Custom foot orthotics (CFOs) are medical devices worn in footwear to make a person’s gait or walking more efficient and stable. CFOs are prescribed and customized for each individual to correct the positioning of foot joints thereby improving biomechanics of movement when standing and walking.
When sitting, the body is an open kinetic chain or all parts operate independently from one another. As soon as a person stands, the body becomes a closed kinetic chain. What happens in the foot can affect what happens in the joints in the rest of the body. The foot can be in three different positions: 1) supinated which makes the arch appear high 2) pronated which makes the arch appears low or flat or 3) neutral when it is neither supinated or pronated. In order for the foot to operate properly it will be supinated, pronated and neutral at various points in the gait cycle and with optimal timing.
If the timing is not quite right, there may be too much supination or pronation. This is evident during a biomechanical assessment and a gait analysis. The alignment of the heel to the back of the leg is observed to determine the natural position of the foot when standing and when walking.  With excessive supination, there will be less shock absorption as the foot will be more rigid and the bottom of the heel will be rotated inwards. This can make a person more susceptible to ankle sprains, knee and back pain. With excessive pronation, there is lots of shock absorption but too much rotation or motion of the heel (bottom of the heel outward), strain can be placed on the plantar fascia on the bottom of the foot and other structures in the foot and leg causing overuse and damage with time. Additionally, the body oftentimes will attempt to compensate in certain ways for too much rigidity or motion, this too can cause pain and discomfort.
It is hard to say if optimal biomechanics naturally exist, but CFOs can help. In order to make a CFO, the lower limb clinicians at BioPed will determine what is happening when a person stands and walks, if a CFO will be beneficial and what features and modifications would be best suited for them. In order to make a CFO, a 3-D image or a plaster cast/mold of the feet needs to be taken. The image or cast/mold is usually taken in a neutral position. The neutral position pertains to the subtalar joint of the foot. The subtalar joint is the joint just below the ankle joint and this is where supination and pronation in the foot occurs. By placing the foot in a subtalar joint neutral position, the intent is to better align the foot to the leg thereby increasing balance and stability when standing and walking.
Make an appointment with a BioPed lower limb clinician today to see if CFOs are right for you!
