Physio Network [Case Studies] Using foot orthoses in real-world lower limb cases with Blake Withers
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Dec 3, 2025 In this engaging discussion, Blake Withers, a musculoskeletal podiatrist and PhD candidate, delves into the world of foot orthoses. He debunks common misconceptions, highlighting their role in load modification rather than simply 'straightening' feet. Blake contrasts temporary use with cases needing long-term support and shares practical insights on prefabricated versus custom devices. He even offers a case example of managing peroneal tendinopathy, emphasizing clinical reasoning in orthosis trials. Tune in for expert strategies that can enhance patient outcomes!
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Orthoses Modify Load Not Align Bones
- Foot orthoses primarily act as load modifiers rather than devices to 'correct' foot alignment permanently.
- Use orthoses to reduce tissue load and allow recovery, not to make the foot perfectly straight.
Don't Treat Foot Posture As Destiny
- Do not assume foot posture equals pathology; account for high individual variability in foot shape and response.
- Use clinical reasoning and load-focused goals instead of aiming to 'perfectly align' the foot.
Not Always Lifetime Devices
- Not every patient needs to use orthoses permanently; many can wean off as tissues recover with load management.
- Some patients (older, multimorbid, structural changes) may require long-term devices to maintain function.