Ankle foot orthotics may be custom made by a podiatrist or prescribed and made by a licensed orthotist prosthetist. There are non-custom or prefabricated ankle foot orthotics too which can be used depending on the nature of the problem being treated. Healthcare professionals trained in this field do not use guess work to determine the best device but make such choices based on a complete examination of the patient. Such exams generally involve a biomechanical exam of the foot, ankle and leg to determine gait, muscle strength, posture, the condition of joints, ligaments and tendons.
Custom ankle foot orthotics, like custom foot orthotics, start with a mold made of the foot as well as the ankle. The podiatrist determines the optimal position of the ankle and joints of the foot during the molding process. An accredited orthotic laboratory uses the mold and presription information to create a working model of the foot and ankle which is used to build the AFO around.
There are three ligaments on the outside of the ankle that help maintain proper alignment of the ankle joint and prevent ankle sprains: the ATF or anterior talofibular ligament, the PTF or posterior talofibular ligament and the CFL or calcaneofibular ligament. The ankle ligaments can become damaged, stretched or torn due to a significant ankle sprain or even a series of smaller sprains. That can lead to an ankle that feels weak, painful and twists easily.
The ankle joint is designed to go up and down (dorsiflexion/plantarflexion), not side to side. Side to side motion of the foot comes from the joint immediately below the ankle, the subtalar joint. Ankle joints may become painful and arthritic for a number of reasons including osteoarthritis, trauma such as severe ankle sprains and fracture and even chronic repetitive type injuries. Dr. Ed Davis has treated a number of retired airborne warriors who developed ankle pain years after leaving the military....repetitive jumps leaving damaged ankle cartilage.