Orthotics - The criteria of the Fit
Any orthotic that is going to work has to address the underlying repetitive motion of “overpronation” (overpronation is the maximum range of motion the arch makes with each step, which results in, “wear and tear” over time).

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By Dr. Dennis Kiper
Posted Friday, 7 April, 2006

The biomechanical damage once it occurs is due to a lifetime of all those
footsteps. Comparatively, each footstep is like a mile in a car. So every
decade of life is like 100,000 miles. In order to repair some, most or all of
that cumulative damage is dependent on two things:

1. The proper prescription fit of the orthotic, must meet 4 criteria:

1. The orthotic must be supportive, the person must feel the support such that
   it is full or snug fitting
2. It “must” be comfortable to wear all day without it causing more discomfort
   or problems [this comfort does not relate to symptoms].
3. It cannot overcorrect your alignment position on the ground, you “must” be
   stable.
4. It “must” fit the way your muscles and feet are working and not necessarily
   the architectural fit of just the foot.

2. The other is much more difficult to understand. The one thing no one can tell is how long it will take to get better. Not “feeling” better does not mean the orthotic is not working for you. In fact, if the orthotic meets the “criteria of the fit”, it is working for you. In most cases particularly if you are under 55 years of age and in good health, symptom relief may start to diminish within 60 days.

To reverse the “tissue health” [100%] that is now felt as pain can take weeks, months or even years to restore. Remember every step you take [including around the house, let alone high activity], antagonizes the time it takes to get better.

Depending on various factors such as age, weight, mandatory daily activities (which antagonize the healing process), chronicity of the problem, complexity of the individual’s biomechanics and lastly if you are athletic and continue to be active despite your pain can result in a long delay in even starting to feel better. This is the area in which many people fail. Your level of frustration and impatience to begin to feel better may cause you to stop wearing the
orthotic prematurely.

So, how does one know? Simply by establishing the “criteria of the fit”. In order for that prescription to be precise, there is no compromise in the criteria. If an orthotic is helping you, but is uncomfortable to wear then that is not a precise fit, but it is probably better than nothing at all.

How long will it take? I can’t tell you that, I do know that correcting your alignment position to the ground will improve your lower extremity mechanics and will reverse the damaging effects that a lifetime of overpronation has caused.

Editor's Note: Dr. Kiper is the developer of the Silicone Dynamic Orthortic. For more information go to http://drkiper.com/.

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