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The Toronto Centre for Sports Medicine is a leading provider of sports medicine and rehabilitation services including physiotherapy, aquatic therapy, custom orthotics and custom made braces. We are centrally located at Yonge and Eglinton in Toronto.

5 Broadway Ave. Suite 105, Toronto On. M4P 1T7 Phone: 416.4801460  Fax: 416.4800074

Midtown Yonge and Eglinton

Custom Foot Orthotics or Custom Arch Supports

Custom orthotics are insoles or arch supports which are custom fitted to a patient's foot and can be used in most settings including day to day wear and in various sports.

Running Shoe Orthotic
Kinetic chain of the lower extremity

The principle of a custom foot orthotic in most cases rests on improving the biomechanics of the foot and the kinetic chain of the lower extremity. The kinetic chain is the system of interrelationship between connected limbs in the body. Each segment of the chain affects the other segments in the chain. It is for this reason that orthotics can be used to treat conditions in the knee hip and back – several joints away from the orthotic or arch support.


Foot conditions for which custom made orthotics or arch supports may be helpful include:

Plantar fasciitis and heel spurs

Morton’s neuroma

Metatarsalgia (pain under the ball of the foot)

Chronic arch strain


Hammer toes, claw toes,


Achilles tendonitis

Peroneal or tibialis posterior tendonitis

Support for previously injured feet and ankles

Osteoarthritis of the foot or ankle

Diabetes with peripheral neuropathy

Runner with hyperpronation

Conditions above the foot for which custom orthotics or arch supports are helpful in treating include:

Shin splints or medial tibial stress syndrome

Stress fractures of the shins

Patellofemoral syndrome or runner’s knee

Patellar tendonitis (jumper’s knee)

Osteoarthritis and other types of arthritis of the knee

Iliotibial band syndrome

Hip girdle dysfunction

Mechanical back pain and postural abnormalities

biomechanical assessment.jpg
Biomechanical assessment

Generally, the closer the location of the condition is to the foot, the more predictable the success of the custom foot orthotic prescription will be in controlling it.  Conditions such as metatarsalgia can be easily addressed with a properly fitted custom orthotic or arch support and may not need any further treatment.

Conditions such as knee pain, back or hip pain are usually multifactorial.  Successful treatment in these cases usually involves other modalities such as exercises, rehabilitation, braces etc.  It is not uncommon for custom foot orthotic prescribers to prescribe and dispense a custom foot orthotic for patients for such conditions without examining the entire kinetic chain or mentioning to their clients that the custom foot orthotic is only a partial solution.  This typically leads to an increased failure rate of the custom foot orthotic with respect to controlling the condition at hand. New problems can be created without a proper examination of all the segments in the kinetic which will be impacted by a custom arch support or foot orthotic. For example someone with tight soft tissues may experience onset of knee pain or back pain after being prescribed custom foot orthotics for a simple foot condition. Another potential problem is aggravation of osteoarthritis of knee due to a standard custom orthotic prescription which has not been adjusted to accommodate for the osteoarthritis.

At The Toronto Centre for Sports Medicine, custom foot orthotics or arch supports are prescribed and dispensed only after a complete medical and orthopedic history and physical exam is performed by Dr. Jack Hakoun MD. Dip. Sport Med. (CASM). 

Dr. Hakoun has over 28 years of experience including not only orthotic dispensing but in orthopedics and sport medicine. After a comprehensive orthopedic assessment is performed, an electronic force plate analysis of static and dynamic forces is made using the TOG Gait Scan system. In addition a mold of the foot is taken. Combining the information from the biomechanical exam, force plate and the foot mold produces optimal results.

3D assessment of dynamic foot forces
Dynamic force scan of foot

Necessary ancillary treatment in addition to custom foot orthotics is conveniently available on site at our centre.

Due to the comprehensive nature of the custom orthotic assessment and treatment at our centre, success rates are very high – approaching 100%.

There is no doubt that the procedure for custom arch supports and foot orthotics at The Toronto Centre for Sports Medicine provides a comprehensive, accurate, efficient and very effective system of orthotic prescription and treatment.