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Pls recommend best orthotics & sources

Posted by Mary De on 3/02/05 at 18:47 (170326)

I am shopping for new orthotics and would appreciate comments, advice, resources. Getting best value for lowest cost is important to me (no insurance, low income).

I have chronic PF (4 years now). High arches. I've been wearing hard custom orthotics, and find them very helpful. They're a bit worn out now. (Hey, I'm a bit worn out now!) I'm working to improve my self-treatment program, and assuming I could benefit by a new pair. I've recently added solid silicone heel cups under these orthotics; extra heel cushion seems comforting to feet. BTW, I've tried Dr. Kiper's silicone orthos for several months, but found they made me wobble and possibly created new pains in legs, so I've returned them. On to new things...

Dr. Manoli, in a msg last month, said he was coming out with new type of orthotic. I googled and found manufacturer djOrtho, but couldn't find anything on these. More info? When, where, how available?

For any new ortho:
Is it a good or bad idea to buy orthotics via the Web? If so, recommended sites? Things to beware of? What is a reasonable price for decent quality? Or must I see someone in person to get the real thing?

Can I use the foot casts I have from 4 years ago? They were made w/ plaster by pod, as I sat . Or have my feet changed too much by now? If I need new casts, I saw the in-motion computer scan thingie on Dr. Z's web site. Seems like an improvement -- what is 'yinz' consensus? Is computer scan worth it? If so, can I get such a thing locally (Northern California/Bay Area)? What is reasonable cost?

I'm intently reading a review of PF studies in 'Journal of Orthopaedic & Sports Physical Therapy' (Dec 1999, pp. 756-760). Doctors, friends: your thoughts on the following:

'[R]earch studies have not demonstrated that food pronation is a primary factor in the cause of plantar fasciitis. This could possibly explain the less than exellent results found with traditional orthotic therapy. On the other hand, Kogler and colleagues recently reported that foot orthoses designed to provide total contact to the plantar surface of the foot in combination with proper footwear significantly decreased the strain on the plantar fascia .... These findings suggest the that the primary role of footwear and foot orthoses in the treatment of [pf] is not controlling foot motion but rather providing total contact and thus support of the plantar structures of the foot to reduce stress. Studies have demonstrated that soft over-the-counter foot orthoses are just as effective as custom-made foot orthoses.' And a bit later, discussing study by Pfeffer: 'If treatment included a combination of stretching and a silicone heel cup, the success rate increased to 95%.'

Does this mean I should go for a simple cheapie? If I accept the above, what would be the best quality o-t-c full-contact orths? As mentioned, I've tried and liked heel cups. Are there orthotic/heel cup combos? Seems like one insert, instead of two, would be good.

It's a jungle out there! Thanks in advance for your advice and helpful comments.

best, Mary

Re: Pls recommend best orthotics & sources

Richard, C.Ped on 3/03/05 at 09:11 (170346)

One of the best off the shelf inserts in my opinion is the power step. If you want to email me about another option, please feel free.
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