Custom-made foot orthotics are typically covered through third-party insurance companies as part of your employer’s extended health benefits program. Because there are currently many types of healthcare practitioners providing orthotics it is important to ensure that you see someone who is qualified and is dispensing appropriate products.
Once you have a prescription for orthotics, your next step is to have a proper assessment by a qualified foot and lower limb specialist. Your assessment should include a detailed history, postural evaluation, biomechanical evaluation, gait analysis and assessment of your current footwear choices.
During the history portion of an assessment, the practitioner is expected to ask you about your current symptoms, any relevant previous injuries or health conditions, your footwear choices and your current activities of daily living.
The specialist should then complete an overall postural analysis focusing mainly on your lower limbs and feet, followed by a detailed biomechanical analysis. A biomechanical analysis will indicate any hypermobility or hypomobility issues in your feet that may lead to compensatory movements when you walk. A gait analysis must always be completed. During the gait analysis, the practitioner will watch how you walk and note any irregularities in biomechanics. An evaluation of your current footwear choices allows the practitioner to evaluate the wear patterns of your footwear and determine whether or not your current footwear is an appropriate type or style for your activities.
Patient-based healthcare empowers the client to understand the reasoning for their treatment. Once your assessment is completed, it is expected that the practitioner educate you what they are assessing for and what their findings have been. This will allow them to help you understand their recommendations in footwear choices and/or orthotic design to treat your current condition.
Prior to beginning treatment the practitioner should have explained to you the reasoning for their recommendations, the process of the treatment, the total cost or treatment, what your expectations should be, and they have answered any questions you may have.
One your assessment has been completed and you have consented to treatment, a 3-dimensional cast of your foot should be obtain by the practitioner. A 3-dimensional cast of your foot captures the exact contours of your foot. Accepted 3-dimensioanl casting methods include plaster or wax casting, foam box impressions and some computerized laser/contact scanning systems. Making a footprint on an ink pad, recording your shoe size or walking over a pressure plate doesn’t qualify, since none provide the information needed to create custom-made orthotics.
Manufacturing of custom foot orthotics should take approximately one week. During your dispensing appointment, the practitioner should ensure your orthotics fit properly into your footwear, perform a gait analysis while you are wearing your orthotics and explain what you should expect to feel over the next few days as your body adjusts to the new sensations.
Once dispensed, you provider should give you a copy of their assessment, an detailed invoice indicating the products purchased, cost and dispense date, and detailed information about the casting method and materials used to make your orthotics.
It is recommended to use an orthotic provider that is able to manufacture orthotics on-site. This ensures that the practitioner who assessed your feet also plays a primary role in the manufacturing of your orthotics. It also allows for any necessary adjustments or repairs to be made to your orthotics while you wait.