Effective treatment of a foot problem sometimes requires the use of biomechanical apparatus, known as orthotics. A biomechanical foot orthotic is a highly specialized piece of medical equipment that enables the joints and bones of the foot to be in a more stable position for standing and while in motion. Orthotics control each phase of the walking cycle, from the moment your heel contacts the ground to when your toes push off the surface.

Common conditions treated with foot orthotics include:
  • Excessive foot pronation (flat-feet)
  • Malalignment syndromes
  • Children's problems including in-toe, out-toe and flat feet
  • Neuromas (burning on ball of the foot)
  • Foot pain and fatigue
  • Leg pain and fatigue
  • Knee pain
  • Back pain
  • Sports injuries
  • Arthritis

As medical specialists focused on foot care and treatment, podiatrists are experts in the proper development and use of orthotics.


Podiatrists have the education and experience to provide complete orthotic care. They receive over 1,000 hours of didactic and clinical experience in the science of biomechanics, and 224 hours of didactic and clinical experience in the science and fabrication of foot orthotics.


They are licensed to diagnose foot ailments and provide follow-up care, which might include other forms of medical or surgical treatment. Only podiatrists and some specially-trained physicians can provide such comprehensive care. Podiatrists have been making orthotics for foot conditions since 1933, and have been leaders in orthotic research and development.


Building an orthotic device
When orthotics are required, the piece(s) is tailor made to the needs of the patient. Provided below is an overview of the five step process used in the creation of orthotics.


1. Diagnosis with proper prescription
A complete foot exam by a Doctor of Podiatric Medicine is the first key step to orthotic success. This should include:

  • history
  • physical exam
  • biomechanical exam and gait analysis
  • all tests necessary to make a proper diagnosis and subsequent appropriate prescription

2. Neutral suspension cast
Functional foot orthotics start with a proper non-weight bearing neutral cast. This captures the foot in its optimal neutral position (a weight-bearing cast would capture the foot in a collapsed position). This cast, with its prescription, is then sent to a professional certified podiatry lab.

3. Fabrication by a professional certified podiatry lab
Pouring of positive models
Prescription added to casts


4. Dispensing by Podiatrist
Many different types of orthotics are available based on your shoe type and activity needs. These include athletic, skate, ski, all-purpose and dress orthotics.


5. Follow up Care
Although most orthotic treatment plans are successful, your podiatrist completes your care with appropriate follow up and further treatment. This can include:

  • adjustments
  • physical therapy
  • prescription medication
  • surgery


The average person takes 8,000 to 10,000 steps each day on pavement, tiles, and other surfaces. With each step, a gravity induced pressure of about three to four times the body's weight bears down on each foot.