Different types of orthotics prescribed by the NDG podiatry clinic

Prescription Orthotics

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A custom foot orthotic is a medical device inserted in a shoe. It is designed to change the amplitude and duration of the forces working on the sole of the foot to allow the lower limbs to function normally. During a weight-bearing activity, the foot orthosis reduces pathological forces by addressing structural anomalies. By realigning forces to work efficiently, it corrects irregular biomechanics. Commonly used with diabetic patients to prevent pressure points and foot ulcers, custom foot orthotics can be also used in sports, young feet correction, pains, injuries, everyday walking and exercises. Since there is a wide variety of foot orthotics, the podiatrist will determine if the treatment and the diagnosis of the foot condition requires a custom foot orthotics prescription. We do provide prescriptions for orthotics and shoes for different labs. Orthotics are commonly made by orthotist / prosthetist and with more accurate prescription, the patient benefits for a more accurate treatment. An adaptation period is usually expected for 4-6 weeks, and ajustements to orthotics and/or shoes are sometimes part of the treatment. Orthotics lifespan can be between one year to over five years, depending on the prescription, level of correction, patient health condition, weight and changes in usage.

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Foot Orthotics Prescriptions

Functional Corrective Foot Orthotics

Depending on the diagnosis, the podiatrist may prescribe a functional orthotic designed to change the way the joints of the foot and lower limb function during walking. Commonly covered, padded and sometimes full length, that can be adjusted in length and width for most of shoes, depending on the treatment and patient’s medical condition.

Accommodative Foot Orthotics

The accommodative foot orthotic are commonly used for diabetics, older patients or with specific medical conditions requiring very soft, gentle and padded correction. Used to relieve the pressure – in terms of magnitude and duration – from a painful or injured area on the bottom of the foot. These insoles facilitate walking because they are less rigid and more comfortable. Orthopedic shors are commonly prescribed and used with accommodative foot orthotics.

Dynamic Foot Orthotics

We offer dynamic orthotics with 3D moulding of the foot. They can be as versatile and as thin as possible to fit most shoes, if the patient's condition allows it. The patient can therefore transfer their dynamic custom orthotic from one shoe to another without having to buy new shoes in most of cases. Delicate orthotics can be made for specific sports, high heel shoes and fitting can be done by sending the specific shoes to the lab during the fabrication process to ensure the perfect fitting.

Advanced Imaging Technology

CryoVizion is an imaging system that helps the patients and the podiatrist visualize and explain the posture with highly detailed images of the body.

Being able to explain the shape of the feet, positioning of ankles, knees and general posture, helps to understand the mechanical aspects that could be related to a foot condition or current pain. It is useful to compare in time the progression of the foot shape and the the alignment of the feet and ankles. In addition to being scientifically proven, the results lead to an accurate diagnosis that supports the best possible treatment. For over 20 years, this technology has allowed us to better understand and objectively assess the progress of treatment. A copy of the images can be useful for future referrals to other healthcare professionals, by helping to explain quicker the visual aspects of the foot and ankle shape and positioning.

CRYOSCAN 3D (since May 2021)

With high level of accuracy and resolution, the CryoScan 3D has the accuracy of 0.5mm, which means that it can precisely create a 3-dimensional image of the foot.

The podiatrist is able to place the foot against a silicone membrane that is adjusted with air pressure. The 3D scan enables the capture of numerous foot shapes from the flattest to highest arches with confidence. The 3D resolution is high enough to properly reproduce that level of accuracy and to assure a quick view of the result is available after a scan is captured. It offers to the podiatrist and the patient the visual experience and helps the patient to understand the customization and the prescription of the custom foot orthotics.

This process allows a quicker ordering of custom foot orthotics, since the orthotist in the lab can start the production quicker by combining the 3D and 2D molds combined with the prescription made by the podiatrist. The visualisation of the custom foot orthotics in 3D can be shared between the lab and the podiatrist during the fabrication process to better understand the possible modifications of the prescription and help the final design.

The Steps in Foot Orthotics

Complete Podiatric Evaluation

Before prescribing foot orthotics, the podiatrist will perform a medical examination, including a case history, a review of major and minor complaints, and an anatomical palpation. If necessary, additional tests will be done, including radiography, ultrasound, magnetic resonance, or referral to a specialist. At the end of the process, the podiatrist compiles the information, makes a diagnosis, and determines whether a foot orthotic is advised. Only a doctor or a podiatrist can diagnose and prescribe foot orthotics.

Comprehensive Biomechanical Evaluation

The examination assesses the biomechanical posture, body alignment, range of motion of the joints, and patient’s gait. This comprehensive review includes more than 70 different tests and observations of the lower limbs. It will help determine the prescription of foot orthotics.

Importance of Foot Molding

The custom mould of the foot is important. It is designed in several different ways depending on the desired treatment and the controlled positioning of the foot. This step is essential in obtaining an effective foot orthotic.

Since May 2021, NDG Podiatry Clinic added the 3D foot scanning and moulding technology as a greener and more environmentally friendly option by reducing the shipping and material used for ordering and prescribing custom foot orthotics. Our new orthotics are now partially made form recycled plastic. We always use the last technology and newest options to our patients with higher precision for each prescription. The custom foot orthotics for each patient are customized by combining 3D scan, 2D images and prescription provided. 



Who Can Prescribe Foot Orthotics?

Only physicians and podiatrists are authorized to prescribe orthotics. These professionals have the necessary training to carry out a diagnosis and treatment, according to the Podiatry Act. You are therefore strongly advised not to consult a professional who is not certified.

What Are the Advantages of Consulting a Podiatrist?

A podiatrist has extensive knowledge of human anatomy, allowing him to understand how certain limitations may impact a person’s gait. His patients benefit from a detailed diagnosis that results in the appropriate treatment. In addition, patients are protected by the College of Podiatrists, because his treatment is governed by the Code of Ethics of Podiatrists.

Who Can Benefit from Orthotics?

All age groups can have foot orthotics to correct biomechanics and posture, if a podiatrist determines that they are necessary. Beginning at age three and up to age seven, children can wear orthotics to permanently correct the shape of the foot.