The Mystery Behind Orthotics

The use of orthotics has well been documented to be an invaluable treatment tool for many lower extremity conditions. There is, however, a lack of strong evidence-based medicine that supports the use of orthotics for many lower extremity conditions. Part of the reason is that there are many variables including how the shoes influence lower extremity motion that make studying orthotic benefits difficult.
Nonetheless, orthotics are used for many lower extremity conditions and ultimately at times probably overused. For most people under treatment, the shoe and orthotic help modify foot pressure and control abnormal foot motion and should be seen as a short-term tool to assist in recovery.
The analogy of a broken bone is a great example to use regarding the use of an orthotic. Healing from a broken bone requires immobilization. A cast or even a screw or plate can be used to assist in healing. After the broken bone is healed the cast is removed and normal motion and activity are restored. Healing the fracture by immobilization, however, is contrary to soft tissue, muscle and tissue health. The term “if you don’t use it you lose it” applies best to what happens to the soft tissue during recovery. After the cast is removed muscle mass and soft tissue resiliency needs to be re-gained through strengthening and therapy to return to normal function.
The shoe and orthotic fit the fracture analogy in that they stabilize and decrease abnormal stresses in the lower extremity that cause pain. During effective lower extremity treatment, strict use of shoe and orthotic is adhered to for “any” weight bearing activity including just getting up in the middle of the night to use the restroom. The shoe and orthotic act like a cast decrease stress and motion in the soft tissues setting the stage for recovery.
After recovery and soft tissue rehabilitation many patients will not require the use of a shoe and orthotic as a long term tool. Exceptions to this, of course, include people who have had chronic recurrent lower extremity problems as well as chronic lower extremity fatigue and postural complaints as well as significantly poor foot posture as seen in severe flat feet.
Obtaining strong medical guidance is always the key in successful healthcare recovery. Don’t hesitate to ask your provider if she views the orthotic tool a short-term or long-term solution for your specific ailment.