Question
My nine year old was recently fitted for and received a pair of orthotics for flat feet. His particular orthotic is about two thirds the length and width of his shoes. They seem to float around in his shoes and cause blisters. When I was in the doctors office I met a man, also getting a pair of of orthotics, but his were made to fit the entire shoe so they couldn't move around. Does this make sense? Roy Mottola

Answer
There are many different styles of orthoitcs and we use them for different reasons. In a 9 year old, I would usually make one that does go about 2/3 of the length of the foot, but usually as wide as the foot (or shoe).  In women, I usually make the narrower ones, so they fit into more shoes.
The orthotic doesn't actually work near the toes, so the plastic shell doesn't have to go to the toes, but it is a simple adjustment to have a top cover put on the orthotic that does extend to the toes, which would help prevent it from moving around.  You can ask the podiatrist to have it put on.
  He might actually have a different problem - excessive sweating.  Are his socks moist when he takes them off at night?  If so, that is what is causing the blister.  Check him now and see if they are moist.