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At Podiatry Affiliates, we offer a wide variety of services in regard to shoes and shoe modifications including custom orthotics, prefabricated shoe inserts and pads, personalized shoe modifications, and diabetic shoes with custom molded inlays. All of these devices are used in conditions to align the foot, which improves strength and function in conditions like flatfeet or high arched feet. They also reduce pain in conditions resulting from abnormal biomechanics such as heel pain or tendonitis, to alleviate painful pressure points due to bunions or hammertoes or to protect the foot affected by diabetes, arthritis, or poor circulation.
What is a Custom Orthotic?
A Custom orthotic is a shell or support made out of various materials which, when placed in the shoe, supports the foot and maintains normal foot function. It usually extends from the heel to just behind the ball of the foot. Custom orthotics should not be confused with prefabricated “arch supports”. A custom orthotic is made specifically for your foot. When you are seen by one of our podiatrists he may suggest a custom orthotic based upon your problem. This includes a biomechanical evaluation of your lower extremities and a plaster cast mold taken of your feet. Based on your evaluation the doctor will write a prescription detailing the choice of materials (rigid or flexible), the proper biomechanical alignment or tilt of the orthotic, any cushions or modifications and take into consideration the patient’s complaint, occupation, sport, and preferred shoe. The mold is sent with the prescription to an orthotic laboratory and the finished product is shipped back and fitted to your foot in the office.
Do I Wear My Orthotic All the Time?
You should wear your orthotics as much as possible to treat your condition. When you first receive them there may be a break-in period where the joints and muscles will function in new positions. When patients first receive the orthotics they are asked to wear them a few hours a day and work up gradually to a full day.
Can I Use Orthotics in All My Shoes?
Ideally, orthotics fit best in a closed in shoe. This includes dress shoes, athletic shoes, hiking shoes, work boots, ski boots, golf shoes, or walking shoes. You may have some difficulty fitting them in loafers and high heels. There are specific, slim orthotics for high heeled shoes. If you are casted in the office for a standard orthotic, a pair of slim orthotics can be made from the same mold. Orthotics will not work in sandals, flip flops or clogs. If the heel is allowed to rise off the orthotic in gait the effect of the device is negated.
What Materials Are Used in the Orthotic?
Some orthotics are made from soft materials like semi rigid air cell foams or leather and cork (used for runners or diabetics). These have more give but require more room in the shoe than rigid orthotics.
Rigid orthotics are made from hard plastic that comes in different thicknesses (to vary the stiffness) or graphite (high rigidity yet light and thin).
Orthotics can be covered with leather, vinyl or durable foam rubber that can cover just the orthotic itself or extend full length to the toes.
Are Orthotics Covered By My Insurance Plan?
Coverage depends on the specific benefits in your insurance plan. Some insurance companies require prior authorization. Many insurance companies do not cover custom foot orthotics and the patient would be responsible for the cost.
This can be determined before fabrication of the devices.
What Are Prefabricated Shoe Inserts?
Prefabricated inserts are stock arch supports that can be used as replacement insoles for your shoes. They are not personalized. They are an inexpensive option for mild foot problems.
What Are Shoe Modifications?
In situations where a custom device is not feasible or useful we can alter the patient’s shoe itself. We can place pads directly in the shoe to lift the arch, raise the heel or reduce pressure off of bony prominences. We can pad the tongue for patients with bone enlargements on the top of the foot, or narrow the heel for patients with large bunions and narrow heels. We can place metatarsal pads in pumps for ball of the foot pain. For modifications such as dropfoot braces, rocker soles or limb length discrepancies we will refer you to a pedorthist( a specialist in orthopedic shoes).
What Are Diabetic Extra Depth Shoes?
Diabetics are at risk of foot infection and amputation due to changes in the foot secondary to diabetic neuropathy. Diabetic neuropathy leads to the foot becoming insensitive to pain and temperature changes. This leads to foot deformities. The deformities and numbness together lead to foot ulcers (wounds in the skin) that may result in bone infections.
Diabetic Extra Depth Shoes are a covered service for diabetics that meet certain medical criteria if they are Medicare Part B beneficiaries. Most HMO Medicare plans also cover this service. We have a wide selection of styles for both men and women on display in our office. They are not custom molded shoes that can be less than aesthetically pleasing. They look like normal shoes, the extra depth shoe is available to fit a custom orthotic into the shoe with plenty of room for the toes and width of the foot. A foam box impression is made of each foot in the office and your foot is carefully measured by our staff. The inlay is molded specifically for your foot based on the impression and foot measurement. This is a custom device with the option of the patient choosing the style and color of shoe they want.
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