A custom orthotic insert is a prescription device designed to assist in the correction of biomechanical abnormalities that affect the feet, ankles, knees and back. Custom orthotic inserts are made by taking a three-dimensional (3-D) cast impression of the patient’s foot and constructed from raw materials to each patient’s individual specifications. Many foot problems can be attributed to collapsed or fallen arches or other biomechanical faults such as pronation (rolling in and collapsing of the arches when walking) and supination (rolling outward of the ankles and raising of the arch). These problems can be genetic in origin and most patients do not realize there is a problem until various symptoms begin to appear. These symptoms will generally manifest as pain. During your initial appointment, Dr. Horowitz will perform a biomechanical examination, gait scan analysis, 3D foot scan, and posture evaluation to determine the cause of the problem. Often, pain in areas such as the knees, hips, or back is caused by improper foot biomechanics. If a biomechanical abnormality is identified, this problem can generally be alleviated through prescription functional orthotics.