In every case, biomechanics practitioners are faced with the decision on what type of orthotic they choose to manufacture for their patients. A quick perusal of the KRM website demonstrates the myriad of choices available to our clients. The spectrum of choices spans from very soft and forgiving models such as the T1 Care soft model, to more highly supportive and corrective models such as the A5 Supporter Model, the P2 Adult Acquired Flatfoot Model, and the T4 UCBL Model, for example. With so many customizations available, the reality is that the vast majority of custom foot orthotics in use today are actually, hybrid functional/accommodative devices. Some are functional orthotics with accommodative features, others can be more accurately described as accommodative devices with functional features. Utilizing this full armamentarium of treating underlying biomechanical deficiencies functionally, along with specific pathological entities accommodatively is what separates and sets apart the true experts in orthotic treatment versus the less knowledgeable and less successful shoe insert dispensers.
The future of lower extremity biomechanics will very likely utilize artificial intelligence, just like the rest of the world. So, let’s look at what ChatGPT has to say on this matter (edited by me).
Functional Foot Orthotic
- Purpose:
Designed to control abnormal motion of the foot, often compensatory in nature, improve biomechanics, and correct alignment during standing and gait. - Material:
Usually made of rigid or semi-rigid materials (e.g., polypropylene, carbon fiber, hard plastics, dense foam materials). - Use Cases:
- Overpronation or oversupination in all age groups and genders
- Flat feet or high arches with biomechanical issues
- Sports and work performance enhancement
- Conditions like plantar fasciitis, tendinitis, patellofemoral pain syndrome, forefoot deformities such as Hallux Valgus and lesser metatarsal issues. Asymmetry issues.
- Effect:
Alters how the foot moves during stance and gait to improve efficiency, reduce strain, and prevent injury. Prevent future deformities in certain children. Or reduce future deformity in adults.
Accommodative Foot Orthotic
- Purpose:
Designed to cushion, protect, and relieve pressure rather than control motion. - Material:
Made of softer, more flexible materials (e.g., foams, cork, leather, gels). - Use Cases:
- Diabetes-related foot problems or other causes of lack of protective sensation of the feet. Elderly people with non functional apropulsive or antalgic gait patterns
- Arthritis or trauma cases with residual fixed deformity
- Severe deformities (bunions, hammertoes, Charcot foot)
- Pressure ulcers or calluses
- Effect:
Provides comfort and pressure redistribution without significantly changing foot mechanics.
Key Difference (in one line):
- Functional orthotics → biomechanical correction (motion control).
- Accommodative orthotics → cushioning & protection (comfort/pressure relief).
Here’s a side-by-side comparison table of functional vs. accommodative foot orthotics:
|
Feature |
Functional Foot Orthotic |
Accommodative Foot Orthotic |
|
Primary Goal |
Correct abnormal motion, improve biomechanics |
Cushion, protect, redistribute pressure |
|
Material |
Rigid or semi-rigid (polypropylene, carbon fiber, hard plastics) |
Soft and flexible (foam, cork, leather, gels) |
|
Effect on Gait |
Alters movement patterns to optimize mechanics |
Minimal change to biomechanics |
|
Best For |
Overpronation, supination, plantar fasciitis, sports injuries |
Diabetes, arthritis, severe deformities, ulcers, calluses |
|
Durability |
Long-lasting, holds shape well |
Wears out more quickly due to soft materials |
|
Comfort |
May feel firm or stiff initially |
Usually soft and comfortable right away |
|
Customization |
Often custom-molded and precisely fit for correction |
Often custom-molded but designed for pressure relief |
The key points in determining is a thorough evaluation and examination of your patient in determining whether or not an orthotic of any kind may be beneficial. Once that is affirmed, then you must determine treatment goals, such as emphasizing either functionality or comfort opr some combination thereof. Selecting the orthotic Rx to achieve those goals. Once dispensed to the patient, rigorous follow up to determine if stated goals are being met, and performing necessary adjustments and refinements to enhance long term therapeutic success.
