Orthotics: Custom Made vs Off-The-Shelf – Is There A Difference?

This is an important question that begs an honest answer. Before I attempt to give the answer, I will briefly outline the nature of each type of orthotic device and then look at the pros and cons of both. Potentially, choosing the best orthotic can be confusing for the person looking for “support”, help with an injury or just seeking to get comfort when standing and walking.

Custom Made Orthotics (Functional Orthoses)

So, what are custom made or “functional orthoses”? In a nutshell, these are devices prescribed by a university trained Podiatrist based on the structure and physics/function of the lower limb. These devices are designed to control the individual foot segments during walking. Functional orthoses are generally based on negative plaster moulds or 3D scans of the patient’s feet. They’re designed to correct specific characteristics of an individuals biomechanics and will only suit that person. The devices may be manufactured by the Podiatrist themselves, or more commonly, be outsourced to a Laboratory that specialises in their manufacture.

Pros

  • Custom made to suit an individual’s requirements
  • Will suit individual foot shape
  • Based on proven scientific principals
  • Adjustable
  • May be refurbished
  • Highly effective in treating a wide range of conditions
  • Very comfortable when prescribed correctly

Cons

  • Will not suit all types of lady’s footwear
  • May be uncomfortable at first
  • Cost – Yes, Functional Orthoses are expensive. In Australia, one would expect to pay between $450 – $950 for this therapy. However private health insurance companies on average offer rebates of approximately 60% of the scheduled fees.

Off-The-Shelf Orthotics

Off-the-shelf devices are generic orthotics that are mass produced. These are not made to suit individual feet and as such are made of forgiving materials that offer less support than custom devices. They are most often made out of flexible EVA of varying densities or thin, flexible thermoplastics such as polypropylene.

There are many types of non-custom devices available. At Preston Podiatry, we commonly issue Vasyli and ICB Medical devices as they offer the best quality.

Pros

  • No manufacturing delay
  • Easy to wear
  • Suitable for young growing children
  • Cost – relatively inexpensive. Expect to pay approximately $60- $80 a pair

Cons

  • May not be effective in relieving symptoms
  • May not provide enough support so patient may end up with custom devices anyway
  • Often too bulky
  • Shape may not suit foot
  • Not covered by private health insurance

In our podiatry practice we choose both custom orthotics and the non-custom devices depending on the patient’s requirements, age and circumstances. Patients are assessed and the most appropriate course of action is recommended.