Prescription Custom Foot Orthotics (PCFO's)

Just like prescribed eyeglasses a PCFO is created specifically for you to address the specific biomechanical and pathological needs of your feet and body. First a biomechanical assessment is performed, then a 3D version of your feet are created either by plaster cast or laser image. The orthotics are then manufactured.

What is an orthotic?

There are many different kinds of in-shoe devices referred to as orthotics You will see orthotics in infomercials, stands at consumer shows, and a growing number in retail shops. Arch supports and insoles sold in drug, sports and shoe stores increasingly referred to as Orthotics There are also the orthotics that foot health care specialists prescribes for their patients. Understanding which device is best for your foot health is a challenge. Below is some information that may help.

There are 3 categories of Orthotics: Custom, Customized, and off-the-shelf.

Custom Foot Orthoses

A prescription medical device made individually for you based on your foot function. It is designed to adjust and control the functions of the foot and its alignment with the lower leg. They are prescribed to address and prevent injury-causing motions including excessive pronation (rolling-in) and supination (rolling-out) and make standing, walking and running more efficient. Some custom orthoses are prescribed to control and correct foot function to prevent current or future foot problems, and some custom prescribed orthoses are designed to accommodate corns, calluses or bony prominences to alleviate pain. There are many different materials and styles that are used to construct orthoses, your Chiropodist will be able to determine what is best for you based on a through foot assessment (biomechanical examination). They will then take a 3-D mould of your foot (plaster of paris or computerized scan), a prescription form is filled out and sent to a professional lab along with your cast/scan where qualified technicians will read the prescription and follow while making an orthotic from your foot cast/scan. These processes make the orthotic Custom to you and therefore, are considered Custom Foot Orthoses.

Customized Devices

Will a scan/plaster cast of your foot be preformed? If the answer is no, these are not custom foot orthoses. Customized devices are commonly a product of a computerized pressure platform system that captures and displays pressure information and are then made by adding components to a pre-manufactured insole. They then are marketed as custom and may be sold at similar prices. If there is no mould taken of your foot then you will not be getting custom orthoses. Walking or standing on a pressure mat with a colourful graphic display is an excellent way to evaluate some aspects of foot function and pressure distribution. In qualified hands, this system can be a useful clinical tool to confirm pressure areas. However, the technology does not capture three-dimensional impressions of your feet and is not the same as a mould of your foot.


Commonly found in retail drug, shorts and shoe stores as well as some specialty shops. They can be used for those with minor foot problems, and are usually not sold for more than $60.00. Popular brands sold in Canada can include; Superfeet, Spenco, Aetrex, and Powersteps.
Custom Foot Orthotics prescribed by regulated Chiropodist/Podiatrist who are specialists of the foot may help your lower limb move more efficiently to prevent or eliminate tired aching feet, back/knee pain, corns or callus, shin splints, heel spurs or heel pain, and bunions.

Who Makes Orthotics?

Dispensing orthotics is NOT a regulated area of health care. Therefore, anyone, regardless of education; training or knowledge in this area can dispense orthotics. This is why each insurance company and each plan is different when it comes to whom they will accept as a provider to dispense orthotics.

* Chiropodists and Podiatrists are the only regulated health care professionals, in Ontario, trained specifically in diagnosing and analyzing foot functions and prescribing orthotic devices.

Common Questions asked about orthotics

How does an orthotic work?

Unlike arch supports bought at a drug store or on tv, a corrective, posted foot orthotics is meant to control abnormal position and movement of the foot while standing or walking allowing the foot and lower leg muscles to function more efficiently during gait. A corrective orthotic is usually made from a rigid material in order to control the foot with the force of gravity and body weight. Various covers may be added to apply padding to the orthotic depending on the patients needs. Although rigid, they are comfortable because they are made from a plaster cast mould from your foot which replicates the exact contours of your foot. Posts are wedges at the heel or forefoot which hold the foot in a proper angular relationship to the lower leg. This type of orthotic should only be prescribed by a properly trained practitioner after a through biomechanical examination.

Will orthotic correct my foot problem?

Just like eye glasses, orthotics only work when you are wearing them. They will prevent the development of progressive conditions, or problems that may occur due to over-pronation or over-supination while you are wearing them. Orthotics will not change the underlying structure of the adult foot. If they are not worn abnormal function will immediately return.

Will Orthotics fit in all my shoes?

The short answer is no. An orthotic made for dressy shoes with a narrower foot bed and a shallow heel counter will not fit into a running shoe or casual running shoe. Mens foot wear may be a little easier to accommodate, then ladies due to the style and fashion. The best way to decide when it comes to orthotics is think about what footwear you spend the most time standing and walking. If you where dressy shoes to work, but sit most of the day the orthotic is not going to be effective as it only works when you are standing. So you want to make the orthotic for footwear you will be standing or walking.

Why do I need to break in my orthotics?

Realignment of the whole lower extremity and pelvis is occurring as you start to wear your orthotics. Muscles and ligaments have to readjust to this new alignment this is why we ask you to gradually introduce your orthotics to daily living so that pain and discomfort may be avoided. Orthotics should not be worn for running until the break in period has past and you have given yourself at least two weeks of consistent wear while walking before introducing them into running.

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