A large percentage of foot and ankle pain is mechanical in nature. What that means is abnormal alignments of bones and or abnormal pull of musculature increases mechanical instability in the foot and ankle. A custom molded prescription orthotic treats these mechanical instabilities. This prescription medical device is completely different from an over-the-counter insert and actually controls and can correct mechanical issues. Custom molded prescription orthotics can only be made and prescribed by a physician and a large percentage of insurance companies will cover these medical devices. To properly prescribe a prescription orthotic a biomechanical evaluation, gait analysis and 3-D image of foot is essential. It is also important to know that not all prescription orthotics are the same they depend on the experience of the practitioner of the number of prescription orthotics prescribed per month. Issaquah Foot and Ankle Specialists specializes in custom molded prescription orthotic and has extensive experience in this practice area and strive to create the best device available. As an additional point, do not be fooled by machines that have you stand on them to evaluate your foot structure as this is already an abnormal position. A Custom insert or foot bed sold in a shoe store or drug stores are not the same as a prescription orthotic. A Shoe store or a drug store cannot describe a prescription orthotic these are plastic inserts which do nothing to correct the mechanical deformity of your foot.