What you need to know about wearing your foot orthoses

You have been prescribed a pair of Functional Foot Orthoses to help your foot or leg problems. They are prescription devices that have been specially made over plaster models of your feet so that the shell fits the arch contour of each foot accurately. The orthoses should not be worn by anyone other than the person for whom they were prescribed.

You will notice that your orthoses may have wedges added to the back and sometimes the front of the shell. These wedges are called 'Posts' and they tip the shell a set number of degrees in a particular direction, so that your feet are encouraged to take up more normal positions at the right time during walking.

To benefit fully from your orthoses you must follow the instructions given to you by your Podiatrist closely. Your Podiatrist should have fully discussed your treatment programme with you and at this stage you should have a full understanding of your therapy. If you still have any questions, please make an appointment with your specialist to discuss them.

The following is a list of important points to remember:

Functional orthoses are prescription devices. Their fabrication is complex and involves many different technical processes, so please do not adjust them in any way. In some cases, certain types of orthoses do need adjustment, however this is usually not carried out within the first three months. If an adjustment is required, your Podiatrist will change the prescription as necessary.

When you first stand on your orthoses, your feet may not feel fully comfortable. Initially, you may be aware of some pressure under the arch and at the front edge of the shell. These sensations are normal and should disappear within a short period of time

You must wear your orthoses in gradually, so that your feet and legs have a chance to gently adjust to the new mechanical positions. During the adjustment period you may experience mild aches in various joints. These sensations are quite normal and should disappear within a short period of time.

A good 'build-up' programme is to wear them for 1 hour on day one, 1 1/2 hours on day two, 2 hours on day three, and so on. When you can wear your orthoses for 4 hours a day, you will probably be able to wear them all day. Do not rush the adjustment period. Wearing your orthoses all day immediately can prove disastrous!

If you experience any frank pain or discomfort when wearing your orthoses, do not increase the wearing time. Stay at the same time until the pain goes away, and then continue the gentle build-up. If after 4 weeks you cannot wear your orthoses for longer than 4 hours a day, contact your Podiatrist to discuss the problem.

You may be having physiotherapy or be on an exercise programme as part of your treatment plan. Treatment success depends on keeping appointments for your therapy sessions and completing your daily exercise routines. Remember that Functional Foot Orthoses are not a 'cure for all ills', they are the part of the treatment that controls the mechanical inefficiencies of your feet. However, the other aspects of your treatment are of equal importance.

One of the most difficult aspects of orthotic therapy is finding suitable shoes. Your Podiatrist will have discussed with you what constitutes a good shoe to accommodate your devices. If you have any problems fitting them into your present shoe styles, make every effort to find shoes that are suitable for them. A deep sided shoe with a fastening and a heel height of below 1 1/2 inches is optimum.

Orthotic devices need to be checked regularly, as does your response to the therapy. The posts do eventually wear down and need replacing, which is an easy and inexpensive adjustment. If your orthoses have vinyl top covers, they too will need to be replaced from time to time. Also, certain foot types will, in time, respond favorably to orthotic therapy and the foot will often change shape and take up more normal structural positions. If this happens, new orthoses with a new prescription will need to be manufactured.

If you have been prescribed sports orthotic devices, it is advised that you wear them for normal walking for the first 7-10 days to ensure that they are fully comfortable before gradually introducing them into your sports activity.

Sometimes orthoses may squeak in the shoes! This is due to the fact that they are dynamic devices that move within the shoe to guide your foot into the best functional positions during walking. As the shell rubs against the leather of the shoe it can squeak. A little talcum powder or candle wax rubbed along the edges of the device usually cures the problem.

It is hoped that the points above will cover most of the initial questions you have when beginning orthotic therapy. As your treatment progresses you may have more questions or to know more about your treatment programme. Please do not hesitate to make an appointment to consult your Podiatrist, who will make every effort to discuss your questions in detail. Overall, remember that it may take more than a few weeks to correct a problem that has developed over many years.