What You Need to Know About Orthotics for Your Child
In some instances, your child’s physical therapist may recommend orthotics for your child. If that’s the case, you may be curious about what exactly goes into providing your child with the proper orthosis.
Pediatric APTA, the American Physical Therapy Association, defines an orthosis as:
“an external device with controlling forces to improve alignment, improve function, immobilize the injured alignment, improve function, immobilize the injured area, prevent or improve a deformity, protect a joint or limb, limit or reduce pain, and provide proprioceptive feedback.”1
As you can probably tell from the definition, there is a wide range of types and uses for orthotics. In this article, we’ll go over some of the basics.
Why would my child need an orthosis?
There are many different reasons why a child might need an orthosis. This could be due to congenital conditions such as plagiocephaly, torticollis, or cerebral palsy (although CP is often diagnosed later). An orthosis can be used to maintain alignment after surgery. It can be used as a preventative measure against common side effects of certain conditions, such as keeping joints aligned and in place to prevent future pain associated with the secondary effects of Cerebral palsy. An orthosis may even be recommended as a simple shoe insert to help with the foot and ankle alignment. Whatever the reason is, the basis behind any orthosis is to improve function in a child.
Types of Orthotics
There are two main types of orthotics: custom molded and custom fitted. Custom-molded orthotics are those that are created from a mold. For example, a mold of your child’s foot. These are the most precise. Custom-fitted orthotics come from a prefabricated design that is then fitted to your child. Custom-fitted orthotics are usually less expensive but, depending on the type of condition, can be just as effective as custom-molded orthotics.
If you would like examples of different types of orthotic devices, here is an excellent article with pictures documenting the most common pediatric orthotics: https://www.llop.com/orthotics-children-pediatric-applications/
Fabrication
If your child needs a custom-molded orthosis, it will likely be created from a cast or mold, as this is the most accurate method.
This helpful video by Pediatric Foot and Ankle explains the different methods of creating custom orthotics: https://www.youtube.com/watch?v=2-JhNiAT_ts&t=89s.
Orthotics in Physical Therapy
Suppose your child’s physical therapist recommends orthotics. In that case, they can help with the production process by setting up an appointment with an orthotist or someone with the qualifications to produce orthotics.
Once the orthosis is produced, or the proper custom-fitted orthosis is ordered, a physical therapist is trained in fitting and can help educate you about appropriate use so that your child’s orthosis is effective.
Each treatment that includes an orthosis is different. Some orthotics must be worn all the time, while others are not. A physical therapist will create the right plan of treatment. They will also help troubleshoot any issues that may come up.
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Barner, Karl and Colleen Coulter-O’Berry, “Foundations of Pediatric Orthotics,” APTA, 2009, https://pediatricapta.org/includes/fact-sheets/pdfs/Orthotics.pdf.
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Barner, Karl and Colleen Coulter-O’Berry, “Foundations of Pediatric Orthotics,” APTA, 2009, https://pediatricapta.org/includes/fact-sheets/pdfs/Orthotics.pdf.
“Orthotics for Children and Pediatric Orthotic Application,” LeTourneau Prosthetics, 20 February 2017, https://www.llop.com/orthotics-children-pediatric-applications/.
Owen, Elaine and Kristie Bjornson, “Fact Sheet: Ankle-Foot Orthoses and Footwear for Children with Cerebral Palsy-Selecting Optimal Design,” APTA, 2020, https://pediatricapta.org/includes/fact-sheets/pdfs/Ankle-Foot%20Orthoses%20and%20Footwear%20for%20Children%20with%20Cerebral%20Palsy.pdf.