The custom foot orthotic style begins with an appointment with you and your Canadian Certified Pedorthist. To help determine how your custom foot orthotics will help you best, your primary area of complaint (pain) is the central focus!

Orthotic Design

The material creating the arch support is made to match the contours of the bottom of your feet. A middle layer can provide additional cushioning and comfort, as well as additional support. The top layer (cover) is the layer that contacts your foot directly. This layer can be thin or thicker with additional cushioning or contain certain properties to provide better comfort throughout the day.

The length of your custom foot orthotic can be full length (heel to toe), 3/4 length (to just behind the toes), or ½ length (to just behind the ball of your foot). The style chosen to meet your needs is determined on what is found during the assessment, your primary area of complaint, and your lifestyle!

When cushioning and shock absorption is important, the custom foot orthotic can be made out of softer materials that compresses more easily. When more support and control is necessary, more rigid materials are made within the device. When additional support is necessary, other strong materials can be used to guide the foot where needed.

If there is less space available inside the footwear, thinner materials can be used without affecting the strength of the device.

There are certain features that can be added to take pressure off painful spots. A groove (indent) or adding material in specific areas can be used to relieve pressure. These features can also be included from the harder material of the orthotic device. One example is for a painful big toe joint. The harder material in the orthotic device can be extended to include the big toe. When pushing off the back leg, this big toe doesn’t bend as much and protects the painful joint.

Footwear Considerations

The fit of the footwear is taken into consideration before the orthotic is made. A tighter fitting shoe without a removable insert will have a different design than a looser fitting shoe with a removable insert.

Custom foot orthotics for shoes with a decent removable insert will allow for more space. These kinds of shoes can be, but are not limited to, football cleats, running/walking shoes, cross-trainers or construction boots. In this case, there are many more features that can be used to create the custom foot orthotic. Typically, all recommended features can be used.

For custom foot orthotics in footwear with a tight fit and a thin removable insert, a thinner device is used. These kinds of footwear can be hockey skates, figure skates, downhill ski boots, and some casual shoes. A full-length device can still be used, but it will be much thinner than the previous orthotic. There are some features that may be limited in this option, but all or most can typically be accommodated.

Women’s heels and dress shoes without a removable insert will require a ¾ or ½ length device. In higher heels or very small dress shoes, a style called the “cobra” can be used. This style looks like a question mark because the middle of the heel and the outside of the foot is cut out. The curved heel section of the orthotic is flexible so it can be easily used in the narrowest to wider heels. In most cases, a different shoe is recommended before using the cobra style to improve the comfort.

For kids the ¾ or ½ length can be a popular choice because it allows for fast orthotic transfer from shoes worn in school and outside. Most kids’ shoes do have a removable insert, and a full-length can be used as well.

For the diabetic foot, neuropathy/lack of sensitivity to the bottom and sides of the foot typically means extra cushioning in the middle layer with an accommodative top cover. The priority is cushioning the whole bottom of the foot to offload painful aspects, prevent sores, and improve comfort.

To determine the best style and features for your feet, your Canadian Certified Pedorthist will help guide you! To find one near you, visit

Written by Richard May, Certified Canadian Pedorthist