Customizing Over-The-Counter Inserts: A Quick Way To Begin Changing Mechanics

Podiatrists often design custom inserts to change a patient’s mechanics in some way to help their lower extremity problems. Sometimes that correction is direct, such as offloading a sore area with a horseshoe-shaped blue pad. Sometimes the correction is indirect, like the white metatarsal pad to help center the foot.

For instance, I had a recent patient for whom I made three adjustments to a pair of over-the-counter (OTC), drugstore-style insoles. First, I added a heel wedge to help with pronation control. Upon follow-up, his knee and lower back felt better with this intervention, but he developed new problems with the distal second metatarsal. The aforementioned horseshoe padding helped that concern. I also added felt metatarsal pads bilaterally. Once these inserts wear out, since I take photos of each customization, I am able to reproduce the same additions if the patient wishes. I find OTC inserts without plastic (unlike pre-fabs with a plastic base) the easiest to work with since they are more adjustable. Therefore, I can modify or manipulate them the most. 

In my experience, the ability to use OTC inserts for mechanical changes does four common things for your podiatry practice. First of all, you can use what patients already have to begin treatment on the first visit. Secondly, you can experiment with needed corrections before finalizing those corrections in a custom device. Thirdly, even as custom devices are made, you give the patient the ability to have some support in all or many shoes. And last, but not least, your patients will begin to appreciate you as someone who understands foot mechanics.

Dr. Blake is in practice at the Center for Sports Medicine, which is affiliated with St. Francis Memorial Hospital in San Francisco. He is a past president of the American Academy of Podiatric Sports Medicine. Dr. Blake is the author of the recently published book, “The Inverted Orthotic Technique: A Process Of Foot Stabilization For Pronated Feet,” which is available at www.bookbaby.com. 

Editor’s note: This blog originally appeared at www.drblakeshealingsole.com. It is adapted with permission from the author.