Frequently Asked Questions

Who needs custom made shoes?

These shoes are not prescribed to address difficult fitting issues that are related to proper width, length, depth or other preferred shoe style. There are many commercially available shoes that can accommodate these fitting issues.

Custom made shoes are prescribed to address the specific needs of individuals with structural foot deformities and special mechanics deficiencies. The primary focus is to accommodate bony, structural deformities of the feet and lower leg due to congenital deformities and conditions (i.e. severe arthritis, polio, diabetic complications ie. Charcot feet). In most cases these custom made shoes are covered by AADL or other insurance plans but only if there is a real medical need for them.

My feet hurt all the time – will custom shoes help me?

Custom made footwear is traditionally reserved for individuals who are physically unable to get their foot into a retail or orthopedic shoe due to a structural (bony) deformity. These people would not be able to wear shoes if we did not build a shoe around their foot.

While foot pain can be debilitating and finding comfortable shoes may be a challenge, custom made footwear is not necessarily the answer. There are many features and high tech materials designed to reduce foot pain, that can not be built into a custom made shoe. Although the term "orthopedic footwear" is enough to make most people shudder, they are no longer the bulky, ugly shoeboxes of the past. The newest styles in orthopedic footwear mean you no longer have to sacrifice fashion for comfort.

If you have a specific fit concern or lingering foot pain, talk to a professional trained in foot care and footwear to determine the source of the problem. They are the most knowledgeable about the latest features, styles and material which would be most suitable to address your foot problems.

My child is experiencing heel pain

It could be Severs Disease, which is probably the most frequent cause of heel pain in children. The condition occurs most commonly in children between the ages of 8 and 14 years. Severs Disease is characterized by activity-related pain that occurs on the back of the heel, where the Achilles Tendon attaches on the heel bone, or Calcaneus. The injury often is associated with running and jumping activities such as soccer, lacrosse, basketball, track and other sports.

Off the shelf Orthotic shoe inserts with soft heel pads are a good way to begin treatment. If your child is suffering from heel pain, talk to your doctor, then talk to us!

Which shoe is best for me?

Standing in front of a giant wall filled a seemingly infinite number of styles and features, finding a good pair of shoes is challenging. There are three simple guidelines to follow.

  • Comfort - Shoe should be comfortable when you first put the shoe on. You do not have to "break in" properly fit shoes.
  • Fit - Do not get stuck on size. Shoes are just like clothing — there is no industry standard for shoe sizing. The length of the shoe should be a thumb's width from the end of the longest toe (this is not always the first toe). The width of the foot should sit entirely on the base of the shoe.
  • Features - Be wary of the marketing gizmos and gadgets built into the shoe. Some selling features actually cause the shoe to wear out faster or unevenly, and can even cause foot pain.

Everyone should have at least one pair of good quality walking shoes that are properly fit. Come and see the Professionals in Foot Comfort for an expert fit of your next pair of quality walking shoes.

Why Special Footwear for Diabetics?

Diabetes mellitus is one of the more common maladies in today's society. Diabetes is often complicated by an affliction of the lower limbs, referred to as "the diabetic foot". One factor contributing to further complications is neuropathy, damage to the nerves of the lower limbs. This lack of sensitivity can lead to dry skin and a sweat formation on the feet. In cases of inadequate care of the feet, these changes may result in cracks appearing, minute skin lesions, a subsequent possibility of infection, or fungus (Athletes Foot). In many cases, this could result in an amputation of the afflicted part of the foot.

There is a possibility of reducing this risk by means of protecting the risky parts of the feet with appropriately selected footwear. Decreased blood supply to the feet and legs from narrowed and hardened blood vessels (Atherosclerosis), and high blood sugar levels (Hyperglycemia) which prevents normal healing, leading to infection, are other such risks.

My feet are very stiff – can shoes help?

Rigid Feet can come from arthritis, fusion or a previous injury.

Rocker soles are very effective in creating a smooth transition. The sole of the shoe is thicker, flat in the middle and tapered off at the toes, heels or both. Heel Rockers are rounded at the back and are used to reduce impact when you plant your heel, and to roll you to a standing position. Toe Rockers are rolled off at the front and dramatically reduce the amount of foot flexibility necessary for a normal stride. The joints stay flat because the rocker allows the body to roll forward without bending the joints backwards. Some retail shoes have rockers built in or a trained professional can add them to your existing footwear.

When should I see a Certified Pedorthist?

If you are dealing with foot pain, suffering from a disease process that affects foot circulation or sensation, or have noticed abnormal wear patterns on your footwear, you may want to visit your local Pedorthist, They will be able to help you with your foot and lower limb discomfort. As one of the few medical professionals educated in the design, manufacture, fit and modification of footwear and orthotics, Certified Pedorthists are regularly called upon to fill orthotic / footwear prescriptions and make recommendations.

Pedorthists are trained to deal with both common and complicated conditions of the human foot. In some cases internal or external footwear modifications (i.e. sole lifts, rocker soles, balloon patches, changes to the shoe profile) may be indicated to treat foot deformities. A custom made foot orthotic may also be indicated to deal with specific biomechanical problems, pressure distribution or impact. Your Pedorthist is qualified to assess and treat these and many other conditions of the foot or lower leg.

My plan only covers Custom Orthopedic Shoes and not Orthotics?

To get custom shoes because your health plans covers it, is not recommended! Custom shoes are only required if a medical condition exists that can not be treated with orthotics and off the shelf therapeutics shoes. There are many commercially available shoes that are deeper and have extra width such as the NB926 which goes up to 6E. If all these options fail, custom shoes might be needed.

Can orthotics help my back?

Orthotics can be a very effective part of a treatment plan for back pain. Force transferred from the feet up the legs to the hips can cause a misalignment of the pelvis and spine resulting in back pain.

Orthotics are most effective for individuals who have ankle or arch instability causing pronation or supination. Pronation occurs when the ankles and knees drop to the inside causing a rotation in the legs and hips. Exaggerated pronation looks like kids when they are learning to skate - blades sticking out sideways and their knees banging together. Conversely, supination occurs when the ankles roll outwards causing stress on the outside of the legs and hips. Exaggerated, it looks like a stereo-typical cowboy with bowed legs.

Orthotics reduce the amount of rotation at the ankles and stop the transfer of this rotation to the knees, hips and ultimately, the back. Foot orthotics are not applicable for all people with back pain so if you are unsure if they will help you, consult with your Physician

My knees are bothering me. Will orthotics help?

January is a popular time to start a fitness program. Knee pain often shows up for one of three reasons:

  • Instability of the feet and ankles. Instability can cause excessive rotation and motion through joints, up the legs and even into the lower back. These people gain the most from orthotics and footwear. By stabilizing the feet and legs, the joint pain is reduced quickly.
  • Improper Footwear. Just because shoes are expensive does not mean they are good shoes for you. Shoes should be selected based on foot structure, fit and activity choice. Get a footwear professional to assist in fitting your shoes.
  • Misalignment of feet/ankles. Not everyone is built the same. High arches, low arches, extra/ limited range of motion in your legs can cause secondary stress to joints and muscles. Even though you can't change the way you are genetically programmed, proper orthotics and footwear can reduce damage. If you feel orthotics would benefit you, consult your medical doctor, then book an appointment with the professional's in foot comfort.

Who is qualified to deliver proper orthotic care?

A good starting point is to provide the practitioner with a prescription from your family physician. The practitioner should perform a complete and thorough assessment. This includes range of motion testing, biomechanical and gait assessment, footwear and footprint analysis.

Along with your footprint, it is critical that the practitioner obtain an accurate 3-dimensional plaster cast impression of your feet in order to properly design and manufacture your custom orthotics. Once the orthotics are fitted into your footwear, the practitioner should have the on-site facilities to make immediate and future adjustments. Check with your extended health insurance company for a list of recognized providers who are certified through a professional college and meet all insurance criteria.

Should I buy orthotics from trade shows?

Buyer beware is the best piece of advise. There are many companies making a lot of money off people at trade shows. Research the company and know what you are getting before you buy.

  • Customized. Custom made and customized foot orthotics are not the same product. Trade show vendors are able to be profitable by slightly altering premade shells and selling "custom made" orthotics in one hour. Charging $250 -$500 for a pair of pre-made insoles manufactured in one hour is very profitable.
  • Education. Many trade show companies provide in house training (as little as one weekend) and provide their employees with a "certificate" for fitting orthotics. Do they really understand what this does to your alignment and posture?
  • Follow up. Trade show vendors are moving from city to city so you never know where they will be next week. Consumers need to be wary of what they are buying. If you are interested in foot orthotics, talk to your doctor or visit us for more information.

Can I claim my orthotics on my health plan?

Everyone's plan is a little different so it's best to talk directly to your insurer to determine your coverage. It may be a percentage or dollars value. Ask about restrictions for frequency, manufacturing methods and yearly maximums. Not all orthotics are created the same way so be sure to double-check the stipulations to protect yourself.

At this time, there is no coverage though public funding agencies. Alberta Health Care (Aids to Daily Living) and Blue Cross for Seniors does not cover foot orthotics. Most other assistance programs are case-by-case so we can provide a letter of estimate to forward to your case worker. Most insurance companies require a prescription from a medical doctor so talk to your doctor, then talk to us!

I can't find shoes to fit my orthotics into. HELP!

You shouldn't be confined to wearing running shoes or clunky footwear just because you wear orthotics. However, wearing orthotics does mean that you have to be more particular about your footwear choices. As a rule, the dressier the shoes, the smaller and less functional the orthotics. If you require a lot of structural control, you will be limited with dressier styles.

If you find your orthotics do not fit into your lifestyle, the orthotics may need to be replaced with different materials to give you the footwear flexibility you want. It is a good idea to bring in your existing orthotics and preferred shoe style so the orthotics can be designed appropriately. If you have any questions about your orthotics, contact our office.

I have one leg longer than the other. What should I do?

There are many reasons your legs will appear to be different lengths. Depending on the reasons for the difference will determine whether you should do anything about it or not.

Structural differences are due to congenital, post-surgical or traumatic reasons that the skeleton is physically different right to left. Anything less than ¼ is considered within normal and intervention is necessary only if there is discomfort associated with the difference. Using lifts for this type of difference is usually very successful if the body have good range of motion in the pelvis and lower back.

Functional differences are much more common and are often due to postural or muscular problems. The spine and pelvis can not stay straight because the posture and muscles hold the spine in a curved position. Often, functional differences are best treated with physiotherapy, chiropractic care or postural re-training. Using lifts or inserts must be closely monitored and are treated very conservatively.
If you have any questions about lifts, talk to your doctor, then talk to us!

Why should we wear shoes indoors when suffering from heel pain?

Heel pain is closely related to Plantar Fasciitis. The plantar fascia is a tight ligament that stretches along the bottom of the foot from the heel bone to the ball of the foot. Plantar fasciitis, a form of tendonitis, occurs when this connective tissue inflames and small fibers begin to tear away from the heel bone.

Wearing footwear with a ½" to ¼" inch heel, reduces stress/pull to the plantar fascia and therefore contributes to the healing process. A house slipper with no heel is not recommended. There are many "slip on" clogs or sandals with some heel height available that also accommodate orthotics. Calf stretching exercises are also very beneficial.

I have exposed bone ends - what are they?

The dropped metatarsal arch exposes the bone ends on the bottom of the foot and creates a pressure area (and often a callous) under the second, third and/or fourth toes. This can lead to skin breakdown, especially in diabetics and arthritics.

I have heel spurs – what are they?

Heel spurs are bony growths extending out from your heel bone. Typically, spurs are a response to soft tissue of the foot pulling away from the bone. The bone tries to protect itself and grows out to meet the soft tissue.

The most common location for a spur is on the bottom of the foot with the spur extending towards the toes along the plantar fascia (which runs the length of the arch). The heel bone is being pulled forward (to the toes) by the fascia and backwards by the more powerful calf muscle in the back of the leg. This internal tension causes the bone to react.

How do you fix the problem? Stretching the calves is the key. Orthotics and proper footwear is important in stabilizing the foot and supporting the soft tissue. For your personal foot assessment please call for an appointment.