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Custom Made Foot Orthotics

Custom made foot orthotics are specially designed insoles that help support the foot which in turn balances and reduces stress on the other joints in the kinetic chain (knees, hips, pelvis and lumbar spine).

The differences when chiropractors make assessments and diagnoses based on the connections to the whole spine and body, not just the feet.

Short legs, anatomical vs functional.

A common example of where this applies is when deciding when and where to add a heel lift. Often people will say that they were told they have a short leg. But what does that actually mean? Having a short leg, or more accurately a leg length inequality (LLI) can be either an anatomical issue or a functional one. Anatomically our legs should be the same length. This means all the leg bones and joints should be more or less symmetrical. An anatomically short leg may be a result of fractures, unequal hip or knee angles, hip or knee surgeries, congenital malformations or trauma. Our clinical estimation is that only about one in ten leg length differences are of anatomical origin. The vast majority of LLI are due to functional changes, the most common reason being torsion or maladaptive motion of the pelvis and lower back. A fallen foot arch or inverted ankle could also cause one leg to appear shorter than the other while standing. Functional LLI are best assessed first with the patient prone (lying face down) and then on standing postural observation. The scientific literature states that up to a 4 mm difference is acceptable while other references suggest as high as 10 mm to be a normal variant. Our professional experience is that even a 4 mm LLI will show some form of compensation along the kinetic chain.

Once you are properly assessed and it is obvious that there is a LLI, the question then becomes what are the goals of any therapy. Is it to reduce the LLI? Is it to increase function of the involved structures? We are extremely cautious about adding any type of heel lift. Adding a heel lift to a functional short leg is one sure way of encouraging and keeping those pelvic and lumbar torsions and misalignments fixed permanently.

Our office will assess and diagnose the necessity for foot orthotics. We will then measure and cast your feet and then send the molds to a local lab for production of your custom made foot orthotics.

The most common reasons a chiropractor will prescribe foot orthotics:

  • Low back and pelvic misalignments
  • Fallen arches and/or inverted ankles
  • Plantar fasciitis
  • Metatarsalgia
  • Bunions and Hammer toe
  • Arthritis of the foot, ankle, knee or hip joints