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Hi all,

I'm curious how people evaluate the fit and effectiveness of custom orthotics particularly in an asymptomatic patient for whom you may be trying to prevent a problem from developing. For example, in the patient who presents with a medially deviated subtalar joint axis, increased navicular drop and drift, and/or other variables intrinsic to the foot leading to "overpronation" and you are trying to prevent tissue stress created by these problems (posterior tib, plantar fascia, etc.) and the patient has no current symptoms to report a change in as a result of wearing the orthotics, what do you look for? When evaluating the orthotic to the foot, I have used the orthosis deformation test, barefoot standing test, and look for the medial arch of the orthotic to line up with the medial arch of the foot in STJN. I'm curious how others evaluate the orthotics if you'd like to share.

Thanks!
Ann