CLINICAL CARE
Orthotics
Not everyone needs orthotics. When they may help, I base them on a detailed assessment of your symptoms, how you move and your footwear.
My orthotic experience includes:
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making custom orthotics for ski and snowboard boots at a boot-fitting shop in Canada
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designing and making custom orthotics at the US Orthotic Center in New York
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an MSc in Podiatry with Clinical Biomechanics, and a PhD on how foot structure and movement relate to midfoot arthritis
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working with researchers at La Trobe University who are studying shoe inserts for midfoot osteoarthritis
Knowing how orthotics are made, and what the research says about them, shapes how I prescribe them.
What orthotics do
Orthotics are shoe inserts that change where pressure sits under your foot and how load travels up your leg. They can be prefabricated, or custom made from a 3D scan of your feet.
I prescribe them using an approach called tissue stress theory: working out which structures are overloaded, and whether changing the support in your shoes could ease that load.
For some problems, a better first step may be:
strength work
changes to your training load
different footwear
We talk through the options and decide together.
How I prescribe them
Prescription starts with an assessment, which includes:
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your symptoms, and which structures may be involved
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video gait analysis of how you walk, or run if relevant, on a treadmill that measures the pressure under your feet
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a 3D scan of your feet, if custom orthotics are appropriate
Your orthotics are then designed around your foot shape, your symptoms, your activities and the shoes you wear most.
I offer both prefabricated and custom orthotics, and we choose together based on your feet, your goals and your budget.
The aim is orthotics that feel comfortable, fit your shoes and suit the activities you want to keep doing.
Fitting and follow-up
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I fit your orthotics in the clinic and check them in your shoes.
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I explain how to wear them in gradually.
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At your follow-up, we review how they feel.
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Many small adjustments can be made in the clinic, often during your appointment, as we have a grinder and the tools to adjust orthotics on site.
Orthotics are usually one part of a plan that also includes exercise, footwear advice and managing load.