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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

October 1998

Orthotics - Giving Your Feet A Lift - Part 2 - Product Options

By Rick Allen, DC

"Better health leads to better dancing."

Last month we reviewed conditions that may benefit from special foot supports or orthotics. This month I'll review the product options we have in this arena. This will be a short article - I'm burning the midnight oil before leaving to treat bicyclists on Cycle Oregon.

Inside or Outside?

The first decision you and your foot specialist must make is whether to put a separate orthotic insert inside the shoe or to build up the sole of the shoe. The basic rule of thumb is the orthotic must not be thicker than half an inch at the heel. Even that may be too bulky to fit inside the shoe. Over half an inch definitely requires a specially modified shoe. In Portland, Oregon, I recommend Cobbler Bill's on 82nd and SE Foster, phone 503/774-9944. They do a good job putting new soles on dance shoes, too.

Hard or Soft?

If you decide on orthotic insert, you must balance the need for support with the need for comfort. Support may require a rigid, plastic orthotic, as is often prescribed by podiatrists. However, most Chiropractors, including myself, prefer softer, semi-rigid orthotics covered with leather or a man-made leather-like material. The manufacturer may insert a layer of sorbothane to give greater shock absorption.

Just as shoe manufacturers have come up with new composite materials, orthotic manufacturers keep coming up with new options. There are heat sensitive, in-office molding procedures now available. I have not had any experience with these techniques personally, so I can't comment on their viability.

Custom or Semi-Custom?

If your foot problem is not severe, I suggest you first check the line of semi-custom shoe inserts available at a good shoe store. They come in a range of shapes and may be modifiable enough to suit your needs. However, you may need to invest in a pair of custom orthotic inserts fitted by a specialist, such as a podiatrist or chiropractor. These will be created by making a mold of your foot and then manufacturing an orthotic insert unique to your foot. This leads to the final decision...

Neutral or Weight-Bearing Casting?

There are two camps of thought regarding fitting custom orthotics. Both have valid points. Both have drawbacks. I suggest you discuss these with the foot specialist fitting you for orthotics.

Podiatrists, in general, advocate neutral casting. They want to create a cast and then an orthotic that mimics your foot's position in a neutrally "perfect" position. So they have you lie down and press the ball of your foot back until it is in a neutral position - the ankle is at a right angle and the foot level. They then either press a foam box on the foot or wrap strips of plaster of Paris on the bottom and sides of your foot to form the cast from which the orthotic is made.

Chiropractors, on the other hand, generally will take a weight-bearing cast. They believe this better reflects the way you will use the orthotics - standing upright. Most often you will step into a foam box to obtain the impression. This mold is then used to create the orthotic.

Which works best? While I prefer the weight-bearing, semi-rigid orthotics for moderate support and overall comfort, I have examined a number of people who are quite happy with their neutral, rigid orthotics. I suggest you ask for a money-back satisfaction guarantee when making your purchase.

I know I have not covered every possible option in this short article. If you are a manufacturer who has successfully met the unique challenges of foot support for dancers, especially females, I'd love to hear from you with your innovative solutions. If you are a dancer who has found such a solution, I would love to hear from you, too.

Wrapping up - check your feet and keep on dancing!

Next article: What are the steps your foot specialist will use to assess postural stability and the need for special foot supports? Let's get an overview next month.

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