US20090025254A1

US20090025254A1 - Orthotic insole assembly

Info

Publication number: US20090025254A1
Application number: US11/828,119
Authority: US
Inventors: Charles A. Smith
Original assignee: MANCINI-SMITH MEDIA LLC
Current assignee: MANCINI-SMITH MEDIA LLC
Priority date: 2007-07-25
Filing date: 2007-07-25
Publication date: 2009-01-29

Abstract

An orthotic insole assembly including a semi-rigid cradle extending forward from the metatarsal region of the foot to the heel, wherein medial and lateral sidewalls extend upward from the cradle. The cradle includes an aperture in the area of heel impact wherein a heel plug is disposed within the aperture. A resilient, foam, cushioning layer overlies the cradle and the heel plug. A riser is connected to the cushioning layer to provide an elevated region in the area of the first metatarsal.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

Not applicable.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

REFERENCE TO A “SEQUENCE LISTING”

Not applicable.

BACKGROUND OF THE INVENTION

1. Field of the Invention
The present invention relates to an orthotic insole assembly, and more particularly, to a corrective orthotic insole assembly that orients and locates the foot within the assembly.
2. Description of Related Art
Typical orthotic devices are designed to distribute the stress of weight-bearing areas of the foot to maximize comfort and minimize trauma to the sole of the foot. Such orthotic devices are custom molded to the individual. Alternatively, the orthotic can be configured to “an average foot” (a non-custom device). However, non-custom devices are either significantly flatter than the average foot or fabricated from a sufficiently soft material, so as to accommodate average uses. Such material overly compresses thereby reducing the effectiveness of the device.
To satisfy the dual requirements of firm support and precisely contoured fit, prior art corrective devices have generally been produced in a custom mold of an individual foot. However, such processes are expensive and time consuming, thereby preventing use by a large segment of the population.
U.S. Pat. No. 4,510,770 discloses an adjustable shoe insert that includes a relatively rigid shell in contact with the foot bed of a shoe and is covered with a foam layer.
U.S. Pat. No. 5,933,984 discloses an insole having a shell portion positioned around the heel and the mid foot, wherein a low friction material is disposed on selected regions of an upper side.
Therefore, the need exists for orthotic insole assembly that does not require custom manufacture, yet provides relief to the lower extremities from gait induced stresses. The need also exists for an orthotic insole assembly that can locate and retain the foot in a favorable location and orientation with respect to the insole assembly.

BRIEF SUMMARY OF THE INVENTION

The present device provides an orthotic insole assembly which guides and restricts motion of the joints of the foot to improve gait efficiency and reduce the stresses imposed on lower extremity anatomical structures during gait. The orthotic insole assembly resists pronation (a complex foot motion which produces the partial collapse of the medial longitudinal arch of the foot) best seen during the mid-stance phase of the gait cycle.
Pronation actually consists of the abduction, eversion and dorsiflexion of the forefoot in relation to the rear foot. Because of the close contiguity of the joint involved, pronation is also accompanied by eversion of the heel and internal rotation of the leg and hip. While pronation is a normal part of gait, excessive pronation can be the source of many lower extremity pathologies, including muscle tiredness and inflation, foot and knee joint pain, tendentious, ligament strain and even neurological damage. Excessive pronation also renders the gait less efficient since time and effort are wasted in collapsing, pronating and recovering supination.
The present orthotic insole assembly is constructed for supporting a foot having a heel, toes, an arch and a metatarsal region. The orthotic insole assembly includes a semi-rigid cradle shaped to fit the heel, wherein the cradle extends forward past the arch to a leading edge extending across the metatarsal region, the cradle further includes medial and lateral sidewalls and an interconnecting heel wall, the cradle further including an opening such as an aperture in the area underlying the heel; a heel plug disposed within the aperture, the heel plug having a given resistance to compression; a cushioning layer having a bottom side and a top side, the bottom side overlying the cradle and the heel plug and extending forward of the cradle to underlie the toes, the cushioning layer including a thickened portion in the area of the arch; and a riser in the area encompassing the head of a first metatarsal.
In further configurations, the riser and the heel plug can have a different compressibility than the cushioning layer. It is also contemplated the riser and the heel plug can have differing compressibility or hardness.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)

FIG. 1 is a bottom plan view of the orthotic insole assembly.

FIG. 2 is a representative foot for engaging the orthotic insole assembly.

FIG. 3 is a top plan view of the orthotic insole assembly of FIG. 1.

FIG. 4 is a front perspective view of the orthotic insole assembly of FIG. 1.

FIG. 5 is a rear perspective view of the orthotic insole assembly of FIG. 1.

FIG. 6 is a representative foot bed of the orthotic insole assembly showing a relative sizing.

FIG. 7 is a bottom plan view of a first construction of the Walker orthotic insole assembly.

FIG. 8 is a top plan view of the orthotic insole assembly of FIG. 7.

FIG. 9 is a bottom plan view of a further configuration of the Walker orthotic insole assembly.

FIG. 10 is a top plan view of the orthotic insole assembly of FIG. 9.

FIG. 11 is a front prospective elevational view of a further construction of the Walker orthotic insole assembly.

FIG. 12 is a rear prospective elevational view of the orthotic insole assembly of FIG. 11.

FIG. 13 is a bottom plan view of a first configuration of the Runner orthotic insole assembly.

FIG. 14 is a top plan view of the orthotic insole assembly of FIG. 13.

FIG. 15 is a bottom plan view of a further configuration of the Runner orthotic insole assembly.

FIG. 16 is a top plan view of the orthotic insole assembly of FIG. 15.

FIG. 17 is a front elevational prospective view of a further configuration of a Runner style orthotic insole assembly.

FIG. 18 is a rear elevational prospective view of the orthotic insole assembly of FIG. 17.

FIG. 19 is a bottom plan view of a configuration of a Cross Trainer style orthotic insole.

FIG. 20 is a top plan view of the orthotic insole assembly of FIG. 19.

FIG. 21 is a front prospective elevational view of the Walker style orthotic insole assembly.

FIG. 22 is a front elevational prospective view of a Runner style orthotic insole assembly.

FIG. 23 is a rear elevational perspective view of a Cross Trainer style [type] orthotic insole assembly.

FIG. 24 is a lateral side elevational view of an orthotic insole assembly.

FIG. 25 is a medial side elevational view of the orthotic insole assembly of FIG. 24.

FIG. 26 is a lateral side elevational view of a further configuration of the orthotic insole assembly.

FIG. 27 is a medial side elevational view of the orthotic insole assembly of FIG. 26.

FIG. 28 is a medial side elevational view of a Cross Trainer style orthotic insole assembly.

FIG. 29 is a medial side elevational view of a Runner Style orthotic insole assembly.

FIG. 30 is a medial side elevational view of a Walker style orthotic insole assembly.

DETAILED DESCRIPTION OF THE INVENTION

As seen in FIG. 1, an orthotic insole assembly 10 includes a cradle 20, a cushioning layer 50, a heel plug 70 and a riser 80, which define a foot bed sized to support a foot.
For purposes of description, a representative foot 12 is shown in FIG. 2. The foot 12 extends from an anterior portion at the toes 13 to a posterior portion at the heel 14. An anterior-posterior axis extends from the toes 13 to the heel 14. The foot 12 also extends from a medial portion 15 to a lateral portion 16. The relevant portions of the foot 12 include the heel 14, the arches 17,18 and the metatarsals 19. The metatarsals 19 define a metatarsal region that encompasses the area overlaid by the metatarsals upon the foot resting on the ground. The metatarsal region extends laterally from the medial portion 15 to the lateral portion 16 and longitudinally between the heel 14 and the ball of the foot. The arches include a longitudinal arch 17 extending along the anterior-posterior direction and a transverse arch 18 extending along the medial-lateral direction. The heel 14 encompasses the calcaneus and includes the rounded posterior portion of the foot.
The cradle 20 is semi-rigid and shaped to fit about the heel 14 of the user and extends forward past the longitudinal and transverse arch 17,18 of the foot to terminate at an anterior edge 22 which extends across the metatarsal region of the foot.
The cradle 20 includes a plantar base 24 and an upwardly extending wall 30. The upwardly extending wall 30 is defined by a medial sidewall 32, a lateral sidewall 36 and a heel wall 34. The sidewalls 32,36 extend along the medial and lateral side of the cradle 20, respectively and are interconnected along the heel wall 34.
In one configuration, the anterior edge 22 is not perpendicular to the anterior-posterior axis of the foot 12. The anterior edge 22 is nearest the anterior portion of the foot at the junction of the medial sidewall 32 and the base 24. The anterior edge 22 is furthest from the anterior portion of the foot at the junction of the lateral sidewall 36 and the base 24.
The medial sidewall 32 extends from the heel wall 34 forward to terminate forward of the longitudinal and transverse arch 17,18 at the anterior edge 22 of the cradle 20. The medial sidewall 32 includes an arch portion 33 in the region of the longitudinal and transverse arch 17,18. The arch portion 33 of the medial sidewall 32 is non perpendicular to the plantar base 24. The arch portion 33 of the medial sidewall 32 can extend from the base 24 at an angle from approximately 30° to approximately 80°. The arch portion 33 of the medial sidewall 32 can have a slightly curved or convex surface, rather than merely defining a planar face. The anterior end of the medial sidewall 32 tapers in height from the arch portion 33 to the anterior edge 22 of the base 24.
The lateral sidewall 36 extends from the heel wall 34 forward to terminate at the anterior edge 22 of the cradle 20. The height of the lateral sidewall 36 is typically less than the height of the medial sidewall 32.
The medial and lateral sidewalls 32,36 of the cradle 20 can have supporting ribs 38 or portions, such as by areas of thickened material to provide enhanced weight bearing and load bearing capacity. Thus, deflection of the sidewalls 32,36 is resisted. In one configuration, the cradle 20 is constructed to substantially prevent detrimental deformation under intended operating loads. That is, the cradle 20 retains the foot during gait, rather than an encompassing shoe retaining the foot.
Referring to FIG. 1, the cradle 20 defines an opening 21 in the calcaneus region (heel portion) of the foot, wherein the opening can be a heel aperture 23. The heel aperture 23 is located in an area associated with heel impact during gait. The heel aperture 23 can have any of a variety of shapes, such as but not limited to oval, circular, obround or polygonal. The area of the heel aperture 23 is selected, in conjunction with the other components, to allow a portion of the heel to displace at least toward the plane of the base 24. Depending upon the size of the orthotic insole assembly 10, the heel aperture 23 can range from approximately 8 cm²to approximately 25 cm².
Referring to FIGS. 7 and 14, further configurations of the cradle 20 has a substantially U-shape configuration, wherein the opening 21 is at least partially defined by the heel wall 34 and an anteriorly projecting medial leg 42 and lateral leg 46. The medial leg 42 includes the medial sidewall 32 and the lateral leg 46 includes the lateral sidewall 36. The medial leg 42 is spaced apart from the lateral leg 46.
The medial leg 42 and the lateral leg 46 can have differing lengths, wherein the medial leg is longer than the lateral leg. The medial leg 42 extends at least to the anterior end of the arch 17. The lateral leg has a minimum length extending to at least to the posterior end of the arch 17 and a maximum length extending to the anterior end of the arch 17.
In the U-shape configuration of the cradle 20, the medial leg 42 can include an anterior bulbous portion 44 in the area of the arch. The anterior bulbous portion 44 can extend laterally to terminate within the lateral dimension of the heel plug or extend further laterally than the heel plug.
In the U-shape configuration of the cradle 20, the spacing of the medial leg 42 and the lateral leg 46 permits the orthotic insole assembly 10 to express lateral flexibility and accommodate various shoe widths, without requiring customization of the given assembly.
Referring to FIGS. 9, 18 and 27, the cradle 20 and specifically the medial sidewall 32 can include a plurality of flexure slots 27. The flexure slots 27 are sized and spaced to permit bending along the longitudinal dimension of the cradle without detrimentally deforming resulting surface exposed to the foot. The flexure slots 27 extend from the edge of the medial sidewall 32 and terminate adjacent the base 24, and can have a generally linear configuration. However, it is understood the flexure slots 27 can be curvilinear, as well as include bulbous portions.
The cradle 20 is formed of at least a semi-rigid material such as nylon having a density of approximately 1.09 to 1.15 grams per cubic centimeter. However, it is contemplated that injection mold polyethylene, polypropylene, thermoplastic urethane or other plastic which is relatively light weight can be employed for the cradle 20. The material of the cradle 20 is selected to substantially maintain the cradle shape under anticipated loading. In one configuration, the cradle 20 is an integral continuous one piece element, such as a molded component.
The cradle 20 is configured to cooperate with the cushioning layer 50 to maintain the shape of the orthotic insole assembly 10 without relying upon inward support from the shoe, as well as provide optimal location of the foot 12 relative to the orthotic insole assembly.
The cushioning layer 50 has an upper surface 52 and a bottom surface 54. A portion of the bottom surface 54 of the cushioning layer 50 overlies and is bonded to a corresponding upper surface of the base 24 of the cradle 20 and the upwardly extending wall 30, as well as the heel plug 70. The cushioning layer 50 extends beyond the anterior edge 22 of the cradle 20 to terminate beyond the toes.
The cushioning layer 50 is joined to the cradle 20 to overlie the area of the cradle. The cushioning layer 50 is formed or joined to the cradle 20 so as to extend above the upwardly extending wall 30. Further, the cushioning layer 50 is formed or joined to the cradle 20 to dispose the exposed surface of the cradle substantially planar (continuous) with the adjacent exposed surface of the cushioning layer. The continuous surface across the cradle-cushioning layer interface can be formed by providing a recess in the cushioning layer 50 for receiving the thickness of the cradle. Alternatively, the bonding process of the cradle 20 and the cushioning layer 50 can locally deform the cushioning layer to provide the substantially continuous surface. In one configuration, the cushioning layer 50 overlies a terminal edge of the upwardly extending wall 30 of the cradle 20 such that a downward force at the terminal edge of the wall encounters a thickness of the cushioning layer.
The cradle 20 and the cushioning layer 50 are sized and configured to interfit with one another to provide substantially continuous contact between the cradle and the cushioning layer. The cushioning layer 50 can be fixed to the cradle 20 by any of a variety of methods including adhesives or thermal bonding. Alternatively, the cushioning layer 50 can be molded with, or subsequent to the cradle 20, thereby providing a thermal bonding of the components. It has been found advantageous for the cradle 20 and the cushioning layer 50 to be joined along a substantially continuous interface, rather than local or spot locations of the joining or bonding.
The cushioning layer 50 generally defines the footprint of the orthotic install assembly 10. The cushioning layer 50 has a varying thickness from approximately 5 mm in the anterior portion to approximately 7 to 10 mm in the heel portion, wherein the cushioning layer includes a thickened arch support 56, in the area of the longitudinal and transverse arch 17,18. The arch support 56 corresponds with the arch portion of the medial sidewall 32. The arch support 56 can have a thickness from approximately 15 mm to 25 mm. The arch support 56 in conjunction with cradle 20 is configured to increase support of the arch of the foot; maintain the arch in a natural (non-conformed) alignment, as well as stabilize the foot.
As seen in FIGS. 7 and 25, one configuration of the cushioning layer 50 can include compression zones 62 formed as lines of reduced thickness, particularly in the anterior portion of the layer. The compression zones 62 allow the cushioning layer 50 to laterally or longitudinally compress without creating a corresponding ridge of material. Similarly, the lines of reduced thickness allow enhanced flexing of the cushioning layer 50, without generation of corresponding thickness variations is spaced locations of the layer.
In selected configurations, the cradle 20 and the cushioning layer 50 are configured to provided substantially continuous support between the arch and the heel.
The cushioning layer 50 can be a breathable material such as an open-cell foam. A suitable material for the cushioning layer 50 has been found to be an open cell polyurethane foam, having a density of approximately 0.30 to 0.034 grams per cubic centimeter. Using a type A and type 000 sclerometer, the cushioning layer 50 has a hardness of approximately 20° to 45 with a satisfactory range of between approximately °23° to 30°. The polyurethane foam has a tear strength of approximately 1.3 Kg/cm, and a compression set loss of less than approximately 3%. In one construction, the cushioning layer 50 includes an antibacterial agent as known in the molding industry.
The upper surface 52 of the cushioning layer 50 can include a cloth or textile cover 58 which is preferably breathable to allow air to circulate to the cushioning layer. A polyester fabric has been found satisfactory as the cover 58, wherein the fabric can include odor inhibiting, anti-bacterial and anti-fungal additives either disposed within the fabric or subsequently added. The porosity or weave of the cover 58 is selected to enhance or promote the passage of air into and out of the cushioning layer 50 in response to the operating pressures on the orthotic insole assembly 10 during use. In addition, the cover 58 wicks moisture from the cushioning layer 50, thereby allowing the moisture to more readily evaporate.
The heel plug 70 is disposed within the heel aperture 23. As seen in the configuration of FIGS. 4 and 5, the heel plug 70 extends above the surrounding portion of the cushioning layer 50. The heel plug 70 can extend approximately 2 mm above the adjacent cushioning layer 50. It is further contemplated, depending upon the intended operating parameters and the material of the heel plug 70, an upper surface of the heel plug can extend above an adjacent portion of the cushioning layer 50 by approximately 5% to 25% of the adjacent cushioning layer thickness. That is, the heel plug 70 has a thickness that is greater than the adjacent cushioning layer 50.
In one configuration, a bottom surface 72 of the heel plug 70 is aligned co-planer with the adjacent surface of the bottom of the cradle 20. Thus, as the cradle 20 has a thickness, the bottom surface 72 of the heel plug 70 is either within the thickness of the cradle or extending along the upper surface of the base 24. Locating the bottom surface 72 of the heel plug 70 is either within the thickness of the cradle or extending along the upper surface of the base 24 reduces wear on the bottom surface, and effectively extends the useful life of the orthotic insole assembly 10. However, as discussed herein, upon impact loading, a portion of the heel plug 70 can be displaced though the heel aperture 23.
The cradle 20 and the heel plug 70 are selected to space a center or central portion of the heel plug and hence the corresponding opening 21 at the heel strike. The heel strike is typically characterized as the local region of highest impact upon the person landing on the heel.
The heel plug 70 can be formed of the same material as the cushioning layer 50. In this construction, the cushioning layer 50 has a localized increased thickness to define the heel plug having a greater thickness than the adjacent portion of the cushioning layer. Alternatively, the heel plug 70 can be at least partially formed of a different material than the cushioning layer 50. In such construction, the heel plug 70 is resilient, but less compressible than the material of the cushioning layer 50. For example, the heel plug 70 can be formed of a dense material such as a gel. A satisfactory material for the heel plug 70 has been found to be polyurethane gel having a density of approximately 1.00 to 1.05 grams per cubic centimeter. It is also contemplated the heel plug 70 can be formed to include gel thickness and a thickness of the cushioning layer 50. The gel can define from 0% to 100% of the thickness of the heel plug 70.
The riser 80 is disposed beneath (or within) the cushioning layer 50 in an area encompassing the head of the first metatarsal. The riser 80 is substantially coplanar with the bottom surface 54 of the cushioning layer 50 and projects above the adjacent upper surface of the cushioning layer (or cover).
The riser 80 can have any of a variety of shapes, such as but not limited to oval, circular, obround or polygonal. The area of the riser 80 is selected, in conjunction with the other components, to rotate the foot outward and locate the heel 14 within the recess defined by the cradle 20 and cushioning layer 50. The riser 80 does not extend across the anterior-posterior axis of the foot (or the orthotic insole assembly 10). Depending upon the size of the orthotic insole assembly 10, the exposed contact area of the riser 80 with the foot can range from approximately 12 cm²to approximately 35 cm². Thus, the riser 80 typically has a greater area than the heel plug 70. In the configuration of the riser having a substantially square, rectangular or faceted periphery, the height of the riser 80 can taper down to the adjacent upper surface of the cushioning layer 50 (or cover) along each of the sides of the riser.
The riser 80 can be formed of a polymer gel including a polyurethane gel, similar to the heel plug 70. It is contemplated in the riser 80 can be formed by a combination of the cushioning layer material and a gel. Further, the cushioning layer 50 can be locally thickened in the area of the riser 80 to cooperate with a correspondingly located gel pad so as to define the riser. In one configuration, the riser 80, in conjunction with the overlying thickness of the cushioning layer 50 has an approximate (8 to 12 mm) one-half (½) inch height and maintains an approximate three-eights (⅜) inch height during use. In certain configurations, the height of the riser 80 includes a gel component and a cushioning layer 50 component. The portion of the riser height resulting from the gel can be from approximately 5% to 100%. Preferably, at least ten percent (10%) of the height of the riser is defined by the gel thickness.
In selected configurations, the orthotic insole assembly 10 includes a plurality of through holes or ventilation ports 61 extending through the cover 58 and the cushioning layer 50. The ventilation ports 61 are generally located in the front portion of the orthotic insole assembly 10, and particularly between the arch and the toes. The ventilation ports 61 have a diameter and spacing selected to preclude detrimental deformation or compression of the orthotic insole assembly. The ventilation ports 61 can have a diameter of approximately 1/32 of an inch to ⅛ of an inch, wherein the ventilation ports are spaced from approximately ±4 to 1 inch apart. The ventilation ports 61 can be symmetrically or randomly disposed within the orthotic insole assembly 10.
In use, the orthotic insole assembly 10 provides a deep cushioned heel cup, by employing the heel plug 70, wherein the semi-rigid upwardly extending walls 30 of the cradle 20 are contoured to the shape of the foot 12 and support the cushioning layer 50. The rigidity and firmness of the cradle 20 are sufficient to stabilize the heel 14 and reduce friction that would otherwise result from lateral foot movement.
The arch support portion 33 of the cradle 20 and the localized areas of increased thickness of the cushioning layer 50 are selected to substantially retain the foot 12 in its natural alignment and to prevent the arch 17,18 of the foot from flattening (falling).
The riser 80 is sized and located to work in conjunction with the arch 33 and the cradle 20 to seat the foot 12 in a desirable position and retain the foot relative to the orthotic insole assembly 10.
The cradle 20, the cushioning layer 50 and the heel plug 70 are configured to absorb and cushion the weight bearing pressure while the rigidity of the cradle minimizes lateral movement of the foot relative to the orthotic insole assembly 10. The heel plug 70 and the opening 21 in the cradle 20 are selected to allow a portion of the heel plug to pass through the opening in response to a heel strike. In selected configurations, a portion of the heel plug 70 passes below the bottom of the cradle 20. In further constructions, the heel plug 70 and the cradle 20 are selected so that in response to the heel strike, the top of the heel plug 70 is compressed below the upper surface of the cradle 20.
It is understood that the flexure slots 27, the ventilation ports 61 and the compression zones 64 can be employed in any configuration of the orthotic insole assembly 10, and are not limited to the specific configurations shown in the Figures. That is, any combination of the flexure slots 27, the ventilation ports 61 and the compression zones 64 can be employed in a given orthotic insole assembly.
A variety of lower extremity conditions can be addressed with the orthotic insole assembly 10. For example, symptoms relating to or resulting from plantar fasciitis, an inflammation in the tough, fibrous band of tissue (fascia) connecting the heel bone to the base of the toes; Chondromalacia patella resulting from poor alignment of the kneecap (patella) as the patella slides over the lower end of the thigh bone (femur); shin splints, heel spurs and patellar tendonitis may be address by the orthotic insole assembly. Further, the orthotic insole assembly 10 may reduce symptoms associated with over pronation.
While the invention has been described in connection with a presently preferred embodiment thereof, those skilled in the art will recognize that many modifications and changes can be made without departing from the true spirit and scope of the invention, which accordingly is intended to be defined solely by the appended claims.

Claims

1. An orthotic insole assembly for supporting a foot having a heel, toes, an arch and a metatarsal region, the assembly comprising:

(a) a semi-rigid cradle shaped to fit the heel and extending forward past the arch to a leading edge extending across the metatarsal region, the cradle including medial and lateral sidewalls and a interconnecting heel wall, the cradle defining an opening underlying the heel;

(b) a heel plug disposed within the opening, the heel plug having a given resistance to compression;

(c) a cushioning layer having a bottom side and a top side, the bottom side overlying the cradle and the heel plug and extending forward of the cradle to underlie the toes, the cushioning layer including a thickened portion in the area of the arch; and

(d) a riser in the area encompassing the head of a first metatarsal, the riser connected to the cushioning layer and extending above an adjacent portion of the cushioning layer.

2. The orthotic insole assembly of claim 1, further comprising a surface layer on the top side of the cushioning layer.

3. The orthotic insole assembly of claim 2, wherein the surface layer includes a textile.

4. The orthotic insole assembly of claim 1, wherein the heel plug includes a material having a greater density than the cushioning layer.

5. The orthotic insole assembly of claim 1, wherein the riser includes a material having a greater density than the cushioning layer.

6. The orthotic insole assembly of claim 1, wherein the heel plug has a greater resistance to compression than the cushioning layer.

7. The orthotic insole assembly of claim 1, wherein the opening in the cradle is formed by an end wall, a medial leg and a lateral leg.

8. The orthotic insole assembly of claim 1, wherein the riser has a plurality of layers, the layers being of different materials.

9. The orthotic insole assembly of claim 1, wherein the heel plug has a plurality of layers, the layers being of different materials.

10. The orthotic insole assembly of claim 1, wherein the opening underlying the heel is an aperture.

11. The orthotic insole assembly of claim 1, wherein the medial side wall of the cradle includes a plurality of flexure slots.

12. The orthotic insole assembly of claim 1, wherein the cushioning layer includes at least one compression zone having a reduced thickness relative to an adjacent portion of the cushioning layer.

13. The orthotic insole assembly of claim 1, wherein the cushioning layer includes a plurality of through holes.