A practical guide to custom orthotics 

What are orthotics? 

Orthotics are insertable devices worn inside shoes that help correct and support how the feet function. They are custom-made medical devices designed for an individual’s specific anatomy and biomechanics.  

They work by redistributing pressure, supporting the foot, and improving alignment of the foot, ankle, knees, hips, and often the lower back. Orthotics help your feet, joints and muscles work together more effectively when you move. 

Orthotics don’t simply cushion the foot; they change how forces move through the body while you're standing, walking or running. Each pair is designed specifically for your body, biomechanics, and goals, and fitted by an experienced clinician. 

While many people might think of orthotics as useful inserts, they are long-term mobility tools. When you are prescribed orthotics, this is a lifecycle-based clinical solution. 

Who needs orthotics? 

Orthotics are commonly recommended for people who have pain, instability or recurring injuries linked to foot mechanics. People who may benefit include those with the following conditions: 

Foot pain  

• Plantar fasciitis 
• Heel pain 
• Arch pain 
• Metatarsalgia (ball‑of‑foot pain) 

Ankle or lower‑limb issues  

• Chronic ankle sprains 
• Achilles tendon pain 
• Shin splints 

Knee, hip or low‑back pain  

• Especially when pain is influenced by walking or standing mechanics 

Structural or biomechanical differences  

• Flat feet (overpronation) 
• High arches (supination) 
• Limb length differences 

Medical conditions  

• Diabetes (to reduce pressure points and prevent ulcers) 
• Arthritis 
• Neuromuscular conditions 

Active individuals  

• Runners or athletes with repeated overuse injuries 
• People whose sport places high demand on the feet 

Not everyone with foot pain needs orthotics. They’re often considered when symptoms are persistent, recurring or limiting your ability to engage in normal activities. 

At Medcan, orthotics may be prescribed as part of a broader mobility care plan to improve comfort, alignment and function during daily activities, exercise and sport. 

What do orthotics do? 

Custom orthotics can help reduce pain in the feet, knees, hips and lower back, improve alignment and movement efficiency, reduce repetitive strain on joints and soft tissues, and support recovery from injury. In some cases, they can also be used to enhance performance and endurance during activity. Here are four common goals of orthotics:  

1. Improve alignment 

The feet are the foundation of movement. When foot mechanics are off abnormal forces can travel upward to the knees, hips and back. Orthotics help guide the foot into a more efficient position. 

2. Reduce pain 

By redistributing pressure and controlling excessive motion, orthotics can relieve stress on irritated tissues such as plantar fascia, tendons and joints. 

3. Support healing and prevention 

Orthotics are often part of a broader treatment plan where they help injuries heal by offloading stressed areas and prevent recurrence once symptoms improve. 

4. Enhance performance and comfort 

For people who stand or walk for long periods – or athletes who train intensively – orthotics can improve comfort, endurance and movement efficiency. 

How are orthotics made? 

Creating orthotics starts with an in‑person assessment by a qualified healthcare professional. This is often a podiatrist or chiropodist. At Medcan, only licensed chiropodists provide custom orthotics. 

They will take a health and injury history, assess foot structure and do a gait analysis – which is a detailed assessment of how you walk or run – along with a joint mobility and muscle balance assessment. The overall goal is to understand how your feet move and how that movement affects the rest of your body. 

Foot mapping or scanning 

Once the assessment is complete, a model of your feet is captured using a 3D digital scan. A 3D digital scan uses optical or laser technology to capture a precise, three‑dimensional image of your feet while you’re standing, seated or in a corrected position. It’s quick, comfortable and highly accurate. 

Using the scan, your clinician will create a detailed prescription that specifies: 

• Level of support or correction needed 
• Arch height and shape 
• Heel posting or wedging 
• Pressure relief areas 
• Materials (rigid, semi‑rigid, cushioned) 
• Intended use (walking, running, work shoes, dress shoes, sport‑specific) 

This is where custom orthotics differ vastly from generic inserts. They are designed for your feet, your body, and your lifestyle.  

Lab fabrication 

The prescription and foot model are sent to a specialized orthotics lab where technicians create a shell from materials like carbon fiber, plastic or composite blends. Then, they add layers for comfort and durability. Finally, they shape and fine‑tune the orthotic to match the prescription exactly. The result is a device engineered for both biomechanical correction and long‑term wear. 

Fitting and adjustments 

When the orthotics are ready you’ll return for a fitting. Your chiropodist will check how they sit in your shoes, assess comfort and alignment and make immediate adjustments if needed. 

You’ll also get guidance on what to expect during your break‑in period, which is commonly gradual over 2-3 weeks. You’ll also be informed as to when and how to wear your orthotics and what sensations are normal and to expect. Follow‑up visits are common and recommended to ensure the orthotics are working as intended. 

Orthotics should be assessed every 12 months because over time your body's mechanics (strength, flexibility, posture), activity level or footwear, and your clinical needs are likely to change.  From compression and wear, the materials in your orthotics may also require an upgrade. 

At Medcan, we recommend reviewing your orthotics annually to ensure they continue to support your movement, comfort and activity goals.  A routine orthotics review helps confirm your orthotics are still providing effective support, prevent new or returning pain caused by wear or misalignment, adjust your prescription as your movement patterns change and decide whether modification or replacement is needed. 

What to expect from orthotics  

Many people notice some improvement within the first few weeks, particularly in comfort and support during walking or standing. For those with pain that has been present for a long time, improvements can be more gradual as the body adapts, and tissues settle. Orthotics are not an instant fix, but they’re designed to support progressive, long‑term improvement. 

Sometimes people feel some discomfort as they are adjusting to orthotics, but it should not be long term. Although you may feel different at first, you shouldn’t be in pain. Since orthotics change how forces move through the foot and body, it’s normal to feel new pressure or awareness, especially in the arch or heel, as your body adapts to improved alignment. 

Mild soreness or muscle fatigue. particularly in the feet, calves, or legs, is also normal during the break‑in period. This is similar to how your body feels when you start using new muscles more efficiently. If discomfort persists or worsens, follow‑up adjustments are typically recommended. 

Frequency of wear 

Most people start gradually and build up their wear time. Depending on your goals and symptoms, orthotics may be most important during long periods of walking, standing, exercise, or sports. Your physician will guide you on when and how often to wear them for best results. 

Some people use orthotics as long‑term support, while others rely on them more during certain phases of activity or recovery. If orthotics are addressing a biomechanical issue, stopping wear may allow old movement patterns and symptoms to return, especially during higher‑load activities. This is where regular review helps determine what is appropriate for you. 

Shoes that work best with orthotics 

Orthotics work best in shoes that have a removable insole, adequate depth and a stable heel counter. Many orthotics are designed with lower‑profile options for dress shoes or narrower footwear. Running shoes, walking shoes and many work shoes work with orthotics. However, in some cases, a second pair may be recommended for specific shoe types. 

Many people can use their existing footwear. If a shoe is very worn, unstable, or shallow, your physician may recommend replacing it to ensure the orthotics work as intended.  

In many cases, one pair can work for most shoes, especially if they are for everyday shoes with similar structure. However, some people benefit from different orthotics for different demands, such as sport versus dress or work footwear. This is reviewed as part of follow‑up care. 

Part of a broader rehabilitation plan 

At Medcan, orthotics are prescribed as part of a comprehensive mobility care plan. While custom orthotics on their own can provide meaningful symptom relief, they don’t address every contributing factor. 

Lasting improvement often comes from pairing orthotics with strategies that strengthen muscles, improve joint mobility and retrain movement patterns. Without this added support, underlying issues such as weakness, stiffness or compensation patterns may persist. Symptoms can plateau or return when orthotics aren’t worn. They can also reemerge as activity levels increase. 

That’s where strength, mobility and targeted rehabilitation play a critical role. When combined with personalized exercises, orthotics work more effectively by supporting alignment during movement, while rehabilitation helps the body move more efficiently and independently over time. 

The goal is not only short‑term comfort, but long‑term function, durability, and confidence in movement. The goal is always for clients to return to daily activities, exercise and sport with better support and stronger foundations for the future.