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Ask the Custom Orthotics Expert - Johan Steenwyk

Updated: Jun 3

www.steenwyk.com


June 2020


Prescription Orthotics


What are they?

Prescription foot orthotics are custom made inserts for your shoes designed to address various foot and lower body conditions. The manufacturing and materials used vary based on patient needs, activities and health factors (see Types of Foot Orthotics). Orthotics are often prescribed to accommodate various “wear and tear” foot conditions such as plantar fasciitis(heel spurs), metatarsalgia and soft tissue degeneration. Foot orthotics can also assist in the care of lower body conditions like back pain, diabetic ulcers and knee problems.


It is important to remember, foot orthotics are one aspect of a treatment program and do not replace other forms of therapy. We urge you to follow all recommendations from your other health professionals. To determine the most appropriate type of orthotic for you, please contact our office for an appointment.


What should I look for?

Proper footwear is the most important partner for foot orthotics. Orthotics need a strong, stable supportive base; avoid poorly constructed, non-supportive footwear. We recommend to purchase footwear from a salesperson who is experienced in fitting orthotic users.


How does an orthotic help?

An orthotic is a custom made device that controls the amount of excessive pronation and supination that a foot goes through when walking, running or cycling. All people naturally pronate and supinate but excessive movement either way can be problematic. Pronation control shoes or shoes with stabilizing features help to control wearing of the shoe while orthotics help to control the stabilizing and mechanics of the body.


May 2020


Craftmanship you can count on Steenwyk Custom Shoes & Orthotics specializes in manufacturing custom made footwear to address the specific needs of individuals with structural foot deformities and special mechanics deficiencies. Our primary focus is on specialty orthopedic footwear to accommodate bony, structural deformities of the feet and lower leg due to congenital deformities and system conditions (i.e. severe arthritis, diabetic Charcot feet). Comfortable footwear demands detailed attention to fit. Research has shown that if footwear does not fit properly, it doesn’t matter how good the materials and components are, the shoes will not be comfortable. Steenwyk’s Customized shoes provides an exciting new alternative; to give consumers ideal fit in a premium quality shoe - at an affordable price. Terms you might encounter Custom Made – a device that is manufactured from raw materials. In the case of a custom foot orthotic or custom made footwear, the term custom made can only be used when a three dimensional image of the foot is used to capture bony alignment and shape, and the device is manufactured from raw materials. Custom Molded (non-casted) – a device molded directly to the foot from raw materials that are warmed until soft. This device can be further modified and used to provide cushioning, pressure relief, redistribute load and accommodate deformity (a self-molded product is not considered custom molded). Customized – a pre-fabricated/over-the-counter device that has been modified by the addition or deletion of material in order to modify movement or accommodate pain or dysfunction. Pedorthic Assessment – the assessment of lower limb bony alignment, movement pattern, general function of the foot, and the interaction of the foot with the rest of the body. Typically a Pedorthic Assessment includes a history taking, bony palpation, range of motion testing, gait analysis, and footwear consultation.

April 2020

My knees are bothering me. Will orthotics help? Knee pain often shows up for one of three reasons: Instability of the feet and ankles. Instability can cause excessive rotation and motion through joints, up the legs and even into the lower back. These people gain the most from orthotics and footwear. By stabilizing the feet and legs, the joint pain is reduced quickly. Improper Footwear. Just because shoes are expensive does not mean they are good shoes for you. Shoes should be selected based on foot structure, fit and activity choice. Get a footwear professional to assist in fitting your shoes. Misalignment of feet/ankles. Not everyone is built the same. High arches, low arches, extra/ limited range of motion in your legs can cause secondary stress to joints and muscles. Even though you can’t change the way you are genetically programmed, proper orthotics and footwear can reduce damage. If you feel orthotics would benefit you, consult your medical doctor, then book an appointment with the professional’s in foot comfort. Who is qualified to deliver proper orthotic care? A good starting point is to provide the practitioner with a prescription from your family physician. The practitioner should perform a complete and thorough assessment. This includes range of motion testing, biomechanical and gait assessment, footwear and footprint analysis. Along with your footprint, it is critical that the practitioner obtain an accurate 3-dimensional plaster cast impression of your feet in order to properly design and manufacture your custom orthotics. Once the orthotics are fitted into your footwear, the practitioner should have the on-site facilities to make immediate and future adjustments. Check with your extended health insurance company for a list of recognized providers who are certified through a professional college and meet all insurance criteria.




March 2020


My feet hurt all the time – will custom shoes help me?

Custom made footwear is traditionally reserved for individuals who are physically unable to get their foot into a retail or orthopedic shoe due to a structural (bony) deformity. These people would not be able to wear shoes if we did not build a shoe around their foot.


While foot pain can be debilitating and finding comfortable shoes may be a challenge, custom made footwear is not necessarily the answer. There are many features and high tech materials designed to reduce foot pain, that can not be built into a custom made shoe. Although the term “orthopedic footwear” is enough to make most people shudder, they are no longer the bulky, ugly shoeboxes of the past. The newest styles in orthopedic footwear mean you no longer have to sacrifice fashion for comfort.


If you have a specific fit concern or lingering foot pain, talk to a professional trained in foot care and footwear to determine the source of the problem. They are the most knowledgeable about the latest features, styles and material which would be most suitable to address your foot problems.



Can orthotics help my back?

Orthotics can be a very effective part of a treatment plan for back pain. Force transferred from the feet up the legs to the hips can cause a misalignment of the pelvis and spine resulting in back pain.


Orthotics are most effective for individuals who have ankle or arch instability causing pronation or supination. Pronation occurs when the ankles and knees drop to the inside causing a rotation in the legs and hips. Exaggerated pronation looks like kids when they are learning to skate - blades sticking out sideways and their knees banging together. Conversely, supination occurs when the ankles roll outwards causing stress on the outside of the legs and hips. Exaggerated, it looks like a stereo-typical cowboy with bowed legs.


Orthotics reduce the amount of rotation at the ankles and stop the transfer of this rotation to the knees, hips and ultimately, the back. Foot orthotics are not applicable for all people with back pain so if you are unsure if they will help you, consult with your Physician.

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