An orthotic insert (1) having a first (2) and second portion (3), the second portion being formed of a material of higher resistance to deformation than the first portion (2), wherein the insert (1) is heat mouldable to conform to a patient's foot. The first portion (2), which forms the main body of the insert (1) provides support for the fore foot, while the second portion (3) is substantially U or J-shaped and extends around the heel region and into the arch region of the patient's foot. Preferably both portions are formed from heat mouldable ethyl vinyl acetate.