Orthotics - worth it?

philstanbridge: Did you have an actual "condition", like wombraider? As have flat feet, but not something that may be too bad.

Thanks.

My feet are exceptionally flat, with no arch at all - I only recently realised this was the reason for all my lower back pain - and the consequential problems with my knees. Probably similar to yourself.

I have to say that since I've started wearing proper insoles, my problems are slightly more tolerable than they used to be. I still can't run though. I should get my left cast in a week or two, which I am excited about. My right cast will be set after I've tested my left one.
 
Did my uni placement at a biomechanics lab specialising in custom orthoses and hope to get into it when I graduate.

The price you've been quoted seems about right :)

I strongly reccomend you go direct to a lab that can assess you and manufacture your insoles inhouse -it means they can sort out any initial problems you may have very quickly and (hopefully) free of charge. The place I was at the podiatrists and biomechanists were trained to be able to make a set ourselves as some people have problems adjusting to them initially it meant we could make on the fly adjustments until they were spot on. I'd guess about 80% of business came from other podiatrists (i.e. posting casts & pescription) and of couse this means if there's a problem you'd probably have to pay for your podiatrist's time and then wait for them in the post and they could come back still not perfect.

As well as the above a proper knowledge of the manufacturing process and materials used is also beneficial to make your pescription as good as it can be. 90% of out of house orders from podiatrists would use the same materials for every pescription and in some cases it'd be up to us to ring them up and suggest a more suitabe material for a particular problem/function.

If going somewhere that manufactures in house isn't an option try to go to either a podiatrist with some form biomechanics qualification or vis versa (though preferably a team with both).

Most places should be happy to give you a free 'chat' explaining what they will do and will give you an opportunity to ask any questions and show you around the lab.

You won't be able to use a pair of custom orthoses in both running shoes and smart shoes as they won't fit correctly so you may be advised to get 2 pairs (or want another if you feel they do wonders!). Some places offer a subscription type service that includes x amount of orthoses, conslutations, free recovering and often other offers on running shoes/sports equipment. Something to bear in mind as they can really save you a lot of money. Where I had my placement, over a year with 2 pairs of orthoses you'd save a few hundred £ on the orthoses alone.

Without breaking forum rules on medical advice the symptoms you've described sounds like the 'bread and butter' of issues that orthoses deal with so you should get some benefit :)

As has already been stated the actual pescription (the hard bit) should last upwards of 20 years and should come with a guarantee, yearly recovering should be offered free or for a minimal charge. Given that they last that long a over 20 years ~£15 a year for something that should reduce pain and help/prevent further chronic injury is worth it to most people.

For the kind of help it can give, when I was working there my favourite part (even more so that working with GB athletes and premiership football players) was an older woman who came in with a photo of herself from 3 years ago. It was her with a walking stick in each hand. I obviously didnt know her but she had come to thank the team because she could walk pain free and said it had changed her life (while welling up) -job satisfaction doesnt get much better than that.

For those asking, quite frequently parents take children to get orthotics privately as fast growing feet with a ~9 week turnaround don't go together too well :D. Also when buying orthoses you should be looking to justify the price in the after service as well as the consultations and product itself.

As philstanbridge pointed out orthoses can also help with a lot of other related problems too!

Not that I really needed them, I made myself a nice pair of carbon fibre orthoses for my basketball shoes (free of charge of course :D) comfiest thing ever (once you get used to them!) ;)

My that was long lol. Hope it helps, any questions fire away.

The place I was at was in stoke called Sub-4 Biomechanics, very far from you but would highly reccomend it to anyone (and no I don't get commission despite what all that sounds like!)
 
Thanks.

Just out of interest... did you get this via scottish health service or private?

Yes mate - all free of charge via the NHS thank god. I have paid for private physio, and am still having regular chiropractic sessions on my spine. I dread to think how much it has cost over the years. Ironically it may have been the feet that I needed to treat first - which I have treated last.
 
....

The place I was at was in stoke called Sub-4 Biomechanics, very far from you but would highly reccomend it to anyone (and no I don't get commission despite what all that sounds like!)

Thank you so much for an excellent post.

I think i might try and ring that company to see if they can recommend someone in London. Think they'll know anyone?

The internet is flooded with podiatrists in London and it's hard to find someone who I know is good.

One thing - I've seen differences in diagnosis. Some video-taping you walking, others using a camera, some just watching you...what diagnosis procedure did you use there?

Thanks.
 
Have found these both look good, but huge difference in price.

Which do you think is better? Which should i go for? Neither mention a complete gurantee, but do offer minmal charge alterations, and seem to be labs.

hops15 I would really appreciate if you could have a quick review of their websites and tell me what you think is best.

http://www.profeet.co.uk/f_2Dcustominsoles.asp

They are MUCH cheaper than...

http://www.footfactor.co.uk/
 
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No problem :)

Basically all of the above. There'd be a ~1.5-2hr assessment with the podiatrist that would also look at posture etc. and a few functional tests done, basically looking to see what the problem was. Next a biomechanical assessment would be done using video cameras, watching even having a feel of your hips and joints as you walk! Then some more functional testing to find why the issue is occuring. Provided both assesments 'confirm' one another a quick set of mock up orthoses using dense foam would be made based on what we thought the best pescription would be. We'd then test these mock ups the same way as before to see if they corrected the functional problems. If not more extensive assessment and testing would be done until we were certain of a diagnosis.

Basically all the things you mentioned are valid, whats more important is that as many different methods are used that all support one another. If not we'd try to establish why. Like any science, you make a hypothesis then test it ;)

I'm sure they'd be able to give you some reccomendations they're decent guys.
 
You won't be able to use a pair of custom orthoses in both running shoes and smart shoes as they won't fit correctly so you may be advised to get 2 pairs.

I just want to query this; as it happens I do have two pairs, one is kept in my running shoes and one that rotates between my work and casual shoes. However, they are identical. My orthotics are 3/4 length so that I can do just this.

I've not had any problems with them.
 
Sorry didn't see that :)

To be honest they both *look* decent but then that's just the info on their websites. Your best bet is to give them both a ring and ask for a chat about what they'll do and a look round, after all it's a lot of money for most people to spend in one go :).

Also if you do get a pair, follow the practitioners guidelines to breaking them in. Especially with arch support you could end up doing yourself more harm than good if you dont gradually break them in (yes some people actually ignore breaking in periods and go run a marathon after a couple of days :( )

Asprilla: To my knowledge although the pescription should be the same in all of them it's because if you put an orthotic in a trainer from an often slimmer fitiing shoe it could move around laterally. Obviously this isn't always the case but were I was we'd try to fit the foam to the shoe it was intended for. And the fact they're not full length means you wont have any gaps/squashing so dont worry ;)
 
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Mine are 3/4 length too, for that very reason. I can swap my orthotics around different shoes/trainers, although I have yet to do so. I'm still wearing a pair of older insoles in my boots. I'm waiting on the casts.
 
Sorry didn't see that :)

To be honest they both *look* decent but then that's just the info on their websites. Your best bet is to give them both a ring and ask for a chat about what they'll do and a look round, after all it's a lot of money for most people to spend in one go :).

Thank you...one thing. The fact that they are heat mouldable I do find a bit concerning. can they not fall out of the mould, and is heat mouldable a decent way to do this? Most others seem to take a plaster cast of your foot.
 
This is something you'll need to ask them. Having only had experience using plaster casts I can't really comment on a 'heat moldable' process. However I'm not sure how they'd achieve anything beneficial from it.

Basically when you have a cast done, the plaster version of your foot will be 'built up' or 'shaved away' until the desired shape is made. This is then smoothed off and the material used for the prescription vacuum formed over it. So for example if someone had low arches you'd rasp away some of the arch on the plaster foot so when the plastic/carbon fiber is vacuum formed onto it the arch of the orthoses will be slightly higher than the persons arch thus supporting it.

If something is simply a mold of someones foot, it will not support any area at all as its never going to be any different than the persons foot. Again, you're probably best asking them on the specifics :)

Here's some pics from my placement journal of the production (sorry don't have the originals so taken on phone!) to give you an idea of what I'm getting at

The casting, expanding (they have to be a few mm bigger than your foot) shaping and smoothing. This is the most important bit as it forms the prescription
http://i42.tinypic.com/28lrriq.jpg

Vacuum forming
http://i41.tinypic.com/oh23qs.jpg

Adding heels and foam
http://i41.tinypic.com/apfz49.jpg

Finishing up -they're not that tidy but functional. It was my 1st attempt at production :rolleyes:
http://i43.tinypic.com/2mi3qc4.jpg
 
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