FAQs about Orthotics

An orthosis is a mechanical aid, such as a brace, to support, restrict or assist movement of a weak or injured part of the body.   It also can reduce weight bearing forces.  The weakness may be due to conditions such as abnormal tone and neurological dysfunction.  They can aid rehabilitation from fractures after the removal of a cast. Orthoses for the feet are generally referred to as orthotics.

Spinal orthoses are often prescribed for conditions such as cerebral palsy, osteoporosis, scoliotic deformities, spinal injuries and muscular dystrophy and also may be recommended after spinal surgery. The TLSO is a Thoracic, Lumbar, Sacral Orthosis and the LSO is a shorter orthosis, not covering the thoracic area of the spine.  A spinal orthotic (brace) is referred to as a Body Jacket when it is made of a rigid plastic shell that encircles the trunk with overlapping edges and stabilizing closures and provides a high degree of immobility.  At Sunshine P&O we custom fit spinal orthoses for adults and children.

Foot orthotics (also known as “orthoses”) are foot supports customized to fit your feet more efficiently than over-the-counter (OTC) arch supports.  Your orthotist will design them to balance the biomechanical inadequacies of your feet and legs. Most orthotics used are for arch and heel pain (plantar fasciitis), knee pain  (e.g. chondromalacia patellae, or “runner’s knee”) or lower leg tendonitis (eg Achilles tendon, or “shin splints”).   Your orthotist will make a cast of your foot and use measurements of your foot and legs and note your exact medical condition to give you the full support you need.

An insole in a foam or gel insert for your shoe which may provide temporary pain relief but it may not give you the support you may need to correct a specific condition such as back or foot pain from a structural or medical condition.  Orthotic foot inserts are designed to correct the function of your foot by helping to control the amount that your foot flattens.  They help to evenly distribute your weight, realign your skeletal system and take pressure off of your joints.  They can relieve pain due to irregularities in your joints or skeletal system.

Start with shorter spans of time and gradually increase.  You may find that if the orthotic is aligning your foot and leg, there will be some pressure and exertion on your muscles and they need time to adjust.  Start for about one hour on the first day and increase by one hour per day until you can wear them all day.

Except for high impact sports, most orthotics can be worn for a variety of activites.  Sports which exert a lot of pressure on your legs, such as tennis, running, basketball, aerobics, may require a specialized orthotic.  Discuss this with your orthotist so that you get the orthotics most functional for your needs.

An orthosis designed for osteoarthritis of the knee will apply a combination of forces to areas of the knee to keep the two affected bones from touching each other.  This will create more joint space and help alleviate pain.

Your doctor will prescribe how often and long to wear the orthosis – it may be all day or only while participating in certain activities for work or recreation.

Also known as an AFO, this is a brace worn on the lower leg and foot to hold the foot and ankle in an optimal position and correct foot drop.  It is commonly prescribed for disorders that affect muscle function such as muscular dystrophy, multiple sclerosis, cerebral palsy, stroke and spinal cord injury. The brace runs down the calf, attached with a strap, and under the foot, fitting into an accommodative shoe.  The orthotist will align the AFO according to the patient’s needs for support and alignment.

Boot walkers are often prescribed following severe injuries of the foot and ankle, when immobilization is required. They provide immobilization of the ankle to limit dorsiflexion and range-of-motion (ROM).   These boots, available from different manufacturers in a variety of styles, have replaced the traditional fiberglass casting.  The orthotist will custom fit the boot for the patient and provide instruction on putting it on (donning) and removing (doffing) as well as care and cleaning.

An orthotist is a health professional who measures, designs, fabricates and fits orthoses.  He/she will also service the orthoses.

Many drug stores and shoe stores will carry orthotics which are designed with general arch support and height to fit a wide range of people but not necessarily YOU.  They may not provide the support, shock absorption or proper fit you need for your medical condition.  Custom foot orthotics are made specifically for your feet and needs.

Your doctor may prescribe a foot orthotic to help alleviate the discomfort of hammer toes, heel spurs, callouses, corns, metatarsal problems, plantar fasciitis, bunions, diabetic ulcerations as well as minimizing shin splints, back pain and strain on joints and ligaments.

You should wipe them off with a damp cloth, wet with a mixture of a mild detergent and water.  Do not submerse the orthotics in water or put them in a washing machine.  Air dry them, do not use heat.

The length of time an orthotic will last depends upon the material it is made from,  how often the level of activity engaged in while wearing them.  Softer materials wear out every year or 2.  It does not necessarily need to be replaced at that point, it may need refurbishing which is less costly.  Harder materials such as polypropelene is extremely durable and can last a lifetime if there are no changes to your needs or measurements.  Orthotics made of graphite may wear after 2-3 years if used in active sports with high impact or by heavy people.

It usually takes no more than 2 weeks to get used to wearing the orthotics.  Most people start with about 3 hours on the first day and then increase by an hour every day until they are wearing them all day.

Depending on your condition, there are several types of foot orthotics which may be prescribed by your physician.  “Functional” foot orthotics are intended to control or limit unwanted motion in the foot or ankle.  They improve the alignment of the skeletal structure of the foot.  “Accommodative” foot orthotics are designed to redistribute weight through the foot to reduce pressure areas.  They are also used for shock absorption and cushioning.

There are some shoes which will just not fit properly with the orthotic inside, such as women’s heels.  Your orthotics should fit the shoes you wear most often or for a specific activity.

Foot orthotics can help your posture by giving you adequate support and properly distributing weight.  They align the inner workings of your feet and can keep you from slouching.  Slouching causes your feet to compensate by flattening your arches to support you.

Orthotics are custom designed and fitted to relieve foot pain and provide cushioning and support for the often insensitive or hyper-sensitive foot of a diabetic.  They also offer balance for diabetics who may have had toe amputations.

Offloading refers to pressure modulation in the treatment of diabetic foot ulcers.  At Sunshine P&O, we custom fit offloading devices such as foot braces and therapeutic footwear to redistribute weight away from specific areas. We also provide Custom and OTS (Off the Shelf) Shoes for Diabetic needs.

A CROW boot or Charcot Restraint Orthotic Walker is designed to reduce pressure and strain on the surface of the sole of the foot. It was developed for patients with severe deformity of the foot and ankle due to acute nerve damage.  At Sunshine Prosthetics and Orthotics, we will custom fit the boot to your need.

Prosthetic fillers also known as orthotics because they are insoles which contain padding to replace the missing toes.  They are custom fit by Sunshine Prosthetics and Orthotics to  minimize patient discomfort and allow natural walking by improving balance.  They can be prescribed for  partial, transmet, or Symes amputations.

Orthotics can stabilize your heel so that your movements are sharp.  No matter what sport, you want support to help align your spine and keep your feet from making weakened movements which can create injuries.

A KAFO is a Knee Ankle Foot Orthotic. This device extends from the thigh to the foot and is generally used to control instabilities in the lower limb by maintaining alignment and controlling motion. Instabilities can be either due to skeletal problems: broken bones, arthritic joints, bowleg, knock-knee, knee hyperextension or muscular weakness and paralysis.  There are many different reasons to use a KAFO and there are many different designs. Each design has its own special features and its own specific way to be put on properly. At Sunshine P&O, the orthotist will customize it to your specific needs and will show you the proper way to put it on.

Upper limb orthotics are slings, braces and supports used for post-reconstructive surgery, spasticity, sports or repetitive injuries and wound healing.  We can provide and fit them for both adult and pediatric patients.

There are some allowances for growth build into some braces.  There is a small space between the end of the brace and the toes.  When your child’s toes extend over that area, it is time for a new brace.  If the sides and top of the foot show a significant amount of redness and indentation, it also indicates the need for a new brace.

Plagiocephaly is a condition that causes a baby’s head to have a flat spot (flat head syndrome) or be misshapen.

Positional plagiocephaly is the most common form of plagiocephaly. It occurs when a baby’s head develops a flat spot due to pressure on that area. Babies are vulnerable because their skull is soft and pliable when they’re born.  Positional plagiocephaly typically develops after birth when babies spend time in a position that puts pressure on one part of the skull, such as the spot where their head presses against the mattress.   Your Sunshine P&O Orthotist will measure your baby’s head with our newest 3D scanner, in a simple, pain-free, short procedure and fit your baby with the most efficient helmet for his needs.

Torticollis occurs when a tight or shortened muscle on one side of the neck causes the chin to tilt to the other side. Premature babies are especially prone to torticollis. Babies with torticollis can also develop a flat spot on their skull because they often sleep with their head turned to one side.

In many cases, a flat spot on a baby’s head will round out on its own around 6 months of age, as he starts crawling and sitting up.  But to be safe, if you see a flattening of your baby’s head at any time, don’t wait – talk with his doctor immediately.   If you do need to take steps to correct the condition, the younger your baby is, the easier it will be.

A spinal orthotic device (orthosis) is an external apparatus that is applied to the body to limit the motion of, correct deformity in, reduce axial loading on, or improve the function of a particular spinal segment of the body.  This includes the area from the lower spine to the cervical (neck) area.  They are used to stabilize the spine after surgery and healing fractured vertebrae.

Scoliosis is a curvature of the spine into a “C” or “S” shape.  One hip may be higher than the other or one shoulder raised, or the child may lean to one side.  There is congenital scoliosis which is caused by vertebral anomalies,  idiopathic scoliosis which may not have an identifiable cause or neuromuscular, which has developed as a symptom of another condition such as cerebral palsy, physical trauma, spina bifida.

A brace is an effective nonsurgical way to prevent the curve from getting larger. Braces are usually prescribed for children who are still growing and the curves have exceeded 25 degrees.

The custom fitted scoliosis brace should not hurt but it is important to know that, in order for it to be effective, it applies pressure to the side of the chest to correct the curve.  It may be uncomfortable at first but if it continues to hurt, your orthotist can see if it needs to be adjusted.

Your doctor will monitor how fast the child is growing and the bones maturing so that the correction can take place during the growth period, usually adolescent years.

For scoliosis, the amount of time your child will wear the brace each day depends on his orthopedic doctor’s prescription.  It may be 20-23 hours or less or it might be a night time brace, depending on the extent of the curvature and age of the patient. For other purposes such as injury or post surgery, your doctor will provide the answer  depending on the condition.

Your child can participate in almost every activity in which he/she currently.  Depending on the brace, it can be worn to school but with the doctor’s agreement, may be removed for specific activities or sports.

TSLO stands for thoracic-lumbar-sacral orthosis.  They are used to treat scoliosis, custom molded and padded to keep the scoliosis curve from getting worse.  This brace is also called a “Boston Brace”.

CTLSO stands for cervical-thoracic-lumbar-sacral orthosis.  It can be custom molded and fitted to support a weak or damaged area of the spine as well as treat scoliosis. This is also called a “Milwaukee Brace.”

LSO stands for Lumbar-Sacral orthosis, restricting movement and reducing stress on the spine.

A Charleston brace is a nighttime brace, worn while sleeping.  This type of brace is also called a “nighttime” brace because it is only worn while sleeping.