Orthoses, insoles, arch support, orthotics are all terms to describe a medical device which is frequently used to improve function, pain, and discomfort. Very often orthoses are needed when symptoms affecting the feet, ankles, and lower limbs are not improving with active and passive therapies alone. In other instances, orthoses are used to solely improve function and efficiency in activities such as running, walking or weight training.

When you consider each foot has 33 joints and 3 arches, with lots of variations on how much movement and control we have over them… there is great potential for a lot of good we can do with them. However, unfortunately we can run into trouble when we develop pain and discomfort. This is where orthoses can be helpful as either something you try first or after trying other treatment modalities such as exercise therapy. If, and when, it is time to explore orthoses there are TWO generalised pathways you can choose from, pre-made or custom made.

Pre-made and/or custom orthoses

The pre-made devices are typically a generic one size fits all with no specific prescription to your individual needs. For the masses these types of devices may improve symptoms and that’s great. However, when you have very specific foot, ankle and lower limb problems, these devices probably won’t cut the mustard. This is where custom made devices may offer a solution to your specific issue/s.

Custom orthoses are a prescription device made by your Podiatrist which are designed to improve the way you move and reduce symptoms. There are over a hundred different internal and external modifications that can be made to each orthotic using our in-house CAD CAM software. These include internal and external angles and raises, bumps and depressions which all vary foot to foot, person to person. These modifications are not exclusive to your “arch”, but can be anywhere at the back, middle or front of each device.

Factors to consider when making orthoses

Factors to consider when making orthoses are the types of activities you do, weight, joint range, and your ability to control those joints and for how long you can do this effectively! Then there is footwear… which needs to be considered in the prescription process… More on this in another post.

Further to this, the choice of materials used in orthoses will have unique effects on your feet, ankles, knees and hips. There are several types of materials used to make orthoses. We like to use Latex and lower density EVA devices which we find are well tolerated by all our patients including athletes, weekend warriors, and everyone in between. In rare instances if this softer material choice isn’t for you, we are happy to accommodate with harder materials.

As you can see, there is a lot that goes into designing your customised orthoses. This doesn’t even include making them… which is conducted in our very own in-house Jackrabbit Orthotic Lab.

Benefits of custom orthoses

  • Improve efficiency and stability when you walk, run or cross train.
  • Improve pain or discomfort in your feet, ankles, and lower limbs.
  • They are tailor made to your individual needs… foot to foot. And shoe to shoe.
  • If required, they may be tweaked, modified, or adjusted as your needs change


When custom made orthoses are needed

Custom made orthoses are needed when you have considered the available options, and feel it is the best current solution for your needs. This may be when…

You are looking to improve your performance or efficiency in the activities you enjoy such as running, walking, hiking, cross-training and many more.

  • Your pain or discomfort is not improving as much as you would like with exercise and or manual therapies alone.
  • You want to throw everything at your injury it to improve your symptoms (i.e., exercise, manual therapies, and orthoses).
  • You are wanting to try orthoses prior to pursuing injection or surgical treatment.
  • You found your last pair of orthoses helpful, but also too hard or uncomfortable and are seeking a softer alternative.
  • You are not in a place to commit to exercise or manual therapies but need a solution.


Orthoses are a tool used to guide and support feet, ankles, and lower limbs. They may be used to improve pain, discomfort, or improve efficiency or performance. The only rules for our orthoses are that they must be comfortable, AND they need to improve what they set out to do… pain, discomfort, and or efficiency of movement. Footwear goes hand in hand with the success of your orthoses, so speak with one of our biomechanical podiatrists for your specific needs.