Patient Resources



Why Choose Custom Orthotics?

This section of our site is dedicated to patients who may be considering custom orthotics. We have put together some basic information that may be useful to you.

Note: If you are a patient who may be in need of custom orthotics, please see a medical professional.

We have also enlisted a number of prominent physicians to write articles designed to provide general information on some common foot related problems.

The following types of medical professionals prescribe custom orthotics:

  • Podiatrists (DPM)
  • Medical Doctors (M.D.)
  • Orthotists (CO)
  • Prosthetists (CPO)
  • Physical Therapists (PT)
  • Chiropractors (DC)
  • Pedorthists (C. Ped)
  • Athletic trainers

About Custom Orthotics

Custom orthotics are a proven solution for aiding in the treatment of various foot related pathologies. They are designed specifically for your feet based on a prescription submitted to us by your doctor.

Over the years, Marathon Orthotics, Inc. has made tens of thousands of custom orthotics for patients all over the United States.

We take pride in knowing that our products can provide real treatment, support, comfort, and pain relief to those who utilize them.

The health of your feet affects your entire body, and we believe strongly that effective custom orthotic solutions can improve a patient’s overall quality of life. Those who have tried custom orthotics tend to agree!

Basic Information on Various Foot Related Issues

Below you will find some articles about various foot related issues that have been written by a number of notable physicians.

Heel Pain – Plantar Fasciitis by Dr. Steven Wachter, D.P.M.

Although there are many reasons for heel pain, the most common diagnosis in adults is plantar fasciitis.

The symptoms are frequently described as an aching, burning or even sharp stabbing pain localized to the bottom of the heel (commonly towards the inside of the heel). It can be at its worst when getting out of bed in the morning or after you have been sitting for awhile and then begin to walk.

Similar symptoms may also occur at the back of the heel where the Achilles tendon attaches to the heel bone.

In children, roughly between the ages of 8 and 14, the most common reason for heel pain is an inflamed growth plate located in the heel bone. The child will usually outgrow the symptoms by age 16 but symptoms can range from debilitating to simply being an annoyance.

All of these problems can be the result of abnormal stress placed on the tissue because of overuse, abnormal foot function, being overweight, less than ideal foot structure such as flat feet or rigid, high arch feet to name a few.

Orthotics can be an excellent choice for resolving these symptoms without the potential side effects of medication, painful injections, time consuming exercises, or cumbersome apparatuses worn while trying to sleep at night.  Orthotics are made using an impression of the feet and knowledge acquired during a biomechanical exam to make a custom “arch support” specifically for you.

Orthotics relieve the stress on the feet by redistributing the weight on the entire bottom of the foot and helping the foot to function in the optimal position. They fit in most shoes and can be easily transferred from shoe to shoe.

Although symptoms usually improve quickly, it may require several months for symptoms to completely resolve.  Younger, active people or individuals who are trying to lose weight may find orthotics to be the perfect choice to prevent reoccurrence of the symptoms.

Dr. Steven Wachter has practiced in a multispecialty clinic in New Ulm, MN for the past 27 years.  He is board certified by the American Board of Podiatric Surgery and a member of the following organizations: American Podiatric Medical Association, Minnesota Podiatric Medical Association (Fellow), American College of Foot and Ankle Surgeons, American Society of Podiatric Surgeons and American Society of Forensic Podiatrists.

Dress Shoes by Dr. Heather N McCombs, D.P.M.

Orthotics are important for maintaining appropriate foot and ankle alignment. While there are many pre-fabricated products readily available in drug stores, shoe stores and online, orthotics are most effective when they are custom made to an individual’s foot.

Marathon Orthotics, Inc. has been instrumental in keeping my patients’ foot ailments at bay by creating individually specific orthotic inserts that address the unique needs of each foot, whether for running shoes, dress shoes or heels.

Women and men share some of the same foot ailments such as heel pain, but the shape and function of their shoes predisposes women to higher incidences of neuromas, bunions and hammertoes than men.

Imagine a men’s dress shoe, with its low to flat heel, a sturdy sole and wide toe box. These shoes have a shape that allows the foot to fit in without much difficulty and typically do not compress the toes together as a women’s shoe does.  Since the men’s shoe is deeper and more accommodating, an orthotic reaching the base of the toes typically fits in very well and encourages compliance. A deep heel cup and a well-formed and padded arch are key elements in construction of orthotics for men’s dress shoes.

Women’s dress shoes are a completely different story.  If you have looked at any department store you know that there is hardly room for a foot inside the shoe. Adding anything inside the shoe is questionable at best. Women are often unable to find a shoe that will hold an orthotic without severely compromising the fit.

A custom orthotic device is the best bet for a good fit, especially when paired with a sensible shoe like a loafer or a heel (up to one-inch heel) with an adequate toe box.  Women’s dress shoe orthotics are best when made to end just before the ball of the foot. This allows for adequate arch support and a lift to spread the toes to be placed appropriately to help with a neuroma (pain usually between the third and fourth toes that feels like a rock is in the shoe).

When this accommodation is paired with a well formed arch, the progression of bunions and hammertoes is halted.  While no orthotic can change the deformity that is already present, it can decrease the progression of the deformity.

Many patients complain of bunion pain and when they begin using an appropriate custom orthotic device, the pain decreases or subsides completely, often reducing or eliminating the need for surgery.

Whether male or female, keeping your feet in tip top shape is elemental to a healthy lifestyle and orthotics play a big role in maintaining overall good health because when the foot falls out of alignment the knees and hips often follow.

Ped Pillows™ are a great pre-fabricated orthotic option, as they are affordable and well constructed and will offer support for heel pain, tired feet and many common complaints.  Still, if you are suffering from other problems such as persistent pain between the toes or the feeling that there is a pebble in your shoe, custom orthotics will be the best choice.

Heather N McCombs, DPM has been practicing podiatric medicine and surgery in Chicago for over a decade and has seen many trends in shoe gear that have had their own unique related issues.  She treats many athletes and has an interest in assisting athletes in returning to peak performance by alleviating foot pain. She is a graduate of the William M Scholl College of Podiatric Medicine and completed her surgical residency in the Resurrection Hospital System.  She is a diplomate of the American Board of Lower Extremity Surgery, and holds degrees in health sciences and interior design.

Foot Ulcers by Dr. Steven Wachter, D.P.M.

The most common risk factors for foot ulcer formation include numbness, poor circulation, and structural deformity.

Diabetics frequently have one, two or even all three of these conditions.  Although diabetics may have these conditions, anyone who has numbness or poor circulation in their feet are at a greater risk for developing an ulcer or sore on their feet, especially if the foot structure or foot functions create an area of increased pressure or callous.

Ideally, it is best to remove any excessive pressure from these areas and prevent the ulcer from developing.

Orthotics or diabetic shoes and insoles are an essential part to any foot ulcer prevention or healing plan in addition to maintaining good control of physiological factors such as blood sugar levels and blood flow to the feet.

Diabetic shoes and insoles have shown to reduce the incidence of ulcers and are covered under Medicare for qualified diabetics.

At other times, custom made foot supports known as orthotics may be more appropriate. Orthotics do an excellent job of taking the pressure off of the ulcer sites and help improve how the foot functions.

An impression of the foot is taken in the office setting and sent to the custom orthotic laboratory, where the orthotics are made.

There are a wide variety of materials and accommodations used in the fabrication process to resolve potential ulcers in almost any type of foot structure.

Dr. Steven Wachter has practiced in a multispecialty clinic in New Ulm, MN for the past 27 years.  He is board certified by the American Board of Podiatric Surgery and a member of the following organizations: American Podiatric Medical Association, Minnesota Podiatric Medical Association (Fellow), American College of Foot and Ankle Surgeons, American Society of Podiatric Surgeons and American Society of Forensic Podiatrists.

Walking Orthotics by Dr. Judith Sperling Hechter

Some people power-walk for exercise, some people stroll for fun, and some people walk merely to get where they need to go.  Regardless of the reason we walk, we all want to walk pain-free.  Most of us are able to walk without significant discomfort.  But there are many reasons that people can have pain from walking. Some people have heel pain. Some people have pain in the ball of the foot or in the toes. Some people have pain in the joints like the ankle, knee or the hip.  Problems arising from how we walk can even cause us to suffer back pain.

Custom-made orthotics are one of the ways in which we can address problems that arise from the shape and structure of our foot.  If we inherit a foot from our parents that is not structurally sound, then the mechanics will be faulty and over time we will develop injuries such as tendinitis or joint pain.  By helping to support the foot to function in a better position, the orthotics help eliminate the overworking muscles and tendons.

To do this, a mold of the foot is made by your doctor or physical therapist and that mold is sent to an orthotic lab, like Marathon Orthotics.  There, the experts will recreate a model of your foot with the corrections the doctor or physical therapist has ordered and then the orthotic is hand-made to those specifications.  The result is a custom made orthotic that will make walking a much more comfortable experience, and your feet will love them!

Dr. Judith Sperling Hechter has been practicing podiatric medicine since 1991 in the Minneapolis area. She practices general podiatric medicine and surgery with a special interest in sports medicine. She has worked as part of the medical teams for New York City, Boston, Twin Cities, and Los Angeles marathons.

Diabetes by Dr. Kristen M. Sigurdson, D.P.M.

Diabetes is the name of a disorder characterized by elevated sugar (glucose) levels in a person’s bloodstream. This is due to defects in the body’s ability to either produce and/or use insulin. Over time, these high levels of glucose lead to complications involving several systems of the body, including vascular (blood flow), neurologic (nerves), dermatologic (skin), eyes, and kidneys.

Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States. Other organ systems can also be damaged by high sugar levels in the diabetic’s blood. The longer a person has suffered from diabetes, the greater the chance that problems will develop.

The disease affects 25.8 million children and adults in the United States – 8.3% of the U.S. population. In addition, 79 million people with ‘prediabetes’ often undergo the same preliminary types of treatments/recommendations as people diagnosed with diabetes. The hope is to avoid the complications of diabetes.

Primary care clinicians / endocrinologists are the physicians who will often diagnose diabetes. Diabetes is diagnosed with a fasting blood test. Certain clinical symptoms can lead to the suspicion of diabetes. Increased thirst, increased urination, unexplained weight loss, and/or fatigue are all signs of diabetes. People who are sedentary, obese or have a genetic history of diabetes are all at increased risk of developing diabetes.

Upon diagnosis of diabetes, a patient will undergo a series of consultations designed to effectively manage the disease. The goal is to lower blood sugar, and prevent/treat the complications of diabetes. Medical literature has shown a direct link between high blood sugar and diabetic complications. By lowering blood sugar, this will slow/stop the development of diabetic cimplications in the majority of diabetic patients.

Diabetic Complications

As noted above, diabetes can affect many of the body’s systems. When discussing the lower extremity (legs/ankles/feet), diabetic complications most frequently include:

-Peripheral Arterial Disease: loss of effective blood flow down to the feet, peripheral edema from difficulty returning fluid to the heart, increased ability of wounds to form, decreased ability of wounds to heal.

-Diabetic Peripheral Neuropathy: pain and tingling/burning with eventual loss of sensation and function, sensation of feet/legs feeling ‘heavy’ and difficult to pick-up when walking, increased ability of wounds to form, decreased ability of wounds to heal.

-Dermopathy: discoloration with thinning of the skin, more prone to fungal and bacterial infections, especially on lower legs/ankles/feet, increased ability of wounds to form, decreased ability of wounds to heal.

Diabetic Footwear

As the compications of diabetes progress, diabetics become more prone to ulcers (open sores) which can lead to significant infections (cellulitis), thereby requiring partial or complete amputation of the foot/leg. These infections can lead to prolonged hospitalization as well as loss of life. They move through the bloodstream very quickly.

People who already suffer from foot/ankle deformities are at an even higher risk of ulcers/infections secondary to pressure points against shoes/weightbearing surfaces over time. Diabetics who suffer from corns/calluses, ingrown toenails, bunions, hammertoes, bone spurs, flatfoot, high-arched foot, or previously poorly healed fractures are at an increased risk of ulcer/infection developing.

Diabetic who consistently wear shoes with adequate length, width, and depth have exhibited significantly lower rates of ulcers, cellulitis, and resultant partial or total amputation. Diabetic shoes frequently include inserts (orthotics) distributed by a pedorthist (specialist in shoes/inserts). These orthotics are meant to improve function and alleviate pressure. In order to best protect a diabetic’s feet/legs and their ablility to walk/remain independent, diabetic shoes and inserts should be the footwear of choice daily.

In those instances where diabetic pressure ulcerations and cellulitis are already present, pedorthists are able to assist with the necessary pressure relief to support the healing process. When amputation has been necessary, pedorthists are able to assist with the restoration of foot function with custom-molded inserts and shoes to meet the diabetic’s needs.

Many insurance plans, including Medicare, will partially/completely include coverage of diabetic shoes and inserts for their diabetic patients on an annual basis. Medical studies have repeatedly demonstrated the benefit of these inserts and shoes in effective avoidance of diabetic foot complications, thereby significantly reducing society’s healthcare costs.

Diabetic Footcare

All people with diabetes should follow a regular footcare plan. Many insurance plans, including Medicare, will partially/completely include coverage of diabetic footcare with a podiatrist approximately every 3 months. Since complications from foot ulcers/cellulitis are a leading cause of hospitalization and amputation amond the diabetic population, prevention of difficulties with these routine visits are a well documented solution.

Comprehensive footcare programs (risk assessment, footcare education and preventative therapy, treatment of foot problems, and referral to specialists) can reduce amputation rates by 45% to 85%.

The following recommendations are made to any diabetic as part of a well-managed footcare plan:

-Any concerns with regards to diabetic foot health should be brought directly to the attention of your treating podiatrist. Treat even minor wounds and skin cracks as an urgent matter when you have diabetes. Phone your podiatrist immediately with reports of redness, swelling, nonhealing wounds, ingrown toenails, and other wound or foot problems. Remember, early treatment is essential to avoid more advanced problems.

-Look at your feet everyday. Include evaluation of the area between the toes, the entire bottom of your foot, and the back of the heel. If you cannot see your feet well, find someone who can. In many circumstances, using a mirror will assist in the evaluation of your feet.

-Always check the insides of your shoes for any foreign objects before putting them on.

-Wash and dry well between the toes. A soft, thin cloth reserved for this purpose and cleaned and dried after each use is helpful for difficult-to-reach interdigital spaces. Do not apply moisturizer between toes.

-Apply moisturizing cream/antifungal cream daily to your feet as directed by a podiatrist.

-Do not soak your feet unless instructed to do so by a physician.

-Do not walk barefoot or stockingfoot.

-Do not use sharp objects on your toes. Seek professional nail care.

-Choose diabetic/seamless socks. If you wear compression stockings, choose open-toed unless medical conditions prevent this as an option.

Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy (DPN) is the term used to describe nerve damage resulting from elevated sugar (glucose) levels caused by diabetes. Other factors also affect the development of diabetic peripheral neuropathy such as neurovascular and autoimmune factors, mechanical injury, genetics, and lifestyle factors (smoking, drinking, etc.)

60-70% of patients with diabetes have mild to severe forms of nervous system damage. This can result in impaired sensation or hypersensitivity/pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, erectile dysfunction. Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

When the nerves responsible for skin sensation are damaged by poorly-controlled diabetes and elevated glucose levels over time, this results in the loss of sensation to the bottom of the feet. These patients are unable to feel pressure sores, foreign bodies, or injuries felt very easily by those without neuropathy.

60-70% of people with diabetes have some form of neuropathy. The risk of neuropathy increases with age/duration of diabetes. Neuropathy may go unnoticed in about 50% of patients. More than 60% of all lower limb amputations in the United States occur in people with diabetes.

Types of Neuropathy

Painful Neuropathy

-Present in about 19.4% of diabetics

-Burning, shooting, stabbing pains with or without ‘pins & needles’

-Increased pain at night in legs/feet

-Absence of sensation

-Reduced/absent reflexes

Painless with Complete/Partial Sensory Loss

-Numbness/deadness of feeling in the feet

-Painless injury

-Reduced/absent sensation

-Reduced thermal sensitivity

-Absent reflexes

Early signs and symptoms of diabetic peripheral neuropathy may include heat intolerance, excessive sweating, or dry skin. With advanced diabetic peripheral neuropathy, foot lesions, neuropathic deformity, cellulitis, and amputation may occur.

However, with appropriate diabetic control, slowing or ceasing of the progression of diabetic peripheral neuropathy is possible.

Improve Glycemic Control

The severity of neuropathy relates to the degree of hyperglycemia.

Achieving and maintaining a stable blood glucose level may slow the progression of diabetic neuropathy.

Regular Assessments

Screening for neuropathy should be done at diagnosis and annually thereafter.

Screening tests may include pinprick sensations, vibration perception (tuning fork), monofilament pressure sensation, and ankle assessment.

Dr. Kristen M. Sigurdson, D.P.M. graduated from the University of Minnesota with a degree in biology in 1992. She completed her Doctor of Podiatric Medical degree from the College of Podiatric Medicine, Cleveland, OH in 1997. She completed her Podiatric Surgery Residency between 1997-1999 in Cincinnati, OH. She is currently a podiatric surgeon at St. Cloud Orthopedics in Sartell, MN.

Orthotics for Running by Dr. Judith Sperling Hechter

The mechanics of running are very complex.  When the runner’s anatomy allows the mechanics of the foot and leg to be just right, the runner can train and race injury-free.  When mechanics are faulty, and there are many, many reasons this can happen, runners will experience overuse injuries.  The best-known of these abnormalities is called pronation.  This is when the joint called the subtalar joint allows the foot to flatten and the ankle to collapse inward.

Orthotics are used in many situations with runners to help correct mechanical  abnormalities.  In the case of pronation, not only do custom orthotics give some arch support, but they counter the collapsing in of the arch and ankle.  The management of the various mechanical issues can be achieved in various ways with different types of materials and styles of orthotics.  This is determined by your doctor or physical therapist.  The type of shoe may also play a role in managing certain mechanical problems.

Recently there has been controversy between leaders in the field of biomechanics regarding barefoot or minimalist shoe wear vs. using shoes and orthotics to correct mechanical abnormalities.  That discussion could take up a whole page here, but suffice it to say that both sides are sure they are right and have the data to back them up.  The best answer varies from individual to individual and lies somewhere in between.  In my practice patients come to see me because what they have previously tried has not worked, so the tools I use include good custom orthotics from Marathon Orthotics and I do not see that changing.

Dr. Judith Sperling Hechter has been practicing podiatric medicine since 1991 in the Minneapolis area. She practices general podiatric medicine and surgery with a special interest in sports medicine. She has worked as part of the medical teams for New York City, Boston, Twin Cities, and Los Angeles marathons.

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