PRIME TIME: Foot problems easier to bear with orthotics

PHOTOGRAPHER: Bill Buell

Not everyone needs foot orthotics, but if you think they might help you, then they probably will. Buy a $10 sole insert and then go see a podiatrist.

“Quite a few people can find relief with over-the-counter products, and I recommend to patients that they try that first,” said Dr. Gerald Campo, a podiatrist in Niskayuna for the past 26 years. “Sometimes the one-size-fits-all orthotic can work. But if you’ve tried a few things without any relief, then it’s time to try a custom orthotic. They’re like eyeglasses. They’ll improve the quality of your life.”

Orthotics have been around for a long time, even before cobblers started making shoes specifically for the right and left foot in the early 19th century. But they were heavy and cumbersome, could be quite uncomfortable, and were typically used only by people with extreme foot problems. New technology in the early 20th century made orthotics more practical and affordable for the general population, and in the 1960s the advances in thermoplastics created a bit of a boon in the industry.

“Then, corresponding with the more functional orthotic, you had the jogging craze in the 1970s and ‘80s,” said Campo. “People were getting older and asking questions, and that aging population started researching orthotics on the Internet, and they became much more aware of what was available.”

‘Never without them’

Dave Graham Sr., a 66-year-old Glenville resident who plays tennis and ice hockey, has worn orthotics for 30 years and is a big believer in them.

“I still have my original hard plastic pair for walking shoes, and then I have two more of the expensive pairs that were made of the more pliable plastic and are a bit spongy and more comfortable,” said Graham. “I wear them religiously, and I also have the store-bought kind for $8 that I can just throw in my gym bag just in case I need more cushioning. I’m never without them.”

While Graham wears his orthotics all the time, that wasn’t, evidently, always the consensus among podiatrists.

“I can remember over the years a lot of athletes telling me that when their doctor prescribed orthotics, they only needed to wear them while they were doing something athletic,” said Graham. “My doctor, however, told me to wear them all the time. He said the whole bottom half of my body is being realigned when I wear orthotics, so it made sense to always have them in.”

Dr. Steve St. Lucia of Union Orthotics and Pedorthics on Eastern Parkway in Niskayuna agrees that using your orthotic in whatever shoe you may be wearing is a good idea.

“If you look at our anatomy when we were born, our legs were bowed, and by 7 or 8 years old they should rotate out,” said St. Lucia, an Albany native and Christian Brothers Academy grad. “But we all have the predisposition for something to happen. When your foot comes off the ground it’s slightly angled, and it’s the degree of the angle between your foot and the ground, and the speed in which it hits the ground that will determine if you have any problems down the road.

“When you transfer all that pressure from your hip, your lower back, your knee and then your foot, a lot of people are going to develop a problem,” continued St. Lucia. “Not everyone, but that repetitive stress over a lifetime may cause an injury to some people. Orthotics can help those people, and we like to feel that it’s preventative as well as therapeutic.”

In Malta, Dr. Russell Mongiovi has plenty of patients who are battling the aging process, and a secret to success is not overlooking the condition of your feet, especially those who are trying to get “back in shape.”

“Unique to many patients in the 50-and-over group is a slower ability to recondition,” said Mongiovi. “After prolonged periods of decreased activity, the body loses natural strength, endurance and flexibility. We find many patients develop foot problems as a result of a change in lifestyle in which they become more active and have not given themselves time to allow their bodies to develop the level of conditioning, strength and flexibility required for their intended activities.”

Whether you’re a mall walker, a weekend warrior or a highly-competitive athlete in superior shape, orthotics can help.

“Our practice has diverse representation in level of athletic performance from professional athletes to recreational walkers of all ages,” said Mongiovi. “When evaluating a patient it is important to understand the level of conditioning of each individual. Our patients are evaluated for structural and functional capacity, and when an orthotic is prescribed, it is used to address the specific pathomechanics of the patient.”

Often not covered

Prescription orthotics generally run between $200 and $400, and are often not covered by health insurance companies.

“I would say they’re covered in about 30 percent of our cases,” said Campo. “We have quite a few patients paying out of their own pocket for something they medically need, and I think that’s wrong. They should be covered.”

“Several insurance companies have developed very specific situations in which they will reimburse for foot orthotics,” said Mongiovi. “This appears to be an ongoing evolution. Without regulating standards of production and fabrication, each patient continues to be evaluated on a case-by-case basis.”

While orthotics are used by world-class athletes to enhance their performance, they’re also vital to members of the general population that are trying to get through their workday without too much pain.

“We get athletes, but we also have just average workers who are on their feet all the time and are in pain,” said St. Lucia. “State workers, teachers and nurses; I’d like to see them all covered by insurance. We are getting more companies to cover them, and hopefully as people see the benefits of orthotics we’ll see an increase in coverage.”