Dr. Joseph Kottoor

Custom Orthotics


Orthotics are custom made shoe inserts designed to treat one's foot biomechanics. Poor foot biomechanics may lead to ankle, shin, knee, hip and back pain. Orthotic insoles can be simple, generic devices which are sold over the counter in stores.The best orthotics, however, are custom-molded orthotics specially crafted to meet the needs of a particular individual. This is done by making an impression of the foot in an ‘ideal position’ called a non-weight bearing subtalar neutral cast. Specialists in an orthotic laboratory use this cast to mold a high quality orthotic. The finished orthotic is then placed in the patient's shoe and helps keep the foot in proper alignment.

We use The Orthotic Group laboratory for our prescription orthotics:

Overpronation and Oversupination are the 2 major types of biomechanical foot disorders which can lead to several different injuries.

Overpronation is often associated with flat feet or low arches.

Overpronators may suffer from a number of overuse syndromes:

  • plantar fasciitis
  • low back pain
  • Achilles tendonitis
  • metatarsalgia
  • shin splints
  • bunions
  • patellar (kneecap) tendonitis
  • iliotibial band syndrome
  • patellofemoral syndrome

Oversupination is often associated with rigid, high arches.

Oversupinators suffer from problems related to poor shock absorption and are at a greater risk for developing osteoarthritis at the major weight bearing joints. They may also experience low back, knee, heel, and hip pain.

With overpronation or oversupination, the wrong muscles contract or they contact out of their proper, critical sequence. Your muscles and tendons eventually fatigue and break down suffering microscopic tears. This triggers inflammation leading to swelling, pain, and scarring in these tissues. As well, your joints may suffer excess wear leading to inflammation and possibly degeneration. Consequently, pain and dysfunction may arise in your feet, ankles, legs, knees, thighs, hips, low back, and further "up the chain."

Treatment for any of the above conditions includes reducing inflammation, strengthening and stretching the involved muscles, and promoting proper joint mobility. In addition, custom made orthotics can play an integral role in the overall treatment of many problems caused by ankle and foot dysfunction and more importantly, prevent re-occurrences.