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Services Custom Orthotics

Custom Orthotics

foot injurySan Diego Custom Orthotics are made at the San Diego Running Institute. Custom orthotics are generally made to correct muscle imbalances, over-pronation during walking and running, prevent knee pain in running and jumping sports and to correct leg length differences.

Some of the injuries successfully treated with custom orthotics are Piriformis syndrome, hip bursitis, lower back pain, sciatica, chondromalacia (runner’s knee), patella tendonitis (jumper’s knee), knee arthritis, Iliotibial band syndrome, shin splints, Achilles tendonitis, heel spurs and plantar fasciitis.

What is a Custom Orthotic?

A custom orthotic is a device made and customized to the shape of your foot. It is meant to stabilize the foot and hold it in an optimal position, increase function, limit motion of a painful joint, decrease weight bearing on painful areas and protect your foot from excessive impact and shearing forces.

custom orthoticover the counter shoe insertscustom orthotic

What is an over the counter orthotic?

An over the counter orthotic differs from a custom as they are prefabricated on an assembly line with the left and right being identical. For those whose feet are identical in length, width and arch height they may be suitable and help alleviate a certain condition. Very few people are perfectly symmetrical and therefore it is common for an over the counter orthotic to not work effectively. Often an over the counter orthotic helps the condition “a little”. This typically indicates that a San Diego Custom Orthotic will dramatically alleviate pain and symptoms condition.

How do we customize your orthotic?

Dr. Runco does not use an outside orthotic lab but instead takes the mold during your visit and then actually makes and customizes them himself for you.  This approach minimizes cost and turn-around time for the patient with most patients having their orthotics in hand within 7 business days after the mold is taken.

Once the patient receives the orthotics they wear test them and report back to Dr. Runco via email (so there is no $ office visit) letting him know if they perceive any discomfort or if they feel they can be improved upon.  At that point at no additional cost to the patient Dr. Runco will modify the orthotics to be both more comfortable and more effective.

Structural Imbalances

Your foot is an adaptable unit comprised of 26 bones. It has the ability to accommodate to various terrains by flexing and spreading out as well as the ability to become a firm lever for push-off during walking and running. Structural and positional deformities of the feet or lower limb can negatively influence foot function during walking and running.

San Diego Custom Foot Orthotics are used to decrease abnormal compensation. The most common abnormal compensation is termed over-pronation. Over-pronation is when the foot rolls excessively inward towards your midline resulting in excessive, abnormal stresses on the knees and back resulting in pain injury. San Diego Custom Orthotics are effective in returning runners to previous levels of activity.

Pronation and Supination

chartExcessive pronation is movement of the ankle towards your midline during the stance phase of the gait cycle (insert picture). With this excessive, abnormal movement at the foot and ankle comes excessive, abnormal internal rotation of the tibia resulting in shearing forces at the knee. When the knee rotates inward the hip and pelvis follow resulting in shearing forces at the hip and sacroiliac joints. Depending on how a runner or walker compensates will dictate where injuries occur.

No two runners or walkers compensate the same. However, the same injuries usually occur in the same areas but for different compensations.

San Diego Custom Orthotics decrease excessive pronation and excessive shearing forces at the knee, hip and lower back. In this way the quadriceps angle is effectively reduced and your Vastus Medialis Oblique is allowed to function without inhibition. Very few walkers or runner’s actually over-supinate. Supination results during the gait cycle during push-off. After your foot comes in full contact with the ground and is in its maximally pronated position then the motions are reversed and your foot supinates, becomes a rigid lever and you are able to then effectively push-off your big toe.

Shock Absorption

San Diego Custom Orthotics provide shock absorption during walking, running and other athletic activities. Runners and walkers with high arched, rigid feet typically have trouble with absorbing shock due to their foot’s inability to flex and dissipate force on impact. This type of foot requires and flexible, soft orthotic, not a hard rigid device.

Shearing Forces

San Diego Custom Orthotics decrease shearing forces. Many runners develop knee pain that worsens with increased running miles. This is generally a result of excessive shearing forces at the knee and kneecap resulting in a condition known as Chondromalacia (runner’s knee) or another common condition called Iliotibial Band Syndrome.

By changing the way your foot interacts with the ground San Diego Custom Orthotics change the way the forces affect your knee decreasing knee pain and making running enjoyable again.

Who needs orthotics?

If you consistently develop pain as you increase your miles then you are probably a San Diego Custom Orthotic candidate. Unlike injuries that occur at a specific moment in time, like an ankle sprain, over-use conditions typically develop due to a repetitive motion. If you plan on continuing in a sport and thus continuing to perform that same repetitive motion than you must have an orthotic to help decrease the abnormal motion and forces acting on your joints.

In a study done by Blake and Denton (1985) runners treated for plantar fasciitis, shin splints, chondromalacia (runners knee), medial quadriceps strain and patellar tendonitis with custom orthotics reported, 83% felt they were worth the expense, half obtained 90% relief and 75% felt the orthotics improved their running. Not all research on orthotics is positive but there is a simple reason for this. Many doctor’s and therapists prescribe hard rigid orthotics which limit the foot’s motion and actually cause pain in many patients.

A foot has 26 bones and 55 joints because it is supposed to move and have the ability to flex and dissipate impact forces. Hard, rigid orthotics prevent this from happening. San Diego Custom Orthotics are semi-rigid and flexible. They do not stop motion but support it which results in decreased shearing forces in addition to absorbing shock. San Diego Custom Orthotics work synergistically with your running shoe to dissipate impact forces and prevent injury to the runner.
Why San Diego custom Orthotics?

San Diego Custom Orthotics are heat molded to your foot at the time of your appointment. So they are formed to your foot while you are present. In the case of most custom orthotics a plaster mold is taken of your foot, you step in foam leaving an imprint of your foot or you stand on a digital pad leaving an electronic imprint. These are then sent to a lab where the lab technician decides how they will mold your orthotic so that you walk or run better and without pain. The problem with this is the technician is not a doctor, did not physically see your foot, take your history nor understand your condition. Finally after $300-$600 and two weeks of waiting your hard orthotics are ready. As you eagerly put them in your shoes hoping they will fix your condition you are disappointed because they are uncomfortable and seem to actually hurt your foot more than without them. The doctor or therapist says you will have to “break them in” or “get use to them”. What they are telling you is you will get used to them being uncomfortable!

San Diego custom orthotics are prescribed by the San Diego Running Institutes store doctor and the heat molds are taken at the time of your appointment at the San Diego Running Institutes sports injury clinic. The cost is $297 and they are typically ready for you within seven days. At this time you return to try the orthotic, run in it and leave with it for a “try out”. About 75% of the time they are perfect and your condition is significantly improving. Sometimes the orthotic is effective but for some reason uncomfortable. We then have the runner return for modifications at no additional cost. Modifications are typically ready within 1-3 days. San Diego Custom Orthotics typically last 2 years or slightly longer depending on the amount of use and the environment you are using them in.

Have any questions? Please contact us and we’ll be glad to help you along!


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