In selecting an orthotic for an overweight/obese patient, a relatively rigid, controlling type of support is required to help counteract the high forces imposed on the lower extremities by heavier loads. There is also a critical need for long-term shock absorption to decrease excessive stress on the articular cartilage and slow the degenerative processes. Comfort is also a factor, since orthotics which are not worn are the ones that are least useful.
Many chiropractors have found that what works best for the obese patient is a compromise orthotic: one that is firm yet flexible, with plenty of support for the arches, and contains shock-absorbing materials in the rear foot area. The ideal orthotic should have a soft, comfortable top layer along with firm support.
It is recommended that all clinicians who encounter obese patients with low back pain and lower extremity problems consider combining appropriate chiropractic care with supportive orthotics, rehabilitative strengthening and stretching exercises, and advice on nutrition, weight reduction and shoe fit. In many cases, this “package” of modalities and guidance will yield a more successful and longer term clinical outcome.
Use the Orthotic Selector Tool for more information about a set of orthotics for you.