One of the early pioneers of pathology-specific orthotic design was Paul Scherer, DPM, former chair of the Department of Biomechanics at the California College of Podiatric Medicine. In his book Recent Advances in Orthotic Therapy, Scherer outlined this philosophy, describing it as a way to “improve clinical outcomes, promote more consistent research, and advance the acceptance of orthotic therapy as a valued therapeutic modality.”1 He believed a complete understanding of pathology and foot type should inform orthotic design.
Of course, any prescription guide needs to be interpreted in relation to the actual patient. Firstly, individual anatomy is unique so there are no single sure-fire solutions that work for all. Experience has shown there are always exceptions, and it is important to remain open to these possibilities. Secondly, there is often more than one right answer, and we should appreciate there may be several good treatment options.