What happens when... I get custom orthotics?
I’m so excited for you, you’re going to feel so much better! I can walk SO much longer without pain with my custom orthotics, and I really hope it’s the same for you! I think it’s super cool how making a tiny adjustment at your feet can make such a massive difference in how you feel.
This post is about the kind of custom orthotics that are like shoe inserts and just go under your foot, not AFOs or anything more complex. And there are a lot of different ways you might get casted for custom orthotics, so I’m just going to write about the one I get. My evaluation and casting was done by a physical therapist, but you can also get custom orthotics at a dedicated orthotics and prosthetics office.
So! Getting custom orthotics starts with an evaluation to figure out what’s going on with your legs. They’ll watch you stand and walk in bare feet, measure your ankles and feet really precisely, and move around your knees, ankles, and toes.
Once you’re done getting measured, then it’s time for getting casted. They had me lie on my stomach on the exam table with my feet hanging off the end. I’m really jumpy, so they also put a mirror up by my head so I could watch what was happening and that was really nice. I think most PT and orthotics clinics have a mirror around, so it’s worth asking if that would help you too!
The actual casting involves strips of plaster placed over the soles of your feet, and then smoothed by hand to become the right shape. It’s very similar to if you’re ever had a plaster cast for a broken bone, except it’s right on your skin. It’s warm and kind of slimy because it gets soaked in hot water to soften it. It takes a bit to get this part done because they have to get the plaster strips smoothed so they’re snug to your feet and cover every part. And then you wait for it to dry and harden while you hold still- I remember that taking around 10 minutes. Once it’s hardened, the plaster cast gets carefully slid off and you have a perfect mold of your foot! It leaves some chalky white residue on your feet, but whatever doesn’t come off with a towel will come right off with water. And then you (most likely) do it all again for the other foot!
The finished molds go off to whoever is making your orthotics, and you wait at least a couple weeks while they make your new “feet”. The actual orthotics will be plastic or carbon fiber on the bottom, with some fabric over the top.
When your orthotics are made, you go back in for the final steps! (pun not originally intended, but now that I’ve noticed, I’m leaving it in) They’ll have you stand on the orthotics to test the fit, and the fabric on top needs to be trimmed. (If you have to trim your own, just trace the inserts that came with your shoes!) The most important part here is to SLOWLY build up how much time you wear your new orthotics for each day. Seriously, add maaaaybe an hour each day. Custom orthotics are adjusting not only the alignment at your feet, but everything else up through your lower back too, it totally changes how you walk. For the first week or so after I got mine, I would just randomly lose my balance and like, tip over in the grocery store! If you go too fast, things might start hurting even if your orthotics are perfect. So if things are hurting, try backing off how much time you wear them for. But if you’re going nice and slow and it’s still ouch, definitely get in touch with your PT or orthotist.
Congrats on the new “feet”!!














