What is an orthosis for the foot?
Definition - what is an orthosis for the foot?
Orthoses are aids that can be attached to various parts of the body from the outside. They serve to replace failed functions of the body part or a specific joint.
This makes them suitable for both chronic illnesses with irretrievable functional losses and for bridging acute injuries.
On the foot, the orthotics are usually used to stabilize the ankle. But orthoses can also be used for the arches of the foot or the toes.
When do you need an orthosis for the foot?
As a rule, orthotics are required on the foot to support the functions of the ankle.
For example, after an ankle fracture, an aircast splint is well suited to stabilize the ankle.
Nevertheless, in contrast to the rigid plaster of paris, it is easy to step on.
The orthoses are also used for ligament injuries to the ankle.
First of all, hard orthoses should prevent the ankle from tilting to the side.
Softer bandages can be used when returning to sport. These stabilize the ankle, but allow normal mobility.
Another major disease area in which orthotics are used for the foot is paralysis of the lower leg and foot muscles.
Orthoses are used for this, which permanently replace the function of the paralyzed muscles or support them with a partial function of the muscles.
A typical disease for this is the so-called dorsiflexion weakness.
This disease requires an orthosis that lifts the foot with every step.
This is usually done using a splint that connects the foot with the lower leg and thus bridges the ankle, which can no longer be controlled by the paralyzed muscles.
The following article is also of importance to you: What does the lower leg orthosis do?
A weak foot can have various causes.
These are either directly on the muscles that are responsible for lifting the foot (tibialis anterior muscle = anterior tibial muscle, extensor digitorum / hallucis longus = long toe / big toe lifter).
The nerve that supplies the muscles can also be affected (deep fibular nerve = deep calf nerve).
However, there may already be a disorder in the spinal cord, for example due to a herniated disc or in the brain (e.g. due to a stroke).
Due to the weakness or complete paralysis of the foot lifter, the affected foot hangs down with every step.
An orthosis connects the foot with the lower leg and thus bridges the weakened ankle joint.
Read more about this under: Dorsiflexion weakness
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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A torn ligament is usually the result of trauma, for example during sports or an accident.
Usually the affected person kinks their foot.
Depending on whether the foot bends outwards or inwards, the inner or outer ligaments of the ankle are affected.
Regardless of whether the ligaments have been overstretched or have ruptured completely, the ankle must first be stabilized with an orthosis.
This is the only way to keep the foot in the correct position so that the ligaments can grow together again in peace.
A rigid orthosis is therefore used for the foot immediately after the trauma.
Even later, the ankle is not yet stable enough for all movements. For this, softer sports orthoses can be used that allow mobility but protect the foot from twisting.
Read more about this under: Torn ligament
What different orthotics are there for the foot?
There are a wide variety of orthoses for the foot, which support different aspects of the foot depending on the type of limitation of the person concerned.
- For example, anyone who breaks their ankle is usually given a vacuum cast. Instead of the heavy and unwieldy conventional plaster of paris, these mostly gray / green splints are much more pleasant and easier to handle. In addition, affected people are usually allowed to (partially) put weight on their feet again earlier than with a normal cast.
- For injuries such as ligament tears, tears and stretching, so-called aircast splints are provided, which stabilize the ankle against re-twisting, but at the same time maintain a certain mobility in the ankle. Later, the Aircast rails are usually exchanged for softer bandages, which are supposed to provide support when exposed to particular loads.
- A forefoot relief shoe is used for a broken toe. This allows the foot to roll, but shifts the pressure from the toes onto the metatarsus. Other small bandages and orthotics can also support injured toes after the initial healing phase.
- Orthoses for the foot, which are used in cases of paralysis and weaknesses in muscle groups, usually include both the foot and the lower leg and therefore usually fall under the category of lower leg orthoses.
The orthosis fixes the ankle joint, which can no longer be controlled by the muscles due to a symptom of paralysis.
The orthosis is attached to the foot and lower leg and thus allows the foot to move with the lower leg.
For detailed information on this topic, see: Ankle brace
How does an orthosis work?
In most cases, an orthosis for the foot has a supporting function.
For this purpose, the injured or diseased part of the foot is enclosed in the orthosis, above and below the orthosis is attached to the lower leg and foot.
So the force is no longer transferred to the injured part of the foot.
Instead, the orthosis carries this load.
Another variant are orthotics that are intended to stabilize the foot. Due to their shape, they only allow certain movements.
When moving in other directions, the foot is stopped by the orthosis.
This is the case, for example, with the Aircast splint, which is used after torn ligaments.
Lateral movements of the foot are prevented because the structures required for this have to heal again. However, it is possible to stretch and tighten the foot.
In the broadest sense, insoles can also be referred to as orthotics for the feet.
These are placed in the shoe and stabilize the arch of the foot from the sole.
The shoe insert often not only has a stabilizing effect, but also corrects the arch of the foot and thus the entire leg axis.
Orthoses for the foot that also encircle the lower leg are both stabilizing and corrective.
Such orthotics can be specially adapted to the deformity, especially in children who have malpositions in their ankles.
Gradually, the orthosis is changed so that it brings the foot into a more favorable position within months to years.
This can prevent or at least reduce gait disturbances.
Should I also wear the orthosis at night?
Whether an orthosis has to be worn at night depends on its function.
Stabilizing orthoses and those intended to correct misalignments usually have to be worn 23 to 24 hours a day.
Especially at the beginning after an injury or an operation, the foot is not yet stable enough.
For this, an orthosis is put on initially.
When the injured structures have healed sufficiently, the orthosis can be taken off at night.
It is then gradually only needed during stress and unfamiliar movements.
Anyone wearing an orthosis that improves gait, for example, usually does not have to put it on until he gets up.
The orthosis is not needed at night.
Can I use it to drive?
Driving a car with an orthosis is generally not prohibited.
However, it is only advisable if all the pedals required can be operated reliably and with sufficient force.
Especially those who wear an orthosis on their right foot should only dare to drive again when they can apply the brake quickly and safely.
On the other hand, if you need an orthosis for your left foot, you can usually drive an automatic car without major problems.
Cars with manual transmissions should also only be driven if the clutch can be operated reliably.
In case of doubt, an individual consultation with the treating doctor or a responsible physiotherapist should take place.
What should you watch out for when wearing?
There are several things to consider when wearing an orthosis for the foot.
The most important thing is that the shape and size of the orthosis are suitable.
If you wear an orthosis that is too large, your foot has too much leeway.
As a result, the support from the orthosis is not sufficiently guaranteed.
Constant rubbing of the orthosis on the skin can also cause chafed areas or blisters.
Orthoses that are too small can damage the skin as they trigger pressure points.
Structures located under the skin such as blood vessels, nerves and muscles can also be narrowed, which can lead to serious defects.
When wearing it, you should also consider in which situations the orthosis should be worn and how long you have to use it every day.
This is the only way to ensure adequate protection of the foot by the orthosis. Wearing the orthosis too briefly or not wearing the orthosis in stressful situations for the foot can cause additional damage to already weakened structures.
But wearing it too often is also a hindrance in the long term.
Ultimately, the foot should learn to function again without the orthosis.
Sufficient training incentives must be created for this.
So if you wear your orthosis too long and too often, your foot muscles are deprived of the opportunity to train and get fit again.
A special feature of orthotics for the foot is that they often have a higher sole than the shoe that is worn on the unaffected foot.
This leads to a tilted position of the pelvis, which can lead to hip and knee pain as well as back problems.
If necessary, extra soles can be worn under normal shoes to compensate for the difference in height.
This article might also interest you: The orthotic shoes.
The cost of orthotics for the foot varies greatly and depends on how big the orthotic is and whether it has to be specially made.
Aircast splints, sports bandages and similar orthoses are usually available for 50 to 200 euros.
Vacuum rails, on the other hand, are significantly more expensive because they are more complex to produce.
Custom-made orthoses can easily cost over 1000 euros
Does the health insurance pay for that?
Normally, the health insurance company pays the costs for orthoses. If there is sufficient medical justification for the assumption of costs, a simple prescription by the doctor is sufficient for the health insurance company to cover the costs.
As a rule, you have to pay 10% of the costs yourself, but the amount must not be less than 5 or more than 10 euros.
A detailed application to the health insurance company is often necessary for custom-made orthoses.
Whether this pays for the orthosis depends on the indication and necessity and is decided individually.