What is a Foot Orthotic?

A foot orthotic is a functional shoe insert designed to control the user's gait. In other words, it is an appliance that moves with your foot. Because of its design, the orthotic aids your body in balance and function. You move easily and there is less stress on body parts which may hurt from poor alignment. You may have inherited the form and lineup of your bones or you may have acquired the structure as the result of injury.

The foot orthotic is usually made from a plastic material, but it can also be made from leather. Your podiatrist will take measurements of your legs and feet from the hip down since they work together to allow you to move. He will record to what degree each part functions. This is called a postural examination.
Then, the doctor or a podiatric medical assistant will make plaster of Paris cast impressions of your feet. These foot castings are often referred to as slipper casts because they slide off your foot after the plaster covered casting tape hardens. The cast is filled with plaster at the orthotics laboratory and the doctor's measurements are marked on the mold so that they can be incorporated into the orthotic appliance.

As you can see, the foot orthotic is a custom-made device. Since we want to help you in the best way possible, the laboratory technicians take care to ensure they translate the doctor's orders correctly. In fact, it requires 23 steps to make an orthotic device for the foot. The technician checks the width and length of your foot as shown on the mold. The heel seat is a fixed depth, but other contours may vary. While the finished product duplicates the original measurements, there are times when adjustments may be required to the orthotic because you may not walk, jog or stand in exactly the same way for which your body is designed.

You may note that foot orthotic devices are shorter and narrower than conventional foot devices. They do not have high inside or outside edges. This is because they are not arch supports! Remember, they are designed to move with your foot. An arch support is just that: it props up the arch of your foot and may or may not address the foot structure or biomechanical problem you are experiencing.

Close inspection of your orthotic will show you that the front edge may appear short, but ends just behind the weight bearing surface of the metatarsals - the long bones in the middle of the foot.

The orthotic's width is geared to be narrower than the foot by as much as one-half to three-quarters of an inch on the sides. This narrower, shorter contour eliminates binding of the orthotic against the shoe and permits greater functional control.

When your foot orthotics are dispensed, the doctor or medical assistant will show you how they should fit in your sports or dress shoes.

After you have had a chance to wear your orthotics for a few weeks, we will schedule an appointment for you to give us an update on your progress.

Wearing Instructions:

If you have not been wearing temporaries, do not expect to be comfortable wearing your orthotic devices the first time. Like eyeglasses, you may be aware of them, but as time passes they will not be uncomfortable and you will enjoy wearing them.

Please follow these instructions exactly. There is no rush. We cannot reverse in a few months what has taken years to acquire.

1. Wear your orthotic devices for not more than 1 hour the first day, not more than 2 hours the second day, three hours the 3rd day, and so on. You may wear them as little as 15 minutes.

2. If at any time the orthotic device becomes frankly uncomfortable before the maximum time for that particular day, stop wearing them.

3. On the next day, do not increase wearing time.

4. Subsequently, increase wearing time by 15 to 30 minutes only if comfortable.

5. In about two to three weeks you will probably be wearing your orthotic devices comfortably for about eight hours or more. We will schedule a checkup appointment at this time.

6. Some patients occasionally report mild aches or discomfort in other parts of the body such as knees, hips or back after three to four hours of consecutive wear. If this is the case with you, do not extend your wearing time. Instead, cut it back by an hour or two. In all likelihood, these symptoms will disappear as your entire body posture realigns itself and functions more efficiently.

7. It is possible that your orthotic devices may require some small change or adjustment to improve their function or make them more comfortable. This is usually not done before two to six weeks have elapsed.

8. In women's shoes, it is not unusual for the heel to slip off, particularly if they are step-in shoes. If this is the case, try other shoes or other styles. In most cases, this slipping reduces or disappears as your foot function improves.

9. Squeaking of orthotic devices in shoes is due to the normal movement of the devices. To eliminate squeaking, simply dust baby powder into your shoes before inserting the devices.

10. It is important that you follow these instructions implicitly. Failure to do so will prolong the adjustment period or create problems which are easily avoided. It makes no difference if you are wearing your orthotic devices for only a few hours after several months, so long as you are wearing them comfortably for those few hours.

Please note:
If you have been wearing temporary orthotics, you have already gone through the breaking-in period, so it may not be necessary to follow the wearing instructions unless you experience discomfort. Please be aware that the orthotic may not fit in all of your shoe gear, therefore, take time to look for the right shoe that would give you the full benefit of this device.

Fees and Insurance:

Some insurance providers offer partial or complete coverage on orthotic devices. Those who do will often require that a letter of medical necessity be submitted with the bill. We submit a letter of medical necessity with all of our orthotic claims. Unfortunately, most insurance providers do not offer coverage for orthotics. In some instances, they will state they are covered, but then do not pay because you, the patient, do not fit their specific medical criteria, or they fall under a separate deductible policy.

For this reason, to cover our essential costs, we collect minimal amounts from you, the patient, at the time certain services are provided in the orthotic process.

At the time of foot casting (L4396) we will collect $120.00. The normal fee for this service is higher and a higher amount will be billed to your insurance provider. Once your orthotic devices (L3030) are ready to be picked up, we will collect $260.00. At that time we will check to see if any payment or response has been received by our office from your insurance provider. Again, the amount billed to your insurance is considerably higher. We are only collecting a bare minimum amount from you.

If payment in full is received in our office from your insurance for the orthotics, and no deductible is assigned to you, the patient, by your insurance provider, we will send you a refund in an amount not to exceed what you have paid out of pocket. This would be a maximum refund of $380.00.

If you are confident your insurance provider will cover your orthotics, you may pay the $120.00 fee at the time of casting and then wait until payment is received in our office before you pick up your completed orthotic devices. In any case, please feel free to contact our office regarding any questions you may have.