What are orthotics?
Custom orthotics are an insert for your shoes that are molded to your foot to help maintain a neutral foot position. Neutral means that the forces going through your joints are equal, and this helps to keep an upright position. Muscle function can change with change of joint position. Malalignment decreases normal functioning of joints and soft tissue biomechanics. Joint malalignment alters muscle functioning resulting in muscular imbalance, which can lead to injury. Sometimes our joints are misaligned due to loose joints and laxity. Orthotics help give an outside force to correct joint laxity that cannot be rehabilitated.

Examples of reasons to get a custom orthotics:
Over-pronation or over-supination due to joint laxity. This can cause premature wear and tear to our knees, hips, and back if not corrected.

Leg length discrepancy.
Over time, our joints and muscles can acquire damage if not corrected. Custom orthotics can include a built in heel lift while still supporting the arch and forefoot position, unlike a standard heel lift that may negatively alter the forces through the arch and forefoot.

Morton's neuroma.
A metatarsal pad combined with arch support can relieve nerve pressure.

Turf toe.
An extension of supportive material can protect a sprained toe joint.

Bunion.
Supporting a hypermobility of the 1st tarsometatarsal joint can improve weight bearing through the big toe and reduce pressure from torsion.

Custom orthotic versus over-the-counter:
Over-the-counter orthotics correct for a lack of arch support only. This may be very helpful for someone who has a mild to moderate amount of pronation without malalignments of the heel. If your heel is angled inward or outward (everted or inverted), posting of solid material around the heel can be built into a custom orthotic. If your arch and heel position cause excessive weight bearing on the outer foot, a custom orthotic with heel posting can re-position the heel inward while maintaining arch support. If you can collapse an over-the-counter arch support with the weight of your hand, chances are that your body weight will not be supported. Custom orthotics can be made of much harder material that will last for years.

How is a custom orthotic made?
When a physical therapist performs and evaluation of a patient and determines the patient could benefit from custom orthotics, the therapist will cast a mold of the patient's foot. The therapist then sends the evaluation and mold of the patient's foot to a lab that specializes in making custom orthotics. The lab will work with the therapist in determining the composition of the orthotics, including materials, rigidity, size and shape, depending on the type of activity the orthotic is designed for. The orthotic is then sent to the therapist, who helps the patient fit the device in their shoe and gives parameters for use.

Anna Ellenberger, PT, DPT, MTC

I know, most of you are thinking "WHAT?" Is it really possible to stay energized without my regular cup of coffee (or 2) or extra large mocha frap? And the answer is yes! There are definitely tricks of the trade to help keep you healthy and awake without a sugar crash from the 32oz sweet tea you think you can't live without... I know, it seems crazy... You may be saying to yourself, "But I have a work schedule in which I need to be awake at 3am..." or, "But I have 4 kids and have to accommodate all of their schedules..." But believe me, it is possible. Thanks to Amy, our registered dietician and newest addition to our staff, we now have ways to help keep you healthy and prevent you from crashing. And here they are!

Eat regularly.
Blood sugar typically rises and falls throughout the day, so be sure to eat a small snack or meal every 3-4 hours in order to stay steady.

Eat right.
Eating carbohydrates by themselves won't make for lasting energy. Be sure that each time you eat, you are getting some combination of protein and/or fats with your carbs, such as a 1/2 bagel with peanut butter or crackers with cheese. Avoid eating too many refined sugars, such as sodas, ice cream, or candy.

Eat all day long.
Start with breakfast no more than 2 hours after you rise, and keep the fuel coming throughout the day.

Eat your colors.
Fruits and vegetables contain the vitamins and minerals needed to process energy in the body. A lack of these vital nutrients can lead to energy slumps. Each of the different colors found in fruits and vegetables contain different nutrients, so be sure to seek out variety.

Avoid caffeine.
Drinking caffeine has actually been shown to throw off the body's natural ability to regulate sleep. It's a vicious cycle! If you are a caffeine-addict already, try tapering down by 1/2 cup every other day until you are caffeine-free. The headaches and cravings will pass and eventually disappear. And the benefits will last a lifetime :)

If you have any other questions about your diet and want to consult Amy, please call (858) 457-8419 to schedule an appointment for a consult!

Amy Ornelas, R.D.