Medial_OTxFor most people when asked what an “in-sole” is, they would reply “something that you put inside a shoe”. To a degree this is true, although overly generalised. The word insole is an umbrella term for exactly that described above, however, there are a multitude of variations to insoles and their purpose for both footwear and individuals. The use of an insole may be necessary to improve foot function, facilitate healing, reduce friction, decrease shoe odour and improve comfort. The following article gives an overview of the different types of footwear inserts that can be obtained in a commercial or healthcare setting.

Medical Grade Inserts
In the medical/ allied health setting there are a number of ways that an insert can be used to benefit a patient.

Orthopaedic Additions may be used for a short period of time in the case of an acute or low risk injury. These additions include; heel lifts, wedging, metatarsal domes, arch fillers and cushioning just to name a few.

Semi-Custom Prefabricated Devices can be easily adjusted by a podiatrist, through heat moulding, subtraction of bulk from the device and the addition of support in appropriate areas.

Custom Fabricated Devices are footwear inserts that have been designed and prescribed specifically for an individual’s foot and their presenting complaint. A cast is taken of the foot with plaster or a 3D scan. From the mould and an accompanying prescription a device is constructed to suit the requirements of the patient.

How the podiatrist develops a patient’s prescription can be based on a number of biomechanical theories associated with observations made during clinical assessment. I have talked about those previous theories here: https://footnotesblogging.com/2016/12/15/biomechanical-theories-and-foot-orthotics-1000-recipes-for-the-same-dish/

Commercially Available Inserts
Commercially available inserts are generic devices; they are made for the “average foot type”. However, feet are like snow flakes – not as pretty by any means, but no one foot is the same.

Cushion and Comfort Insoles are commonly made from a gel like substance similar to silicon. Structurally the insoles offer little in regards to support, however for shoes that provide more of a fashion statement than something of comfort these low bulk easily malleable insoles can be perfect for softening the ground under foot.

Anti-Odour Insoles use substances such as charcoal to reduce the smell from inside the shoes. For mild cases this may prove successful, however, in many cases further investigation is required to assess the cause of the odour.

Diabetic Insoles aim to reduce pressures in common known areas of friction. It is recommended that patients with diabetes take serious consideration when purchasing over the counter devices as they are at an increased risk of developing complications. The most appropriate device for a diabetic patient is a custom designed device made specifically for their individual feet.

Until Next Time

Jackson McCosker
Chief Editor/ Director

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