What happens to my foot orthotics as they age?
This is a question we answer on a daily basis. These devices are not cheap and until you’ve actually benefited from genuine custom orthotic intervention it’s hard to place value on their presence in your shoes.
So to answer that question properly we need to start at the beginning of the process, with a proper diagnosis. If the structural misalignment causing your problem is not accurately identified and understood, any orthotic device dispensed will be of little benefit and thus have a brief functional life span.
Such a diagnosis cannot be done in 10 minutes without a proper history, physical exam, weight bearing exam and gait analysis. All of which should be explained to you the patient to your satisfaction. Only then can orthotic therapy be discussed with specific design consideration for the degree of functional control required, lifestyle, occupation, footwear, athletic activity, and ease of transferability, to name but a few factors.
Design of a custom orthotic should one hand be a scientific process, but from 38 years of practice, I can assure you it is also a craft.
CATCH 22 OF ORTHOTIC PRESCRIPTION
In truth, the larger the physical design of an orthotic, the more control it can exert. The bulkier an orthotic, the more challenging it can be for you, the patient, to get used to, but the greater the benefit where that control is required. The bulkier the device, the more challenging it is for the practitioner “ME” to fit it into a variety of your shoes and to adjust to give “YOU” the best results!
So the challenge for me is, if I make a relatively flexible, non-bulky, minimally corrective orthotic, your immediate reaction will be positive, but any relief will be short-lived and require replacement due to “the orthotic has worn out,” and/or your foot structure has continued to change due to the lack of control. OR……… I do the right thing!
So back to the original question about the aging process of orthotic devices. Assuming the the orthotic is properly designed, well prescribed and paired with suitable stable footwear the expectation is that they should last several years. Eventually, thermoplastic shells will become more flexible. Interestingly graphite and some of the more high-tech custom shells appear to be superior in some characteristics, for example, strength vs weight. However when they fail, the process is less linear than plastics. In real language that means, one day they work, next day they don’t.
Many of the orthotics we prescribe utilize extrinsic posting. That is the material attached to the bottom of your orthotic shell and serves two purposes.
The posts themselves are probably the area of greatest wear and tear that affects the functional life span. These are made of EVA (ethyl vinyl acetate, the same as the sole of running shoes), and are subject to compression and abrasion. Over time they can become increasingly compressed and with that a decrease in the prescribed degree of correction. In situations where this happens prematurely or we deem an increase in control beneficial, we can quickly in-house, make a modification or addition to the original posting. The benefit is again the prolonged life span, increased effectiveness of your orthotic, lower cost, less downtime or injury.
- First is that they allow a sizeable platform for the corrective influence necessary to change your foot stability, position and function.
- Second, these increased areas of contact for the orthotic reduce distortion of the shell, thus increasing the functional life span of your expensive orthotics.
In closing this is why we strongly encourage our patients with orthotics to come back and see us when they become aware of changes in the foot function, return of symptoms, and aggressive wear in their shoe design. There is no set lifespan for an orthotic, only you will know when something is wrong.
Most frequently this will be attributed to improper shoe design, or possibly the prescription does need to be tweaked. Genuinely nothing gives us more pleasure than to see a patient’s relief at having a problem resolved without the expected and anticipated immediate “you need new orthotics”. Now more than ever we appreciate a patient’s need for prudent spending, value for money and their sense of fair play.
If you can’t have trust in those tasked with your health care we do you start? Elbows up doesn’t work if your feet aren’t firmly planted firmly and safely on the ice.
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