Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results using functional orthotics to treat heel pain, arch pain, arthritis, bunions, pain from flatfeet or high arches, knee, hip and back pain. 

Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to custom-made orthotics. Certain types of tendonitis respond well to orthotics and other types require a more invasive treatment. Posterior tibial tendonitis is the tearing and inflammation of the tendon that
helps to hold up the arch. When this tendon is overstressed by arch collapse it cannot heal. Custom made orthotics are essential in the treatment of this condition. 

Individuals with high arches may also require orthotics, but they usually take longer to respond to the treatment. Custom made orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not “cure” the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended to control this motion, therefore continued use is recommended.  

A custom made accommodative orthotic is soft and designed to reduce pressure and prevent excess friction. Diabetics can develop numbness and loss of circulation in the feet. This numbness and circulation loss puts them at risk for developing open sores on the feet called ulcerations. To help prevent excess rub and friction in certain areas on the feet, accommodative orthotics are recommended. Diabetics who do not have numbness or circulation loss (as diagnosed by their doctor) do not need to have accommodative orthotics, unless the foot has a deformity, like a bunion or hammertoe, then accommodative orthotics are necessary. However, a diabetic with no foot abnormalities may prevent and protect the feet from unnecessary problems with the use of a good custom made orthotic device. 

Both types of custom-made orthotics are formed by taking a mold of the foot. A functional orthotic mold is best taken using a bio mechanically sound 3 point procedure allowing the foot to determine the maximum amout of support using a non weight bearing method. To obtain an accommodative orthotic mold, the process should be the same only using a weight bearing method to release any heavy pressured support.  An impression of the foot in a standing position is then created.

 A model of the foot is then made form the mold. The orthotic material is usually vaccumm pressed over the foot model and the orthotic is created. The most common material for a semi-rigid custom made orthotic is polypropylene, but other materials, such as graphite are used. A softer material is typically used for custom-made accommodative orthotics.

In both cases of functional and accommodative orthotics, the foot is helped by releasing pressure points that can be a root cause of pain and discomfort. 

All custom orthotics, as mentioned above have the ability to create a custom seat within the shoes for the foot to rest, aiding in comfort and relieving stress on the working foot. 

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