Patients who tackle the slopes have specific requirements for orthotics. In addition to reviewing the pedal mechanics and biomechanics of skiing, our expert panelists take a closer look at the design of ski boots and what impact the skier’s skill level will have on prescribing an appropriate orthotic. Without further delay, here is what they had to say. Q: What pedal mechanics are unique to skiing? A: During alpine skiing, the patient’s lower extremities never go through a complete gait cycle, notes Nicholas Sol, DPM, CPed.