Treatment
Using orthoses and aids in ways that fit your everyday life
An insole is intended to make walking easier, a brace to provide support or a walking aid to make getting around safer again. Even so, a recommendation often leaves practical questions unanswered: what exactly do I need the aid for? How long should I use it? How can I tell if it fits? And what does it mean if it presses or is rarely used in everyday life?
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Assessing fit in everyday life
An aid must work during the activity for which it is intended. An insole should therefore be assessed together with a suitable shoe. An orthosis should sit as explained when it was fitted. If you find it difficult to put on, please say so. Especially if hand mobility is limited or relatives need to help, it must be practical to use in everyday life.
Do not simply put up with a new feeling of pressure for a prolonged period. Increasing pain, a wound, persistent redness, numbness or unusual discolouration needs a timely check. Newly cold or pale toes, marked changes in sensation or other signs of an acute circulation problem require immediate medical help. In an emergency, call 112. Do not change a prescribed movement restriction yourself; have the device and your symptoms assessed.
Understanding
A closer look
At OrthoCoast, we first want to clarify with you what the aid is intended to do. A device is useful when it fits the findings and has a clear purpose. It should help you with a particular activity or support a medically necessary restriction. The name on a prescription alone does not answer every question about how to use it.
What different aids can do
An orthosis is a device worn externally that can, for example, stabilise a joint, reduce load or limit certain movements. Soft joint supports vary in design and do not automatically serve the same purpose. Insoles change the support or distribution of pressure within a shoe. Walking aids can improve safety and reduce load when walking.
These examples are not freely interchangeable solutions. An orthosis after an injury may have a different purpose from a device for longstanding joint symptoms. Equally, an aid that worked well previously is not automatically suitable for a new situation. The key questions are which function needs support and what you can continue to move or exercise yourself.
From your goal to a suitable aid
Try to describe a specific difficulty. Can you no longer walk a particular distance? Does a joint give way during a movement? Do you need to find ways around difficulties when dressing? This makes it easier to work out what support might help. A more elaborate device is not a better choice simply because it is more elaborate.
The medical assessment includes the condition or injury, mobility and capacity for activity, and your previous experience. Skin problems, reduced sensation, swelling or poor circulation may also matter. Please mention these factors before a device is chosen. For example, reduced sensation in the foot may mean that a troublesome pressure point is noticed later than expected.
Further information
Medical prescription and technical fitting
If an aid is medically appropriate, the doctor assesses the goal and the type of provision required. The actual supply and fitting are carried out by the relevant supplier, such as a medical supply shop or a suitable orthotics provider. Which provider is responsible and which documents are needed depend on the route through which it is supplied.
We want the medical purpose to remain clear throughout. Ask if you are unsure how the device should be worn or what effect is intended. Changes to the aid and changes to the medical treatment plan need to be coordinated. The exact arrangements, delivery time and insurance cover are clarified individually; a prescription is not yet a promise of a particular product or delivery date.
How long a device is worn
There is no useful single wearing schedule for all orthoses, insoles and conditions. Some aids are used for particular activities; others provide temporary protection during a healing phase. Whether an orthosis may be removed at night, when showering or for exercises depends on the specific treatment plan. General website advice would be too imprecise for this.
Ask for the rules that apply to you to be explained, and seek clarification if you receive conflicting information. With adjustable orthoses, angles or movement limits should only be changed as directed by your doctor. Stopping use of a device may also need to be planned. Finding an aid comfortable does not automatically mean it remains necessary indefinitely; conversely, a period with less pain does not reliably mean it is safe to leave it off.
Considering aids and active treatment together
A device can make activity easier or temporarily limit it. However, it does not by itself build the strength and mobility needed for what you do. Where appropriate for your findings, exercises, movement advice or physiotherapy measures are included in the plan. Particularly after injuries or operations, the movement that is allowed or advisable must fit the individual treatment.
At follow-up, it matters whether you are getting closer to the agreed goal. Do you feel steadier when walking? Is an activity easier? Do you actually use the aid, or is it in a cupboard because it causes pressure points? If a device is not being used, that is a reason to discuss the obstacles. This tells us more than simply noting that an aid has already been prescribed.
Your contacts at OrthoCoast
For questions about orthopaedic aids, you can contact Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling, Björn Weidemann and Dipl. med. Matthias Dallmann. Appointments with Mr Dallmann are arranged as part of individually agreed cover arrangements. Bring any device you already use and any existing documents. We can then discuss together what it should do and whether it suits your current situation.
What matters for your decision
Clarify costs before a device is supplied
First, we discuss what the aid should do and which type is medically appropriate for that purpose. A more elaborate or expensive device does not automatically promise greater benefit. You should understand what support you need and which alternatives are available.
What German statutory health insurance covers, and whether co-payments or additional costs arise, depends on the particular aid and how it is supplied. Before deciding, ask for an explanation of what is covered and any additional costs for a version you would prefer. You should also discuss the practical supply and fitting, and their costs, with the supplier providing the aid. A recommendation alone does not mean you have to choose a particular product immediately.
If you have German statutory health insurance and would like to pay for a medical service with us that your insurer does not cover, we explain the possible benefits, limitations, alternatives and costs beforehand. You will receive a cost estimate. We provide the service only after you have signed to confirm that you want the treatment and agree to pay its costs. This practice policy does not replace a separate discussion of costs with the supplier.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profile
Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileThese doctors discuss with you whether an aid suits your needs. The movements and tasks involved in your everyday life are part of that conversation.
Frequently asked questions
Is a more expensive device necessarily better?
No. What matters is the medical purpose, fit and usability. Ask what additional benefit a different version is expected to provide in your particular situation and what costs it would involve.
Can I change the settings on an orthosis myself?
Do not change a prescribed movement setting on your own. If the device presses or does not work in everyday life, have the fit and instructions checked. A technical alteration may also change the protection it is intended to provide.
Should I bring old insoles to my appointment?
Yes, if you have them. The shoes you regularly wear with them are helpful too. Your experience shows what has worked so far and where an adjustment or reassessment may be needed.
Does an aid replace movement and exercise?
Not as a general rule. It can support a particular function or temporarily restrict a movement. The active treatment that fits alongside it depends on the condition, the stage of healing and your individual capacity.
Insoles and orthopaedic footwear in everyday life
Understanding
A closer look
If a shoe starts to press after a short time or every step puts pressure on one particular spot, it is natural to wonder about an insole. Sometimes it can help; sometimes the shoe itself needs altering; and sometimes the cause lies somewhere that needs closer examination first.
We first want to clarify with you what the device or footwear is intended to do. Is the concern a painful pressure point, a change in foot alignment, restricted rolling of the foot during walking or protection for an at-risk foot? These differences determine which support is helpful.
When an insole may help
Insoles can distribute load, relieve pressure on particular areas or support a function. Their design must fit this purpose. Soft cushioning, for example, has a different role from targeted guidance or limiting a painful movement. An elaborate design is not better simply because it is more elaborate.
We consider the foot and shoe together. A suitable insole needs enough room and a shoe in which it can perform its role. An existing insole that stays at home because it does not fit any everyday shoes is not a satisfactory solution. Please bring previous insoles and the shoes you wear most often for assessment.
What orthopaedic footwear provision means
Orthopaedic footwear does not always mean a completely made-to-measure shoe. Depending on its purpose, a targeted alteration to an existing shoe may be an option, for example to support the rolling movement of the foot during walking. Other findings call for special shoes or a custom-made solution.
The medically appropriate design depends on foot shape, loading, skin condition and function. A suitable orthopaedic footwear specialist carries out the technical fitting. The medical recommendation should clearly state what the provision is intended to achieve. Manufacture, specific material choices, fit and delivery time are agreed with the supplier carrying out the work.
Further information
How to recognise a device that works in everyday life
The device or footwear should help with the activities for which it is intended. Do not judge it only by your first impression while sitting down. How does it feel when you walk? Can you get into the shoe safely? Is there pressure in a new place? Can you actually use the shoes at work or at home?
Persistent redness, a new wound, increasing pain or unusual discolouration needs to be checked. If you have reduced sensation, diabetes or circulation problems, do not wait for a problem to become painful. Do not cut away or alter problem areas of insoles or shoes yourself; any technical adjustment should support the medical goal.
Coordinating the device and movement
An aid can relieve pressure or provide protection. However, it does not replace every form of active treatment. Depending on the findings, exercises, movement advice or physiotherapy may complement it. A wound or a need for immobilisation, by contrast, requires specific rules on reducing load; “move more” is not general advice in these circumstances.
Specific feedback is helpful at review: is it easier to manage an agreed distance? Does your skin remain healthy? Is the device being used regularly? If you are not getting closer to the goal, the diagnosis, fit and suitability for everyday life should be reconsidered, rather than simply supplying the same thing again.
What matters for your decision
Clarify the costs of the device or footwear in advance
The medical prescription, the supply and fitting of the device or footwear, and any costs you may have to pay are separate matters. Before it is made, clarify with the supplier and, where appropriate, the funding body what is covered and whether co-payments or additional costs apply. A particular version you would prefer may be treated differently from the medically necessary provision. A prescription alone is not a blanket promise of reimbursement.
If you have German statutory health insurance and would like an additional medical service at OrthoCoast that you pay for yourself because your insurer does not cover it, you will receive a cost estimate beforehand. We discuss the scope, benefits, limitations, alternatives and likely costs. The service is provided only after you have signed to confirm that you want the treatment and agree to pay its costs. This agreement does not replace a separate discussion of costs with the device or footwear supplier.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
View profileDr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileBjörn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileFrequently asked questions
Do I need new shoes for every insole?
Not necessarily. What matters is adequate room, support and suitability for the planned device. Have the shoes you already wear assessed before buying new ones just in case.
Are made-to-measure shoes always the best option?
No. The extent of provision needed depends on its medical purpose. A less elaborate solution may be sufficient if it works safely and suits the findings.
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