5/15/2012 9:21 PM
When prescribing functional foot orthotics it is important to not only discuss that orthotic devices should be comfortable and address foot mechanics for pain relief, but also explain which shoes the devices fit best in. I frequently see patients who present with orthotics and the complaint that they can't wear them everyday because they don't fit in their shoes. This leads to continued pain, and in many cases, patients have a difficult time breaking in the device because they are only in them when they are in their athletic shoes at the gym (for example 1-2 hours per day).
A great way to make the point about the size of an orthotic is to have your patient stand barefoot on a piece of paper and trace the foot. This will be a visual for the patient to take home with them and compare their actual foot width to the shoe widths that they want their orthotic device to fit into. Many patients will learn that they are wearing shoes that are simply too narrow for them. I also make sure to educate patients on what exactly to expect with regards to the orthotic they will be receiving. I explain why I am putting them in orthotics and the goal of therapy. As an example, many patients will present with really narrow orthotics and pronate over them medially. In this case, I explain that the new orthotic will be wider to stop the patient from flattening their arch over the top of the orthotic. We discuss their expectations; what types of shoes this patient wears, their activities. It is also important to have patients not purchase any additional shoes until the devices are dispensed and they can shoe shop with the orthotics in hand. Know your local shoe shops and where to send your patients for the best outcomes.