Orthotic Devices and AFOs

When it comes to the possible tools and techniques we have to help patients overcome painful conditions, perhaps the most versatile is the use of orthotic therapy. Custom orthotics can be used to treat issues as diverse as bunions, cavus foot (high, rigid foot arches), flatfoot, metatarsalgia (forefoot pain), and plantar fasciitis (the leading cause of heel pain for adults),  any and all problems related to how the foot is functioning.


These medical devices are customized to the unique specifications of a patient’s feet, typically fit within regular footwear, and allow normal movement (in a biomechanically-improved functional position). When ailments are discovered early on, the use of custom orthotics can prevent or delay the necessity of surgery later on down the road.

Why Do We Prescribe Orthotics?

Orthotic devices generally fall into one of two categories:

  • Soft Orthotics – Soft orthotics are typically prescribed to absorb shock, increase your balance, and/or relieve pressure on sore or uncomfortable areas in your foot. Foot deformities (bunions, hammertoes, corns, calluses), arthritis, and diabetic foot care are all reasons you could benefit from soft orthotic devices. In order to provide superior cushioning, they are constructed from soft materials and may extend along the length of the entire foot.
  • Rigid Orthotics – Whereas soft orthotics serve to decrease pressure and protect the foot, rigid models are used to restrict or control abnormal movement and improve function. In order to do so, this type of medical device has a solid construction necessary for regulating movement. Rigid orthotics are constructed from plastic, carbon fiber, or other firm materials. They are often intended to be worn in athletic, walking or dress shoes and can help alleviate or eliminate foot pain, aches, strains or even tears of the soft tissues in the lower limbs by shifting the body weight to the more durable boney structures.
  • Hybrid-Rigid Orthotics with accommodative extensions– When you need both the cushioning benefits of soft orthotics with the motion-controlling aspects of rigid ones, our doctor might prescribe a Hybrid version. These usually combine layers of soft materials in those areas that need them and are reinforced with rigid ones to provide structure, improve balance, and still offer a certain degree of cushioning. They are especially excellent for athletic use, and may be prescribed to athletes who experience pain while training or competing. Children with certain issues, including flatfoot conditions, can also benefit from this particular orthotic style, as well as adults with painful callus areas that are protecting a boney prominence


The primary reason that orthotics are so effective at addressing medical issues is the simple fact they are customized for a patient’s unique feet and gait pattern. In addition to the aforementioned conditions, we use them to treat hammertoe, Morton’s neuroma, and limb length deformities. Additionally, we may prescribe orthotic devices as treatment (and prevention) for neuropathic ulceration.

There are also as many types of orthotic modifications as there are conditions that benefit from using them as part of a treatment plan. These include:

  • Heel wedges used to guide the foot into turning either inward or outward and improve function to better align the bones in the ankle region decreasing stress on the soft tissues and cartilage.
  • Heel flares used to prevent inward or outward turning and offer stability for a longer period of time during the contact phase of gait
  • Rocket bars used to shift the rollover point from the metatarsal head to the metatarsal shaft to prevent discomfort under the ball of the foot from bone pressure that caused calluses with good circulation, ulcerations in patients with poor circulation.
  • Toe crests used to fill the void under the under curled toes. (These devices are typically closer to the body and are often placed behind the second, third, and fourth toes to reduce pressure, causing corns at the tips of the toes)

How Do Orthotics Help Pronation Issues?

In addition to a wide array of medical conditions and injuries, orthotic devices are also used to correct pronation abnormalities. Pronation is a natural process used by feet in every step they take. During the ground portion of a step, the foot rotates inwards from the heel strike all the way through the final push of the toes. This rotation isn’t intended to be particularly great—around fifteen percent is ideal—but it is quite important for ensuring proper distribution of the forces that come from walking and running.

Depending on an individual’s foot structure, he or she may either pronate too much (overpronation) or not enough (where the foot is left in a supinated position). As a general rule, overpronation is often linked to flatfoot and supination is connected to cavus foot. These pronation abnormalities lead to unequitable distribution of force loads, which means that certain areas of the foot face more pressure than they are intended. This can lead to a variety of issues.

The good news is that custom orthotics can help with either of these biomechanical irregularities. Rigid (also known as “functional”) orthotic devices are particularly useful in this regard.

Healthy Running with Orthotics

So What Are AFOs?

Whereas many orthotics are designed to slip inside your shoes and reside there unseen, sometimes it is necessary for us to prescribe Ankle Foot Orthosis where the foot plate is attached to a leg brace.

Ankle-foot orthotics (AFOs) are designed for greater control of the ankle’s position and motion to compensate for deformities and weakness caused by conditions like arthritis damaged ligaments or drop foot. AFOs are also used to treat peripheral neuromusculature, disorders that affect muscle function, and stroke patients.

No matter what type of orthotic is right for you, the office of Jan David Tepper, DPM Family Foot and Ankle Center will make sure you are prescribed custom orthotic inserts that alleviate pain and discomfort. If you experience any conditions of the foot and ankle that you prefer to take care of non-surgically or an adjunct to surgery, contact our Upland, CA office by calling (909) 920-0884 and schedule an appointment with us today!

Why See a Podiatrist

If you (or any of your family members) are suffering from a condition or injury causing pain in the lower limbs, it could warrant an office visit to see a podiatrist. Why? Well, because podiatrists are doctors who specialize in treating foot and ankle issues. This means a prime reason to see a podiatrist is to find relief from a foot or ankle problem causing pain, difficulty, or taking away your ability to participate in favorite activities.


When everything performs as intended, it is quite easy to take our feet for granted and not think about everything they do for us.

Feet and ankles not only enable movement, but they also have to support the entire body when we stand. Whereas this typically goes unnoticed (unless a problem develops), the lower limbs endure tremendous amounts of physical force. Even just walking at a normal pace places up to two times your bodyweight on a foot as it lands while taking a step!

At our Upland office, we provide a wide range of podiatric services for patients. Some of the broader categories of problems we can resolve include heel and arch pain, toe deformities, skin and nail conditions, and sports injuries.


An especially important service podiatrists provide—one you might not think about—is diabetic foot care. Most people might be aware of the other areas of foot care, but not as many are aware of the fact diabetes can cause serious problems in the lower limbs. Perhaps the most serious of these problems is the development of diabetic foot ulcers.

Foot ulcers are wounds that do not heal because of systemic damage caused by the diabetes. Left untreated, ulcers can become gangrenous over time. There is no treatment for gangrene, which means amputation is the only way to keep it from spreading.

Losing a limb is concerning enough, but this can be a life-threatening situation. In fact, the mortality rate for a diabetic foot ulcer is greater than the rate for several forms of cancers – including breast, colon, and prostate cancer.

If you were to ask a sampling of podiatrists why patients come see us, you would learn that one of the most common conditions we treat is heel pain. A couple of reasons explaining this are the tremendous force loads we all place on our feet (even when simply walking) and the way the foot is structured, specifically with a couple of tissues connected to your bone (the Achilles tendon and plantar fascia).

In addition to internal injuries and conditions that cause pain, you should also see a podiatrist if you have a toenail condition or an issue with the skin on your lower limbs. We provide effective care for issues like fungal and ingrown toenails, plantar warts, and severe cases of cracked, dry heels.

cracked heels

Unfortunately, despite having pain or discomfort, many people do not seek the help of foot care specialists because they believe it is not serious. However, many podiatric issues can be indicative of more serious health issues and can lead to chronic problems. It is important to come in for a visit and give us the opportunity to provide you or your loved ones with a proper diagnosis and treatment plan to resolve the problem, take away any pain, and let you get back to your favorite activities!

Keep in mind that physical pain and discomfort is never a normal state. Pain is how your body tells you something is wrong. Remember, many foot and ankle ailments are most-easily treated in early stages and become harder when left unaddressed, so it’s best to listen to your body.

If your body is telling you something is wrong with a foot or ankle, call us at (909) 920-0884 for more information or to request an appointment with our Upland, CA office.