What custom orthotics are
Custom orthotics are shoe inserts made from an impression or scan of your own feet. Unlike the cushioned insoles sold in stores, they are designed around the shape of your arches and heels and the way your feet move when you stand and walk.
Your feet are the base for everything above them. When an arch flattens a lot with each step, or weight shifts unevenly across the foot, the change can travel up through the ankle, knee and hip. An orthotic aims to support the foot so those forces are spread more evenly.
Orthotics are not a stand-alone answer for most people. They tend to be most useful alongside exercises that strengthen the foot and hip, appropriate footwear and treatment of any stiff joints or tight muscles found during your exam.
Who custom orthotics may help
Orthotics are not right for every foot. They are generally considered when your exam shows a mechanical pattern that support could reasonably influence.
- Flat feet and overpronation
- If your arches collapse and your ankles roll inward as you walk, arch support may help reduce strain on the inner ankle and knee.
- Heel and arch pain
- Pain on the bottom of the heel, often worst with the first steps in the morning, is commonly linked to plantar fasciitis. Orthotics may be one part of a plan that also includes stretching and load management.
- High, rigid arches
- Feet with very high arches can concentrate pressure on the heel and ball of the foot. A custom insert can help spread that pressure more evenly.
- Knee or hip discomfort linked to foot mechanics
- When the way your foot lands seems to influence knee or hip pain, supporting the foot may ease the load further up the chain.
- Uneven shoe wear
- Soles that wear down much faster on one edge can hint at how weight moves through your feet. See uneven shoe wear for what it may mean.
- Long hours on your feet
- People who stand or walk for most of the day, such as healthcare, retail and restaurant workers, often notice foot fatigue. Better support may help you feel more comfortable by evening.
From exam to fitting
Not everyone who asks about orthotics ends up needing them. The process starts with finding out whether they make sense for you.
Foot and movement exam
Dr. Okhowat looks at your feet standing and moving, checks arch height, ankle and big toe motion, and watches how you walk. A gait analysis may be part of this step. Bringing a pair of shoes you wear often is helpful.
Capturing your foot shape
If orthotics are recommended, an impression or scan of your feet is taken so the inserts can be made to match them. The office will explain the method used and the expected timeline when your pair is ordered.
Fitting and break-in
When your orthotics arrive, they are checked in your shoes. Most people wear them for a short time on the first day and add time gradually over one to two weeks as their feet adapt.
Follow-up
You check back in on comfort and symptoms. Exercises for the feet and hips are often added so your body builds strength rather than relying only on the inserts.
Potential benefits
Responses to orthotics vary, and they are only one part of care. For the right person, they may offer the following.
- May reduce strain on the arches, heels and ankles.
- Can help spread pressure more evenly across the foot.
- May ease knee or hip discomfort linked to how the foot moves.
- Can make long periods of standing or walking more comfortable.
- Provide support shaped to your feet rather than a generic insole.
Is this right for me?
Custom orthotics may be worth considering if your exam points to foot mechanics as part of your pain, and simpler steps like supportive shoes and stretching have not been enough on their own.
Some foot problems need a physician or podiatrist first. This is especially true if you have diabetes, poor circulation or reduced feeling in your feet, because small problems can become serious without the right medical oversight.
Often a good fit
- Heel or arch pain that keeps returning
- Flat feet or feet that roll inward noticeably
- Foot, knee or hip discomfort after standing or walking
- Shoes that wear unevenly in a consistent pattern
See a physician first
- Diabetes with numbness, wounds or color changes in the feet
- An open sore, ulcer or signs of infection such as warmth, redness or drainage
- Sudden severe pain and swelling in a joint, such as the big toe
- Calf pain and swelling, which can signal a blood clot
- Pain after a fall or a suspected stress fracture
- Inability to bear weight on the foot
- Cold, pale or bluish feet suggesting a circulation problem
If you have any of these, please see a physician or go to urgent care before booking. In an emergency, call 911.
How Dr. Okhowat approaches custom orthotics
Chiropractic training covers the joints of the feet, knees and hips as well as the spine, and foot mechanics are a natural part of that work. Dr. Omid Okhowat, a Cleveland Chiropractic College graduate licensed in California, has over 19 years of experience looking at how the whole lower body works together.
As a Diplomate of the American Association of Integrative Medicine's College of Manipulative and Body Based Practices and an AAIM Fellow, he looks at the foot as part of the whole body. The intent is to recommend orthotics only when the exam supports them, and to combine them with joint care and exercise rather than offer them on their own.
The office on Wilshire Boulevard is a short drive from the Fairfax District. If you spend much of your day walking or standing, expect practical guidance on shoes and activity alongside any recommendation for inserts.
- DC, Cleveland Chiropractic College
- AAIM Fellow
- AAIM Diplomate, Manipulative and Body Based Practices
- Over 19 years of experience
Questions patients ask
What is the difference between custom orthotics and store-bought insoles?
Store-bought insoles are made in standard shapes and mainly add cushioning or general arch support. Custom orthotics are made from your own foot shape and chosen based on an exam, so the support is matched to your feet.
Does everyone with flat feet need orthotics?
No. Many people with flat feet have no symptoms and do not need any inserts. Orthotics are usually considered when flat feet seem connected to pain or strain somewhere in the leg or back.
How long does it take to get used to orthotics?
Most people need one to two weeks to adjust, starting with an hour or two a day and building up. Some mild awareness in the arches is normal early on, but blisters or sharp pain are not and should be reported.
Will they fit in all my shoes?
They usually fit most easily in shoes with a removable insole and enough depth, such as athletic and walking shoes. Dress shoes, flats and sandals can be harder. Bring the shoes you wear most so fit can be discussed.
How long do custom orthotics last?
It depends on the materials, your activity level and your body weight. They should be checked periodically for wear, and replaced or adjusted if they lose shape or your needs change.
Are custom orthotics covered by insurance?
Coverage varies widely between plans, and some do not cover orthotics at all. Call the office and check with your insurance company before ordering so you know what to expect.
Can orthotics help knee or back pain?
They may help when foot mechanics are contributing to the problem, by changing how forces travel up the leg. They are not expected to help every case of knee or back pain, which is why an exam comes first.
Should I still do foot exercises?
Yes, in most cases. Strengthening the muscles of the foot, ankle and hip helps your body support itself, and orthotics are most useful as one part of that plan.