Prescription Orthotic Inserts
Written and reviewed by Peter Charles, Sports Podiatrist — 20+ years clinical experience
Prescription orthotics are one of the most powerful tools in sports podiatry for managing and preventing lower limb injuries. At Shoes Feet Gear in Bardon, we design, manufacture and fit custom orthotics entirely on-site — giving our podiatrists complete control over every millimetre of your orthotic, and you a same-visit turnaround when you need it most.
What Do Orthotics Actually Do?
The primary purpose of an orthotic is to optimise or alter the way load travels through the foot, ankle, shin, knee and the rest of the lower limb. By changing how your foot functions, we can use orthotics in several distinct ways:
- Reduce load on an injured structure while it is weak and cannot handle normal mechanical stress
- Optimise load distribution for long-term efficiency and injury prevention
- Protect joints and structures that no longer function as they once did, keeping load minimal so people can continue doing what they love
- Improve performance by optimising biomechanical efficiency
Do You Actually Need Orthotics? Why Diagnosis Comes First
The most important part of the orthotic process is working out why we are using orthotics — and this starts with an accurate diagnosis.
When a patient has pain, we diagnose the injury to understand its specific cause. If that cause is related to foot load or function, then orthotics will be a genuinely helpful part of treatment. But if the cause of pain has nothing to do with foot load or function, orthotics are not going to help — and in some cases can make the condition worse.
This is where clinical approaches can differ significantly. Some practitioners prescribe orthotics without a clear diagnosis, which is a very hit-and-miss approach. At Shoes Feet Gear, we will only recommend orthotics when we have a clear clinical rationale for why altering your foot mechanics will improve your outcome. Getting the diagnosis right before prescribing is non-negotiable.
Conditions We Commonly Treat with Orthotics
Once we have confirmed that foot load or function is contributing to a problem, orthotics become a highly effective treatment tool. The conditions we most commonly use orthotics for include:
Plantar Fasciitis
The plantar fascia takes enormous mechanical stress with every step. Supporting the foot to reduce load on this structure is one of the most effective ways to allow it to repair and strengthen.
Ankle Pain and Tendon Problems
The tendons that wrap around the ankle control foot movement. Optimising foot mechanics with orthotics and appropriate footwear reduces the workload on these tendons and the pressure on the ankle joint itself.
Bunions
Many people don't realise that foot flattening and tightening of the plantar fascia places enormous tension through the big toe joint every time it bends. This is a primary contributing factor in bunions forming and progressively worsening. Orthotics can significantly slow this process.
Shin Pain and Shin Splints
The muscles of the shin control foot movement. Optimising foot function reduces the workload of the shin muscles — both for treating shin splints and, more importantly, preventing their recurrence.
Anterior Knee Pain
The most common complaint we see. The knee is heavily influenced by the foot — if the foot rolls in, the knee rotates inward; if the foot rolls out, the knee rotates outward. Optimising foot function directly improves knee stability and alignment, and the vast majority of patients with anterior knee pain benefit from orthotics.
Hip and Lower Back Pain
This becomes more technically complex as you move further up the kinetic chain, but certain hip and lower back pain presentations respond well to optimising foot function. Our podiatrists will assess whether your presentation is likely to benefit.
Orthotics for Kids with Flat Feet
Deciding whether to use orthotics for a child with flat feet requires clarity about what we are trying to achieve. We look for specific clinical indicators before recommending orthotics for children:
- Pain with a clear cause: If a child is in pain and we can diagnose that their foot function is increasing load and contributing to that pain, improving foot mechanics with orthotics has clear value.
- Instability or functional limitation: If poor foot function is limiting a child's stability, power, or ability to keep up and thrive in sport and activity, orthotics can meaningfully improve their function and performance.
- Strong family history: If a parent has had significant lower limb problems and orthotics have helped them immensely, we will sometimes use orthotics early to help a child thrive and reduce the likelihood of similar problems developing.
- Severely poor foot function: In some cases the foot mechanics are poor enough that we will begin treatment knowing how beneficial it will be for the child's function and pain reduction.
If a child has mildly flat feet, no current or recurring pain, and no significant family history of lower limb problems, we will generally recommend monitoring rather than orthotics — and we will make sure the family knows exactly what to watch for and when to return.
Choosing the Right Orthotic Type
Once we have decided to use orthotics, the next critical decision is the design and material. We need to understand what we are trying to achieve — the specific injury, the functional anatomy around it, and how we want to manipulate load and movement to get the best outcome. A deep understanding of foot and lower limb biomechanics is essential here.
Soft Computer-Milled Foam Orthotics
Made from the same high-quality EVA foam used in running shoe midsoles, these are our most common choice for runners, children, hikers, and people who stand or cover large distances for work or sport. They offer excellent cushioning, comfort, and design flexibility, and significantly reduce the risk of pressure injuries during extended activity. These are milled on-site using our CNC machine to an accuracy of 0.2mm.
Hard 3D Printed Orthotics
For certain injuries or foot types that require rigidity and firm support, we use laser fusion 3D printing to produce traditional hollow-style orthotics from eco-friendly polymer. These last a long time and are easy to transfer between shoes. The firmer material can be less forgiving if not designed precisely, but when indicated they provide a level of structural support that foam cannot match.
Pre-made Orthoses ($110)
Available in-store without an appointment. These provide mild support and are a lower-cost option, but carry a higher chance of irritation or discomfort and are not suitable for managing specific injuries.
How We Make Your Orthotics — The Shoes Feet Gear Process
Owning our scanning, design, and manufacturing equipment on-site gives our podiatrists complete control over every aspect of your orthotic — and means we can manufacture and fit within hours when needed.
Step 1 — 3D Laser Scanning
We use 3D laser scanners to capture a high-definition digital model of your foot in any position we choose. This is the most accurate method available for capturing foot geometry and is critical for an orthotic made precisely for your anatomy.
Step 2 — Biomechanical Assessment and Digital Design
We take detailed biomechanical measurements and use advanced CAD/CAM software to digitally realign your foot, design your orthotic, and specify every angle and feature to 1/100 of a millimetre. This is where clinical expertise matters most — the design reflects your specific anatomy, your injury, and exactly what we are trying to achieve mechanically.
Step 3 — On-Site Manufacture
The digital design is sent directly to our on-site CNC milling machine, which routes the orthotic from your chosen foam material with 0.2mm accuracy. We import different density foams — the same materials used in quality running shoe midsoles. For hard orthotics, the design goes to our 3D printer for laser fusion printing.
Here is a time-lapse of our CNC milling machine in action:
Step 4 — Fitting, Adjustment and Review
We fit your orthotics and make any adjustments live on-site to ensure they are perfect before you start using them. We review patients one week after fitting to confirm everything is optimised. Most patients are confident and comfortable well within that first week.
We also recommend a 12-month review. Soft foam materials gradually compress with use — like a running shoe — and slowly lose some effectiveness. They never stop working, but updating them annually keeps your orthotics performing at their best. Additional pairs for different shoes are available at a reduced cost due to our on-site manufacturing.
Your Orthotic Appointment — Two Pathways
New to Orthotics — Initial Assessment
We start with a thorough history to understand your activity, situation and goals. We then assess your natural body mechanics and lower limb function, and determine whether orthotics are the right plan for you. If they are, we take your 3D scans, complete the biomechanical design, manufacture your orthotics on-site, and fit them — typically within one to three days depending on what other treatments are in place. Any adjustments are made live at fitting at no extra cost.
Existing Orthotic Users — Orthotic Review
If you already use orthotics and want to review, optimise or update your set-up, you can book directly for an orthotic review. We check your mechanics, take new scans if required, and update your orthotics to suit your current function and activity.
Pricing: Soft Digital Orthotics — $750 | Hard 3D Printed Orthotics — $900 (full item codes and health fund information here)
Common Orthotic Misconceptions
"Orthotics need to be broken in and will be uncomfortable at first."
This is not true of well-made, well-fitted orthotics. Because we manufacture on-site, any pressure or comfort issue can be adjusted immediately. Orthotics should never be painful. Uncomfortable pressure spots should be resolved straight away, and orthotics should feel very natural within a few hours. If we are making significant changes to your mechanics we will build up gradually, but most patients can rapidly increase their activity and be fully running within a day or two.
"I should have put my child in orthotics when they were young to prevent flat feet."
This is one of the most common misconceptions we hear. When poor foot function is due to inherited bony and joint structural alignment, using orthotics at age three, four or five does not result in better foot structure when the child is older. The structural angles you inherit are what you have for life. With the right shoes and orthotics your foot will function very well — but as soon as you remove them, your foot will work the way it always has. Orthotics optimise function while you use them; they do not change your underlying structure. There is a small exception for certain acquired injuries where structural failure alters foot mechanics, but for the general population, what you inherit is what you get.
"Once I start using orthotics I'll need them forever."
Not necessarily. Many patients use orthotics during an injury — such as plantar fasciitis — as a tool to allow the injured structure to repair and strengthen back to normal. Once the injury has resolved and the structure can handle normal load, orthotics may no longer be needed. As an injury improves and strength returns, patients can progressively introduce more barefoot time and less supportive footwear. Most people settle into a balance — optimising their set-up for the high-load periods that matter most.
"I need to wear my orthotics all the time."
For most patients, this is not necessary. If you are a marathon runner covering 100km per week, having your orthotics optimised for those training sessions is what matters. Day-to-day low-load activity is a relatively small mechanical contribution and orthotics may make little difference for those periods. However, patients with severe injuries and significant weakness may need to wear orthotics for every step while they are at their most vulnerable — and then progressively reduce this as they recover and strengthen.
"Do orthotics need to be replaced?"
Soft foam orthotics gradually compress with use and slowly lose some effectiveness — similar to a running shoe midsole. They never stop working entirely, but we recommend reviewing and updating your main orthotics annually. Old orthotics can often be kept for lower-load activity. Worn covers are usually a sign that the orthotic is approaching the end of its optimal period and can be replaced easily — free of charge in the first 12 months.
Serving patients from Bardon, Ashgrove, Paddington, Red Hill, The Gap, Toowong, Kelvin Grove, Newmarket and across Brisbane Northside.