Question
I've been wearing custom orthotics in my shoes for ~20 years.  I love them, but they're getting a little ratty and need new insoles to attach to the custom heels.  I'm having trouble finding anyone who will refurbish for a reasonable price.  Suggestions?  

Secondly, are over-the-counter orthotics any good?  I'm suspicious of anything that is advertised so heavily. I fear they are unregulated devices, much as many dietary supplements go unregulated despite untenable claims and dubious contents.

Thx.

Answer
Hi, Ken,

Thank you for writing and sharing these questions with me.  I'm sorry you're having such a difficult time finding someone to refurbish your orthotics.  Unfortunately, I don't know anyone in your area who does this.  If you have already called all the podiatrists in your region without success, you might see if there are any orthotists or prosthetists or perhaps even shoe repair shops that might do it.  If you were in FL, I would suggest Cortez Foot & Ankle Specialists, as they have an orthotics lab in their Sarasota and Bradenton offices and routinely refurbish patients' orthotic devices.  

I would have to agree with you when it comes to the over-the-counter inserts.  Some are better than others, but a lot of false claims are made, and none would be nearly as good as your custom pair.  My biggest concern is that many of them are too soft (providing cushion, not support), and the rigid ones typically need to be customized and cannot be mass-produced and still fit accurately, as everyone's foot is uniquely shaped.  Pre-fabricated inserts are an option for individuals who cannot get custom orthoses for whatever reason, but by the time you spend the amount of money for a really decent pair, you might as well get custom-fitted ones.

One more word of caution..."custom" means that a mold or imprint is taken of your foot, using plaster, fiberglass, foam, or sometimes an electronic device, and a pair of inserts is then created from various materials to fit exactly and specifically for you.  Some places advertise "custom fit" and use special machines that you stand or walk on, evaluating pressure points etc, but if after the scan, they can pull out a package containing a pair of already-built inserts (or can hand you anything before you walk out the door), they haven't been made for you and are not truly "custom built."  Most custom foot orthoses take approximately two weeks to get from any doctor's office.

I hope this helps and that you're able to find something that works well for you.  Hopefully there's a repair place not too far away that can help you get the new top over you need, at a reasonable price.

Wishing you health, happiness, and peace,
Dr. Bodart