Realistic custom foot orthotic expectations

Prescribing custom foot orthotics is an integral part of a podiatrist's career. Podiatrists use Custom orthotics to offload, correct, align and redistribute forces thus reducing peak plantar pressures. CFO’s have been continuously shown to positively influence the loading patterns acting on structures of the foot, ankle throughout the gait cycle.

However, when it comes to prescribing custom foot orthotics meeting patient expectations is an often overlooked area resulting in poor compliance and poor patient outcomes.

Setting realistic expectations with patients should be done in a patient-centred approach, offering education to allow patients to understand what to expect. Patients need to understand that orthotics are part of an overall holistic treatment approach and practitioners should avoid using phrases such as cure or completely fix their diagnosis or pains. Alternatively, using phrases such as offload, redistribute and reduce tension on the tendon/ligament/bone/muscle etc. should be used. Patients should also understand that Custom foot orthotics do not magically fix pathologies such as plantar fasciitis or tibialis posterior tendon dysfunction but help to alleviate tension and allow for appropriate rehabilitation.

Podiatrists should also be careful not to sell custom foot orthotics as a “one time fix” and ensure patients understand that adjustments may be needed and are often an integral part of orthotic therapy. When informed ahead of time, patients should be more receptive and understand that things may not be “perfect” upon the initial fitting appointment. 

Remember as practitioners the best and most effective way to obtain good patient outcomes is a combination of utilising correct casting techniques/.methods, using appropriate prescription variables, having close relationships with your lab as well as educating patients to ensure realistic expectations have been obtained.