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Orthotics: What to Expect


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When a patient is fit for custom fitted orthotics, even if it’s a perfect fit, there usually will be a reaction, by those muscles affected.

Hopefully one of the first reactions is the patient should feel some level of comfort. Simply that it feels good putting your feet on to the fitted orthotic.

If the reaction is pain, it may be perfectly normal. Don’t judge the orthotic by your symptoms alone. Your level of pain, may mask the fact that the orthotic is fitting and it requires a different focus to understand that.

If the orthotic continues to feel comfortable enough to wear, without problem (and not necessarily any relief of your symptoms), this is good. We would assume, that we’re on track to a correctly fit custom fitted orthotic. Of course it goes without saying that each foot must be considered an entity rather than “how are your orthotics doing?”

If the reaction continues to be painful, it is important to assess where the pain is coming from. In other words,

  • Is it your underlying pain just reacting to a new way of walking?
  • Are you wearing the orthotics too long, too soon?
  • Is it from the orthotic itself?

The first two are normal, and you need to have the patience to allow your Dr to figure that out, and make the correct next step.

In my opinion, the orthotic itself should never be the problem. If it is, then the cast was off. We don’t really know today to what degree a cast needs to be off to not work properly and often be uncomfortable, and the experience of many here can testify to that.

If the orthotic is meeting the initial criteria of being comfortable, there is a leeway from an optimal position, that orthotic should work,

  • to fit properly,
  • be comfortable and
  • work the way an orthotic should and relieve your symptoms (this process of healing, can take days, weeks, months or years to get better).

As long as the orthotic fits correctly to each foot, then the healing process is working. As healing improves, the health and vitality and flexibility of those painful tissues are improving.

Eventually, your positive improvement should plateau. This is normal, and expected.

The health and mostly “flexibility” have improved. Generally one plateaus and doesn’t feel positive improvement or one may start to feel an exacerbation of symptoms, because the new health and flexibility of those soft tissues, need a new alignment support.

If you’re comfortable and have plateaued, then it’s OK to stay that way, but understand, chances are you do require a new Rx for the most efficiency of your postural complex, and eventually you could go back and start to feel problems again.

Copyright 2007 Dennis Kiper, all rights reserved.
Dennis N. Kiper, D. P. M. , specializes in Podiatric Sports Medicine.
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