. In other words orthoses work best in good supportive shoes — shoes with a closed toe and a low heel. Orthotics are made to work in all types of shoes from women's heels to golf shoes and all those in between. Support for your feet is important all the time even at home when you want to go without shoes which is a common error that leads to further foot pain. Even sandals now come with removable foot beds. If your favorite sandals do not allow the insertion of orthotics at least use a supportive or sport sandal for leisure activity. But if you wear different shoe styles or enjoy a sport that places special demands on your feet, you will need more than one pair of orthotic devices. Shoe fit is also very important in the orthotic process so bring your orthotics when ever you buy shoes to ensure proper fit.

Dr. Ravick is past president of the DC Podiatric Medical Association, a spokesperson for the American Podiatric Medical Association, in private practice at Capital Podiatry Associates since 1980 and often quoted in national and local media.

Founded in 1912, the American Podiatric Medical Association is the nation’s leading professional society for foot and ankle specialists, with membership of over 10,000 doctors of podiatric medicine. Visit APMA or call 1-800-FOOTCARE.