Custom Orthotics and Insoles

Orthoses, often called orthotics, are inserts that sit inside your shoes to support the foot and change how load travels through it.^1,2 Podiatrists prescribe them after an assessment, and you do not need a doctor's referral to see one privately (a Medicare rebate needs a GP plan and referral).³ At PDC Health Hub, orthoses are prescribed by our podiatrists. Our physiotherapists work alongside them on exercise and load, but do not prescribe orthoses, so if your assessment points that way they will refer you across. There are two broad types. Prefabricated insoles are made in standard shapes and sizes, and a podiatrist can adjust them for a specific problem. Custom made orthoses are made for your foot from a cast, impression or scan, to a prescription written from your assessment.^1,2 They are prescribed for symptoms and function, for example heel and arch pain, forefoot pain, corns and calluses that need pressure moved off them, or leg pain linked to how your foot takes load. They are not prescribed to change how your feet look. For people living with diabetes who are at risk of foot ulcers, the Australian prevention guideline says orthotic interventions or medical-grade footwear may assist in preventing ulcers, as part of a wider foot protection plan.⁵

Orthoses are one part of care, not the whole of it. A custom device is not always necessary, and for some problems a prefabricated insole is a reasonable first step, so we recommend what your assessment points to rather than defaulting to custom.⁴ For many conditions they work best alongside an exercise program, sensible changes to activity and footwear that suits the foot.^1,4 Your podiatrist considers your foot structure, how you walk, the shoes you wear, your work and your activities before deciding on a device.² For a wider look at insoles and the shoes that go with them, see our orthotics and footwear page.

The visit is straightforward. After the assessment we take a scan or impression if a custom device is needed, and the orthoses are made to your prescription. At fitting we check them in your shoes and explain how to build up wearing time gradually, because feet usually need time to adjust. A follow-up visit lets us check comfort, fit and symptoms and adjust the device if needed.^1,2 Bring the shoes you wear most often, as orthoses need enough room in a shoe to work properly, and your podiatrist may suggest a change of footwear.¹