Plantar Warts
Plantar warts are a type of skin infection on the bottom of your feet, caused by the human papillomavirus (HPV). The infection causes rough bumps to form which may be uncomfortable and painful.
Normal standing and walking tends to force them into the skin, and the pressure causes pain to the affected area. Calluses formed by the body’s attempt to prevent spread of warts can also cause pain when walking. Plantar warts are harmless and may go away, but in many cases, they are too painful to ignore. Plantar warts may also grow together in a cluster, known as mosaic warts.
When the warts do not go away on their own and are painful, it’s time to see our Chiropodist. At BeacHealth, we use an incredibly successful treatment application called “Swift”.
Unlike historically ineffective destructive methods of wart removal (freezing, salicylic acid, surgery, laser, etc.) Swift targets the root cause of the wart, the HPV virus. Microwave energy is introduced into the skin, heating cells to between 42°C and 45°C.
This heat initiates an immune cascade which allows the body to detect and attack the HPV virus, eliminating this painful condition from the body.
Treatment protocol includes an average of 3-4 visits with each treatment lasting just 5-10 minutes. There is no need for local anesthetic, site preparation is minimal and there is no need for post-procedural dressings. Patients are typically back on their feet immediately following the procedure and can continue on with their daily life, making this a preferred and efficient treatment.
Visits are spaced four weeks apart to coincide with the body’s immune cycle, with a follow up appointment scheduled at twelve weeks following the final treatment.
Complete resolution depends on the strength of the patient’s immune response so younger people may experience a faster resolution, where the elderly with more recalcitrant warts may sometimes require additional treatment.
SWIFT™ is Health Canada approved. Cost for treatment is based on the use of this advanced technology and the equipment required to administer it.
Our Chiropodist Lada Milos Lee is here to address any of your concerns.
Ingrown Toenails
Ingrown toenails can be painful, making it hard to stand or walk and it can even become infected. Signs of an ingrown toenail are pain, redness, warm to the touch and can feel hard and swollen.
This foot condition develops when the corner of the toenail grows down into the skin and usually affects the big toe. Ingrown toenails often happen when people cut their toenails too short, or too rounded at the corner. The toenail curves with the shape of the toe and can grow into your skin. Other causes can be from improperly fitting shoes, tearing the corner of the nail, toe trauma (such as stubbing your toe) and congenital (your foot shape) when the nail is larger comparatively with your toe causing the surrounding tissue of the nail border to grow around the nail.
Ingrown toenails are common and anyone can get one, but treatment is fairly straightforward. Our Chiropodist can remove it and take steps to prevent it from happening again.
If you have an ingrown or infected toenail, see our Chiropodist Lada Milos Lee for complete care!
Medial Ankle Sprain
Ouch! So, you missed your footing on the stairs and fell. You landed badly, twisting your ankle in a funny direction. It could have been worse of course, but it’s still not great. It’s time to call your Osteopath.
What Is a Medial Ankle Sprain?
When your foot rolled, it stretched or even tore the ligaments holding your ankle together. A medial ankle sprain is an injury to the ligaments on the inside of the ankle. Ligaments, by the way, are tough bands of tissue that connect bones to each other. They help to stabilize joints and prevent them from moving too far out of place. Medial ankle sprains are less common than lateral ankle sprains, which occur on the outside. This is because the deltoid ligament which runs along the inside is particularly strong. Not only does the strength of the deltoid ligament make a roll outward (called an eversion) less likely than an inward roll (called an inversion), but it makes injury less likely. However, if the twist, trip, or direct blow is bad enough, even the deltoid ligament can tear.
Symptoms of a medial ankle sprain may include:
- Pain on the inside of the ankle
- Swelling
- Bruising
- Tenderness
- Difficulty walking or putting weight on the affected foot.
How Do I Treat It?
The treatment for a medial ankle sprain will depend on the severity of the injury. At first, you must apply the RICE protocol: Rest, Ice, Compression, and Elevation. We know you’ve heard it before, but it bears repeating. You must keep your weight off the injured foot for a time – skipping this step or attempting to fast-forward through it could seriously impact your healing. What does Ice mean – it means ice it for twenty minutes every two to three hours (and yes to all the smartie-pants out there – you can have a break while you sleep!) Wrap your ankle in a compression bandage and prop it up above your heart level. RICE is generally considered effective for up to three days, but don’t hang about. Remember to get in and visit your Osteopath early in the injury. We will work with you to promote healing, reduce pain, reclaim your ankle’s range of motion (preventing it from stiffening up as it heals) and strengthen the muscles around the ankle to stabilize and support it. It’s essential that we do this as, left untreated, your injury could lead to chronic pain, instability and recurring injuries.
The good news is that ligaments can heal. They just heal a little slower than muscles. Crucially, they need to bear a little weight to do that and exercise stimulates growth and healing. Your Osteopath will be able to prescribe the right exercises for you along with performing manual manipulations to make those exercises more possible.
Every injury is different, but your exercise regime will likely include stretches and strength training for the leg muscles, ankle mobility exercises, and progressive balance exercises.
Getting Back to Normal
The bad news is that a history of ankle sprains is one of the greatest predictors of future ankle sprains. The good news is that your Osteopath can advise you on ways to make that less likely – from exercises for strength, balance and proprioception to advice on strapping your ankle and footwear. Our Osteopaths are here to help!
Lateral Ankle Sprain
How many of us have rolled our ankle and damaged a ligament at some point in our life?! The answer is many of us. Approximately 2 million ankle ‘sprains’ (the word used to describe a ligament that has been over-stretched or torn) occur in the US every year alone, which gives you an idea of how many happen worldwide! Whilst many of these sprains occur in the sporting world, there are surprising amounts that occur in the general population. This shows us that we don’t have to be an elite sportsperson to be at risk of rolling our ankles. It’s an injury that can literally happen to any one of us… Picture Joe Bloggs walking down the street and slipping unexpectedly off the curb. Ouch!
What is a ligament sprain?
Let’s start at the beginning… Ligaments hold bone to bone. Two bones held together become a joint. Ligaments are responsible for providing a joint with stability (along with the muscles and tendons surrounding it), ensuring the bones of a joint do not move away from each other and dislocate. Ligaments are thick, strong bands of tissue that can withstand the majority of the large forces that run through our bodies when we move. Sometimes the force placed upon a ligament is too great for it to withstand, and this is when damage (or a sprain) occurs. Ligament sprains are generally categorized into the following grades:
- Grade 1: A mild sprain with only damage seen at a microscopic level and no joint instability.
- Grade 2: A moderate sprain where some, but not all, of the ligament fibres are torn. There may be very mild joint instability (or none) associated with this grade.
- Grade 3: A severe sprain where all of the ligament fibres are torn leaving the joint unstable.
Why is a sprain of the outside of the ankle so common?
The outside (or lateral aspect) of the ankle joint is one of the most commonly sprained regions of the body. The two leg bones (the tibia and fibula) run down the leg from the knee and slot in with the ankle bone, or ‘talus’ (pronounced ‘tay-luss’). The fibula bone runs down the outside of the leg and the tibia runs down the middle/inside of the leg. The very ends of these bones are enlarged lumps (known as malleoli… ‘mal-ee-oh-lie’). You can feel these lumps either side of the ankle. Where the malleoli meet the talus is where the outside (lateral) and inside (medial) ligaments are found. The medial ligaments are much stronger than the lateral ligaments which result in the lateral ligaments being injured more commonly. A simple roll of the ankle can cause an over-stretching or tearing of the ligaments here, depending on the force being placed on the ankle as it rolls outwards. In a normal healthy ankle, the ability to roll the ankle outwards is greater than that of rolling inwards… Another reason why lateral ankle sprains tend to occur more often.
Risk factors
One of the biggest risk factors for a lateral ankle sprain is having a history of ankle sprains. If you have done it previously, you are more likely to sprain it again! Other risk factors include:
- Being hyper-mobile or having excessive range of motion at the ankle joint due to naturally looser ligaments.
- Playing sports where turning, twisting and pivoting at high speed are a large part of the game (i.e. netball, basketball, football (any form), and racket sports)
- Being taller and heavier in weight
- Having wider feet
Signs and symptoms
Sometimes when you roll your ankle, the force placed on the ligament is not great enough to damage it. In these instances, you may experience no symptoms at all. For instances where the force is great enough to damage the ligament, you can expect to experience any or all of the following (depending on the severity of the injury):
- Pain (possibly preceded by an audible click or pop) over and around the affected ligament
- Swelling
- Bruising
- Limping on the affected side when walking
- Reduced movement of the affected ankle
- Instability of the ankle joint (i.e. excessive movement) if severe enough
After a severe injury you may not be able to walk immediately. The more severe the sprain, the more likely other structures in and around the ankle may be affected, including the possibility of fracture and/or dislocation (if the force is great enough).
Treatment
Most cases of lateral ankle sprains that enter our clinic are mild to moderate in nature. More severe injuries are often dealt with initially at an emergency department (i.e. if it has been necessary to rule out a fracture/dislocation), but may present to our clinic for ongoing management once the acute injury has begun to heal.
The first goal of treatment for lateral ankle sprains is to regain a normal walking pattern, whilst reducing the risk of further injury. This is likely to mean zero participation in your chosen sport to begin with, especially if pivoting and turning play a large part. We will work on reducing pain by massaging the muscles of the leg and foot. We may also need to work on muscles higher up the body, such as your back, glutes, hamstring and quad muscles. Any stiffened joints will be mobilized gently to restore range of motion. Any swelling can be dealt with using drainage techniques of the lower limb.
When normal walking has resumed, you can progressively load the ankle by adding in strengthening, balance, and more multi-directional agility exercises. The end goal for a sportsperson is to return to training followed by full match play. A non-sportsperson will look to return to their normal daily life without pain or dysfunction. A mild to moderate ankle sprain will take approximately 6-8 weeks to heal. More severe injuries can take months.
If you have sprained your ankle and need some help, look no further than your trusty osteopath. Call us today on (416) 546-4887 or book online to book your appointment and begin treatment immediately.
References
1. Mackenzie, MH. et al. 2019. Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training. 54 (6). 603-610. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602402/pdf/i1062-6050-54-6-603.pdf
2. Physiopedia. 2021. Ligament sprains. [Online]. Available from: https://www.physio-pedia.com/Ligament_Sprain. [Accessed 08 March 2021]
3. Beynnon, BD. et al. 2002. Predictive Factors for Lateral Ankle Sprains: A Literature Review. Journal of Athletic Training. 37 (4). 376-380. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164368/pdf/attr_37_04_0376.pdf
Lateral Ankle Sprain
How many of us have rolled our ankle and damaged a ligament at some point in our life?! The answer is many of us. Many sprains occur in the sporting world, but there are surprising amounts that occur in the general population. This shows us that we don’t have to be an elite sportsperson to be at risk of rolling our ankles. It’s an injury that can literally happen to any one of us… Picture Joe Bloggs walking down the street and slipping unexpectedly off the curb. Ouch!
What is a ligament sprain?
Let’s start at the beginning… Ligaments hold bone to bone. Two bones held together become a joint. Ligaments are responsible for providing a joint with stability (along with the muscles and tendons surrounding it), ensuring the bones of a joint do not move away from each other and dislocate. Ligaments are thick, strong bands of tissue that can withstand the majority of the large forces that run through our bodies when we move. Sometimes the force placed upon a ligament is too great for it to withstand, and this is when damage (or a sprain) occurs. Ligament sprains are generally categorised into the following grades:
- Grade 1: A mild sprain with only damage seen at a microscopic level and no joint instability.
- Grade 2: A moderate sprain where some, but not all, of the ligament fibres are torn. There may be very mild joint instability (or none) associated with this grade.
- Grade 3: A severe sprain where all of the ligament fibres are torn leaving the joint unstable.
Why is a sprain of the outside of the ankle so common?
The outside (or lateral aspect) of the ankle joint is one of the most commonly sprained regions of the body. The two leg bones (the tibia and fibula) run down the leg from the knee and slot in with the ankle bone, or ‘talus’ (pronounced ‘tay-luss’). The fibula bone runs down the outside of the leg and the tibia runs down the middle/inside of the leg. The very ends of these bones are enlarged lumps (known as malleoli… ‘mal-ee-oh-lie’). You can feel these lumps either side of the ankle. Where the malleoli meet the talus is where the outside (lateral) and inside (medial) ligaments are found. The medial ligaments are much stronger than the lateral ligaments which result in the lateral ligaments being injured more commonly. A simple roll of the ankle can cause an over-stretching or tearing of the ligaments here, depending on the force being placed on the ankle as it rolls outwards. In a normal healthy ankle, the ability to roll the ankle outwards is greater than that of rolling inwards… Another reason why lateral ankle sprains tend to occur more often.
Risk factors
One of the biggest risk factors for a lateral ankle sprain is having a history of ankle sprains. If you have done it previously, you are more likely to sprain it again! Other risk factors include:
- Being hyper-mobile or having excessive range of motion at the ankle joint due to naturally looser ligaments.
- Playing sports where turning, twisting and pivoting at high speed are a large part of the game (i.e. netball, basketball, football (any form), and racket sports)
- Being taller and heavier in weight
- Having wider feet
Signs and symptoms
Sometimes when you roll your ankle, the force placed on the ligament is not great enough to damage it. In these instances, you may experience no symptoms at all. For instances where the force is great enough to damage the ligament, you can expect to experience any or all of the following (depending on the severity of the injury):
- Pain (possibly preceded by an audible click or pop) over and around the affected ligament
- Swelling
- Bruising
- Limping on the affected side when walking
- Reduced movement of the affected ankle
- Instability of the ankle joint (i.e. excessive movement) if severe enough
After a severe injury you may not be able to walk immediately. The more severe the sprain, the more likely other structures in and around the ankle may be affected, including the possibility of fracture and/or dislocation (if the force is great enough).
Treatment
Most cases of lateral ankle sprains that enter our clinic are mild to moderate in nature. More severe injuries are often dealt with initially at an emergency department (i.e. if it has been necessary to rule out a fracture/dislocation), but may present to our clinic for ongoing management once the acute injury has begun to heal.
The first goal of treatment for lateral ankle sprains is to regain a normal walking pattern, whilst reducing the risk of further injury. This is likely to mean zero participation in your chosen sport to begin with, especially if pivoting and turning play a large part. We will work on reducing pain by massaging the muscles of the leg and foot. We may also need to work on muscles higher up the body, such as your back, glutes, hamstring and quad muscles. Any stiffened joints will be mobilized gently to restore range of motion. Any swelling can be dealt with using drainage techniques of the lower limb.
When normal walking has resumed, you can progressively load the ankle by adding in strengthening, balance, and more multi-directional agility exercises. The end goal for a sportsperson is to return to training followed by full match play. A non-sportsperson will look to return to their normal daily life without pain or dysfunction. A mild to moderate ankle sprain will take approximately 6-8 weeks to heal. More severe injuries can take months.
If you have sprained your ankle and need some help, look no further, our team can help you get back and running. Our osteopaths can help with treatment and rehab, whilst our chiropodist can help out with alignment corrections and shoe recommendations. Call us today on (416) 546-4887 or book online at beachealth.janeapp.com to book your appointment and begin treatment immediately.
References
1. Mackenzie, MH. et al. 2019. Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training. 54 (6). 603-610. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602402/pdf/i1062-6050-54-6-603.pdf
2. Physiopedia. 2021. Ligament sprains. [Online]. Available from: https://www.physio-pedia.com/Ligament_Sprain. [Accessed 08 March 2021]
3. Beynnon, BD. et al. 2002. Predictive Factors for Lateral Ankle Sprains: A Literature Review. Journal of Athletic Training. 37 (4). 376-380. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164368/pdf/attr_37_04_0376.pdf
Compression Stockings
Our foot specialist, Lada Milos Lee is proud to offer Ofa Bamberg line of compression therapy. Compression therapy is achieved using gradient compression, which has the greatest pressure at the base, and reduces pressure as the compression garment goes up the leg. This helps encourage the movement of fluids, including blood circulation and the lymph fluid circulation. The gentle pressure helps blood vessels and lymph vessels absorb fluids more easily, providing relief for tissues. This helps to relieve pain by reducing swelling and preventing accumulation of fluid buildup. Venous disorders are very common and it is estimated that 20% of men and 30% of women suffer from some form of venous disorder.
- Do you suffer from tired, aching legs at the end of your day?
- Do you suffer from spider or varicose veins?
- Do you travel long distances frequently?
- Do you sit or stand for prolonged periods of time?
- Are you pregnant?
- Do you struggle with some excess weight?
If you answers “YES” to any of these questions, compression stockings may be helpful in alleviating pain, reducing swelling and preventing chronic venous disorders.
Prevention of Varicose Veins
When the valves of the veins are damaged or do not function properly, blood pools and the increased volume causes pressure within the wall of the veins. This can then cause veins to bulge and distend. Over time, the veins loose their ability to bounce back, causing “spider” veins ( in the small superficial veins), and “varicose” veins ( in the larger veins). Compression therapy is effective in preventing the veins from becoming damaged and noticeable.
Sports
Studies have shown that wearing compression stockings during exercise helps reduce muscle soreness.
Travel
Long-distance travel wether by car, train or airplane, can be associated with the leg discomfort and increased risk of DVT (deep vein thrombosis). Lack of leg movement due to prolonged sitting and cramped spaces gives way to swelling of the feet and legs. The swelling contributes to leg fatigue, discomfit, and a heavy sensation in the leg. Studies have shown that a traveler not wearing a graduated compression stockings is 12.5 times more likely to develop DVT.
Wearing gradient compression stockings appeared to be effective in reducing the risk of DVT and prevent overall swelling during frequent or long travel.
Pregnancy
As the baby grows, the enlarged uterus applies pressure on the vena cava, which returns blood to the heart. The pressure can cause stasis and valve damage, which results in swelling, leg discomfort, and even varicose veins. On average 23% of pregnant women will have venous disorders as early as their first pregnancy, and this number rises to 31 % by their fourth pregnancy. Compression hosiery helps to relieve leg fatigue and discomfort by helping to prevent the superficial veins from becoming distended with blood. It also helps to reduce pressure in the tissue underneath the skin.
Are You Covered?
Compression stockings with a pressure of 20-30, or 30-40 mmHg are covered by most insurance plans on an annual basis. A physician prescription is required.
Consultation 
A 20-min initial consultation is required. The appointment should be scheduled at the beginning of the day to ensure the best measurements. Styles and materials will also be discussed to determine the best product for your needs.
Plantar Fasciitis
It’s morning, and the alarm clock has just told you it’s time to get out of bed. Another few minutes won’t hurt. You check your emails, social media sites, and you even ring your mom to see how the dog slept last night… basically anything to delay putting your feet on the ground and taking those first steps to get the day started. And it’s because of this pain you’ve been getting on the bottom of your heel every morning for the last few weeks. And it’s getting worse… Time to see your osteopath!
There are a few things that can cause pain on the bottom of the heel, but the most common cause is a condition named plantar fasciitis (also known as plantar fasciopathy).
What is plantar fasciitis?
Plantar fasciitis is an overuse condition affecting the plantar fascia. The plantar fascia is a layer of soft tissue that stretches along the bottom of the foot, from the heel bone to the metatarsal bones in the front of the foot. It helps to provide stability to the arch of the foot and is similar in make-up to a tendon (the things that attach muscle to bone). If too much stress is placed on this structure, over time the tissue can degenerate, weaken, and start to give you pain. The pain is commonly felt where the plantar fascia attaches into the heel bone.
Risk factors
Scientific research suggests there are a few groups of people who are more prone to developing plantar fasciitis. These include:
- Runners
- People who are over-weight and lead a sedentary lifestyle and/or spend long periods standing for work (e.g. a factory worker)
Important things to consider with these at-risk groups include:
- Foot alignment and arch height: Having a very low or high arch or having excessive or not enough movement in the foot joints can lead to the development of this problem.
- Amount of training: Increased levels of training can place greater stress on the plantar fascia more regularly.
- Footwear: Wearing certain types of footwear when training can lead to an increased risk of plantar fasciitis (i.e. wearing athletics spikes, or the wrong footwear for your foot type).
- Muscle strength and flexibility: Decreased strength in the muscles that control toe movement, as well as weakened and tight calf, hamstring and gluteal muscles are all associated with higher rates of plantar fasciitis.
Signs and symptoms
The signs and symptoms of plantar fasciitis include:
- Pain at the bottom of the heel
- Pain that appears as a gradual onset
- Pain felt first thing in the morning (i.e. taking those first steps out of bed in the morning is classic!)
- Pain that decreases with activity, but increases again afterwards (early stages)
- Pain that increases with activity and pain felt at night (latter stages)
- Pain felt after periods of prolonged rest during the day (i.e. being sat at your desk for 2-3 hours and then getting up again)
- Tight calf, hamstring and gluteal muscles
- Weak muscles that help to support the arch of the foot
- Stiff or over-flexible foot and ankle joints
Diagnosis and treatment
First things first, if you have heel pain that sounds similar to the picture we have painted above, make an appointment with us now (you know what to do call us on (416) 546-4887). Once we have asked the relevant questions, performed the necessary tests, and are convinced that the issue stems from the plantar fascia, we will formulate a plan with you with short and long-term goals to reach within a set time.
Initial hands-on treatment will include a combination of massage, joint mobilisation and manipulation, and dry needling of the lower limb muscles with the aim of correcting any mechanical issues that are playing a role in this issue. Depending on the presentation, we may also use tape around the foot and ankle to provide support and reduce the stress being placed on the tissues. Other treatment will include advice on weight loss (if required), training regimen, footwear, and exercise prescription that helps to lengthen and strengthen tight and weak muscles. Some cases of plantar fasciitis may require a foot orthotic or in-sole to provide extra support to the foot whilst wearing shoes. This would be best recommended and assessed by our Chiropodist (foot specialist) at Beachealth.
Plantar fasciitis is a tricky condition to treat which may require ongoing treatment for several months. We will endeavour to get you pain-free in the shortest time possible, so we recommend following all advice to a T, which may include a reduction in the amount of training you are doing at present. When you start to hit goals and we see improvements being made, we’ll have you back up to your full training program before you can say “plantar fasciitis”.
Imaging?
People regularly ask if they need imaging for such an issue, but the majority of cases of plantar fasciitis can be diagnosed with a thorough case history and physical assessment. This is where we excel! Imaging is there for cases that do not respond to treatment and for those instances where we need to rule out a more serious problem.
If you need help with heel pain, please call us today on (416) 546-4887 to book your appointment. Let’s have you putting your best foot forward, ASAP! 👌
References
1. Thompson, JV. et al. 2014. Diagnosis and management of plantar fasciitis. Journal of American Osteopathic Association. 114 (12). Available from: https://jaoa.org/aoa/content_public/journal/jaoa/933660/900.pdf
2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
3. Harvard Health Publishing. 2007. Easing the pain of plantar fasciitis. [Online]. Available from: https://www.health.harvard.edu/newsletter_article/Easing_the_pain_of_plantar_fasciitis. [Accessed 15 Jul 2020]
4. Orthoinfo. 2010. Plantar fasciitis and bone spurs. [Online]. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs. [Accessed 15 Jul 2020]
Orthotics
Do I need orthotics? What kind?
Many people come to the clinic complaining of foot pain from conditions such as bunions, hammertoes, a pinched nerve (neuroma), or heel pain (plantar fasciitis). I perform a thorough evaluation and examination, and together we review the origin, mechanics, and treatment plan for the specific problem.The patient usually asks if they need and orthotic and, if so, which type would be best.
I recommend a foot orthotic if muscles, tendons, ligaments, joints, or bones are not in an optimal functional position and are causing pain, discomfit, and fatigue. Foot orthotics can be made from different materials, and may be rigid, semirigid, semi flexible, or accommodative, depending o your diagnosis ad specific needs.
Different types of orthotics
There are few types of foot orthotics: over-the-counter/off-the-shelf (OTC) orthotics; “kiosk-generated” orthotics; and professional custom orthotics. OTC orthotics are widely available and can be chosen based on shoe size and problem. Kiosk orthotics are based on the scan of your feet. A particular style or size of orthotics is recommended for you based on a foot scan and the type of foot problem you are experiencing.
For custom prescription orthotics, a health professional performs a thorough health history, including an assessment of your height, weight, level of activity, and any medical conditions. A diagnosis and determination of the best materials and level of rigidity/flexibility of the orthotics is made, followed by casting mold of your feet. This mold is then used to create an orthotic specifically for you. The difference between OTC/ kiosk and custom made orthotics may be likened to the difference between over-the-counter and prescription reading glasses.
Which type of orthotic is right for you?
A person of average weight, height, and foot type and with a generic problem such as heel pain, usually does well with OTC or kiosk orthotic. They are less expensive, however you may have to replace them more often. Someone with a specific need, or a problem such as severely flat foot, may benefit from custom prescription orthotics. These also last longer.
Another important fact is that your foot specialist will be able to educate you about proper footwear. You may be surprised to learn that many people have not had their feet professionally measured in years. As we age our foot length and width changes, and sizing may not be consistent between brands.
In my experience, certain groups of people benefit from an examination performed by foot specialist, and prescription for custom orthotics. These may include people with diabetes who have lost a feeling in their feet, people with poor circulation, and people with severe foot deformities caused by different foot misalignments and medical conditions.