Custom Molded Orthotics


Custom Molded Orthotics (CMOs) are insoles that are placed into shoes to achieve a certain goal. Both children and adults may benefit from them, but not everyone needs them. Each patient must be examined as an individual as no two people have the same feet. The need for CMOs is based on physical examination of the entire lower extremity, biomechanical examination and gait analysis, specific patient complaints, activity levels, and shoe styles worn.



This type of CMO is used to hug and cushion the foot where there may be a bony prominence, or an area that needs to off loaded. This type will not control or correct the foot. It is merely designed to reduce pressure off certain areas. An example would be a diabetic insert.


This CMO is used to control several aspects of the foot’s function and biomechanics during gait. There will be individualized aspects built into the CMOs to alter or change the way the foot and ankle move and the way the joints act upon one another while walking or doing physical activity. An example would be an insert that helps correct flat foot.


This CMO type is used to attempt correction of a certain deformity. This is most often usually accomplished in children but can be for adults as well.  An example would be an insert designed to lift the heel up 1cm due to a limb length discrepancy that arose secondary to an injury.


Custom orthotics are inherently better than store bought inserts in that they are molded specifically to the patient’s feet. CMOs are is made with specific materials and are handmade following a specific individualized prescription by Dr. Legel. An over the counter inert will not have the specific accommodations and tweaks that can control the specific needs of the patient. CMOs are never meant to be “one size fits all.”  Also, CMOs can be made specific for special shoes, like high heels or soccer cleats.


This is a hot topic and an area where lots of debate currently exists. There are 3 main ways to make CMOS: plaster, foam impressions, and computer scanning. When I first started practicing, I only used plaster molds because that’s what I learned in school. That was the gold standard. After being in practice a few years and dealing with dirty plaster stains and crushed molds, I switched to foam boxes.  This worked well for a while until one box got lost in shipping. I was informed of this until six months later when the patient called and inquired about his CMOs.  It was during that discovery process that I was informed how they make CMOs now. The lab takes a computer scan of my foam box and plaster mold! Well, gosh darn it! Why don’t I eliminate the middleman and just scan them myself? That started my current method of utilizing an iPad with a scanner. Genius invention. Fast, no mess, instant electronic scan sent and stored for perpetuity, and quicker turnaround times for the lab.  I can make all the adjustments and accommodations I need on the electronic prescription. I can even order repeat pairs later just pulling up the previous prescription.


ORTHOTICS SQUEAK? DO add baby powder. Oftentimes, custom orthotics prescriptions from our office will include a bottom cover to prevent this. If your orthotics are still squeaking, baby powder between the layers will help. Your orthotics may also need to be adjusted if this problem persists.

ORTHOTICS DON’T FIT IN SHOES? DO trim extensions with a straight edge, razor blade, or scissors to fit them into shoes. DO return your orthotics WITH shoes for adjustments if necessary. DON’T by larger shoes to accommodate your orthotics. DON’T assume your orthotics will fit into all of your shoes.

MY ORTHOTICS DON’T FEEL RIGHT.  DO wait 2-3 weeks for your feet to adjust. DO contact us for adjustments if necessary. Approximately 95% of patients will easily accommodate the orthotics in their shoes once the adjustment period has passed. Very rarely are adjustments required. But this is free of charge so don’t hesitate to ask. DO remove them if there is significant pain. DON’T assume they will always be uncomfortable. There needs to be a significant “break-in period” to be able to tolerate them.

MY ORTHOTICS ARE DIRTY, PUNGENT AND THE TOP COVERS ARE VERY WORN. DO wipe them down with a damp cloth or, spray them with fabric freshener. If necessary, top covers can be replaced at a nominal cost. DO expect them to last about 5 years, depending on activity level. DON’T submerge them in water, put them in washing machines, or dry them with a blow dryer.

ONE OF MY ORTHOTICS IS CRACKED OR BROKEN. DO return them to us for FREE replacement. All custom molded orthotics we do are guaranteed for LIFE against breakage. DON’T throw them away as the lab will use the breakage area as a point of information for repair and quality improvement.