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Break-in Instructions and FAQs for Icon Orthotics (Total Contact Custom Orthotics)

Break-in protocol

  1. Wear your orthotics for only 4 hours today, Day 1

  2. Wear your orthotics for only 6 hours tomorrow, Day 2

  3. Wear your orthotics for only 8 hours on Day 3

  4. Wear your orthotics for only 10 hours on Day 4

  5. Wear your orthotics for 12+ hours on Day 5 (12 hours is considered “full time”)

Most people can wear their new orthotics full time in five days, but it can vary from person to person. It usually takes about two weeks to become completely used to wearing the orthotics. (If you normally don't wear your shoes 12+ hours per day, you don't have to 'force' yourself to wear them this much.)

Do’s and Don’ts

DO start each day with your orthotics in your shoes.

DO count all the time you are wearing your orthotics, regardless of whether you are standing or sitting. The orthotic holds your foot in its neutral position and your muscles and joints will become used to his position whether you are walking or not.

DO remove any other insoles before placing your custom orthotics in your shoes. This includes any heel lifts, cushions, heel pads and the sock liner of your sneakers. During the break in period, remember to put the insoles back when you take out the orthotics each day.

DON’T exercise with your new orthotics for at least the first week. For runners, I recommend waiting at least 2-3 weeks to give your muscles a chance to adapt to this new position.

DON’T skip a day if you accidentally wore them too long during the break in period and you feel sore. Wear them for half as many hours as you did on accident and continue the break in period from there. (i.e., if you accidentally wore them for 12 hours on Day 2, wear them for 6 hours on Day 3, then 8 hours on Day 4, etc.)

What if I don’t follow the break in protocol?

If you don’t follow the break in protocol, you might get some unnecessary muscle soreness and joint aches. It usually doesn’t cause any significant problems but it won’t make you better any faster and, in fact, may prolong the time it takes to get you comfortable and completely satisfied with your orthotics. Think of this break-in period like starting a new workout routine. It’s hard to build up your workouts if you over-do it when starting out.

How will it feel when I first start wearing my orthotics?

It is normal to feel different and slightly awkward. Your custom orthotics will change the way you walk and as with any medical appliance, your body must adjust to their use. Because some muscles are contracting earlier and some are contracting later, you might get some cramping or arch pain or minor muscle soreness in unexpected areas, but that is also to be expected. These minor aches should not get worse after the first day and they should all resolve themselves within three days. If these aches are too uncomfortable, you can always slow down the break-in period. The slower you start, the easier the break-in process will be. You will never hurt yourself by starting out slower.

When will my original problem start to feel better and go away?

Very few people start to feel better from Day 1, but most people feel the greatest amount of improvement between weeks 2-8.

How long will my total treatment time take?

This depends on a number of factors including but not limited to the severity of your problem(s), how asymmetric your posture is and how strongly your body will fight the correction of that asymmetry. The majority of people do well after 3-4 months of treatment, however, more complicated problems will need to have ongoing treatment for longer.

Why are my return visits to see the doctor still important if I’m getting better?

These orthotics need to be periodically adjusted in the office for maximum effect. After each adjustment you will improve incrementally and these improvement build upon prior improvements in your posture and body alignment. The doctor needs to monitor your changes in gait to help determine how many adjustments the device needs or whether you would be a good candidate for serial orthotic treatment. The end goal of treatment is to take away your pain and ultimately make you symmetric and stable.

Why are these orthotics different than my previous custom orthotics?

Only two doctors in California make orthotics like these. They are made based on a new understanding of the function of the foot and how the mechanics of gait affect the whole body. The orthotic materials are different and have a memory that enables them to be periodically adjusted back to their ideal position, allowing for progressive and dynamic treatment instead of static, fixed treatment. As a result, your feet can begin to function in a more natural and efficient manner. You’ll feel a definite improvement in your feet, legs, hips and even your lower back. Related corns and calluses usually diminish and disappear as well.

How do my new custom orthotics work?

They work by changing your body’s overall posture and alignment. By changing the way you walk, they can cause dramatic changes in both the position of your joints as well as increase your muscle balance and stability. Your orthotic treatment process takes place in four phases:

  1. Phase 1 - Adjust phase (Week 0-2)

First week is the break-in period and the second week is just getting used to how the orthotics feel.

  1. Phase 2 - Re-balance phase (Week 2-8)

This is the most important phase because your body gradually adapts to a more symmetric and stable position. You’ll notice the most improvement and start feeling differences in how you stand, move, walk and run.

  1. Phase 3 - Strength phase (Week 8-16)

After your joints and muscles get used to this new, improved position, you will start to develop strength in this new position which will reinforce all the changes your body has made. This will make your body more efficient and you will feel more energized or less fatigued at the end of the day.

  1. Phase 4 - Resilience phase (Week 16+)

You develop additional stability in a more symmetric position. Your soft tissue adapts well enough to the point that when you get injured, your recovery from injury is easier and faster because your body wants to heal you in a better position and function, without developing new compensations for the injury.

How do I care for my orthotics?

  1. Avoid leaving them in hot areas such as car dashboards, home heaters and dryers

  2. Keep away from pets that could chew on the plastic

  3. Wear socks or stockings to wick away moisture from the orthotics

  4. Clean with a mild soap or detergent and a soft cloth or sponge. Let them air dry thoroughly before replacing them in your shoes

My orthotics squeak when I walk. How can I stop this?

Squeaking is a sign that you are twisting in the shoe and this usually goes away after the first few days. If it persists, try sprinkling foot or baby powder in the shoe, under the orthotic. For sneakers and running shoes, apply a single layer of cloth tape to the bottom of the heel and across the ball of the foot at the end of the plastic. If your orthotics start to squeak AFTER SEVERAL WEEKS, this is usually a sign of a change in your body’s balance and you should return to the doctor’s office for an adjustment or re-evaluation of your walking gait. Changing to new shoes may also be necessary.

How do I shop for shoes with my new orthotics?

Always take your orthotics with your when you shop for shoes. Remember to buy shoes late in the day because everyone’s feet swell by the end of the day. If you have flatter feet, look for shoes with a firm heel counter (back of the shoes that cups the heel around the Achilles tendon) or sneakers designed for added stability. Avoid shoes with any tilt in the shoe bed. In general, if your shoe can bend in ways that your foot cannot, don’t buy it. Ask your doctor for more information, specific to your feet.

Often times, new shoes will slip in the heels with your orthotics. This is not a problem with the shoe. It is because your arch is being held in greater support and your calf muscles need to balance and adjust their timing of when to contract. You will adjust to this in a few days. If you have any questions, ask the doctor to explain further.

Some shoes with a higher heel will cause the orthotic to rock in the shoe. This can make you walk out of the back of your shoe and is different than the heel slippage described above. A simple adjustment can be made in the office to fix this problem.

Your orthotics should fit in easily without bending or being wedged against the side of the shoe. Initially the top cover might be too long, but that can easily be trimmed with scissors to properly fit in your shoe. If you are unsure how to do this, return to the office to have them trimmed. It is always better to trim too little than trim too much.

Shoes with a removable insert are preferable because removing the insert creates more room for the custom orthotic. Other shoes may have an inner lining that is spot glued and can be similarly removed after you purchase them. Usually the lace-up type shoes (with moderate to deep heels) are the best. It’s best to avoid slip-ons, backless shoes and heel heights greater than 1.5 inches unless your orthotics were specifically designed for those shoe types. Most patients can wear a greater variety of shoes more comfortably once their body alignment has been adjusted by their orthotics - you are not doomed to wear only sneakers forever!

Diabetics and people with decreased sensation in their feet should be especially careful not to have foreign objects in their shoes and not overly compress their feet. These patients should check their feet daily for red or sore areas. Consult the doctor immediately if they do occur.

If you have any questions not covered here,  please don’t hesitate to ask!