Your feet are what connect us to the ground, helping you run, skip, and walk your way through each day. Foot health is thus a key to unlocking happiness, or can be the reason why your day is filled with pain and misery. Luckily, orthotics can be the solution you need for addressing common pains like plantar fasciitis, heel pain, arch pain, and many others. You might be asking yourself how orthotics/insoles actually work.
In this article, we will explore what orthotics are, and how they specifically work to help you eliminate that foot, leg, or back pain that has been keeping you down.
What are Orthotics - Defined
Orthotics are inserts into your shoes that provide various levels of support, cushioning, and re-alignment for the foot. Within orthotics, there are many different types, from accommodative/corrective and different types of materials and different types of sports. Let’s take a look at the different types of orthotics.
History of Orthotics
Orthotics have been used for hundreds of years as a first line treatment for common foot pains and to increase foot comfort. Orthotics were originally made with hard metal, but have now evolved into lighter and more durable plastics and even carbon fiber. While the materials and imaging has improved, the basic principles of providing pain relief through gait/pressure redistribution has persisted.
Type of Orthotics
Custom Orthotics
At the top of the food chain are custom orthotics. These orthotics are generally made by a podiatrist and are designed specifically for your foot by using a cast or digital scan of the foot. They also have specific ‘corrections’ which are designed for your specific condition and concerns.
Stride Soles, for example, sells custom orthotics which are made based on your shoe type, conditions, pain areas, foot scans, and what we see from your gait analysis.
Over the Counter (OTC) Orthotics
These are pre-made orthotics/inserts that are generally sold online and through retail locations. While they may have some of the corrective components of a custom orthotics, they are not as aggressive in nature, especially as it comes to arch support. They are perfectly suited for those who have general foot discomfort and are a good place to start when looking to improve one’s foot health.
Functional vs Accommodative Orthotics
Functional/Corrective Orthotics are designed to correct specific biomechanical issues, like a shortened gait or offsetting leg lengths. On the other hand, we have accommodative Orthotics, which can provide general cushioning during one’s day.
Conditions for Orthotics
Orthotics can be beneficial for those with a number of conditions, so lets take a look at a few.
1: Plantar Fasciitis - Orthotics reduce pressure on the plantar fasciia and help distribute pressure more evenly throughout the foot. This can give the PF more time to heal as it’s not engaged so directly on each step.
2: Flat Feet - With arch support, the foot will be aligned more naturally which reduces the changes for overpronation and improves distribution of the bodies weight. People with flat feet often roll their ankles in which puts pressure on the knees, hips, and other joints.
3: High Arches - People with high arches often put pressure on their heel or ball of foot as the arch is too stiff to absorb the ground. Orthotics can offset that pressure leading to a more comfortable walking motion.
4: Bunions - Orthotics can take pressure off the big toe joint and reduce overall pain throughout the body
5: Heel Spurs - Heel Spurs are bony growths on the underside of the foot by the heel caused from repetitive stress on the heel. Orthotics help by redistributing weight from the heel area, allowing proper time for the area to heel
While not mentioned, orthotics are also fantastic at addressing morton’s neuroma, achilles Tendonitis, and Metatarsalgia.
Signs you need Orthotics
While everyone is different, you should consider orthotics if you have a known foot condition as mentioned above. Additionally, if you do not know what condition you have, but are experiencing foot, ankle, knee, or back pain, orthotics can be a good first step. While going in person to see a doctor can be beneficial, the time and cost associated with a visit make orthotics a good first step. If the pain is eliminated from orthotics, than you have potentially saved yourself thousands of dollars and 10-20 hours of time!
Here are some additional signs that orthotics might help you
- Uneven wear on your shoes – check the bottom of your shoes, if there is more wear on one foot than the other, that can be a sign of leg length issues which are a good trigger to buy orthotics
- Heel pain or swelling from normal, every day activities
- Balance issues – if you find your self leaning to one side or falling over your feet often, orthotics can be beneficial.
How Do Orthotics Work
Supporting and Stabilizing
At the most basic level, orthotics provide support for the arches.
You can think of the foot as a big arch that, under pressure, collapses like a shock being squished down under the ground reaction force.
As you take off from a step, your foot unloads pressure and then springs back to its normal shape.
For those with normal arches, the arch supports the foot and the ‘spring’ effect helps us in our walking or running during daily life.
However, if you have a flat foot (no arch), there is no ‘shock absorber’ to help offset that strong ground. The result is often a combination of pain and overpronation. Overpronation means your foot is rolling inwards as the extra time of foot contact lessons the pressure on one specific part of the foot. Some level of pronation is normal and encouraged, however, too much pronation can lead to other issues such as lower back pain.
Thus, It can be beneficial to have an orthotic act as an ‘artificial arch’, collapsing and helping to take on that ground reaction force that the arch would normally provide.
Stabilization
Additionally, orthotics often stabilize the heel, preventing issues like overpronation from occurring. Good orthotics have a deep heel cup, which prevent the foot from rolling inwards or outwards (supination). Without excessive rolling of the foot, the body stays in a more neutral walking position, and thus lessons pain on the foot.
With the foot in the correct position, there is less likely going to be pain on the tendons/ligaments, thus preventing pain and future injury.
Pressure Offset by cushioning
Foot pain is often a cause of high pressure on certain areas of the foot, especially in conditions like plantar fasciitis, bunions, or high arches. With orthotics, the pressure is more evenly distributed across the entire foot, thus lessoning that pain in that specific area of high pressure.
It’s important to note that much of this pressure offsetting is also prevelent in OTC insoles. For this reason, simple cushioning is not enough for an orthotic to be covered by insurance.
Biomechanical Correction
You can think of your body as one big kinetic chain. If one area, say your knees are out of alignment, it can throw off your whole body, causing issues in other areas of your body. Orthotics act by aligning your body into a more neutral position, which prevents your body from overpronating or supinating (under pronation). Usually this is done through a deep/stiff heel cup which keeps the foot aligned.
Cushioning
While also relevant for OTC insoles, orthotics add a level of comfort by reducing pressure
Do Orthotics Weaken the foot
There is a lot of discussion over if orthotics weaken the foot and are thus non-beneficial. Let’s look into this…
Yes, overly rigid orthotics can weaken the foot. Think about it, if the foot doesn’t have to use itsown arch and can rely on a external resource, over time it will be used less. HOWEVER, it’s important to note that many individuals are not even engaging their arch to begin with as they have flat feet or other conditions, thus the orthotic only helps.
Additionally, the weakening is only relevant for overly rigid orthotics made with Polypropolene. This is a more traditional material which does not let the foot any opportunity to use it’s own arch. Many older podiatry offices use this material.
Semi rigid orthotics provide a goldi-locks level of support
More modern orthotics (like Stride Soles) are not as rigid, thus allowing the foot to still use its own arch but provide enough support to lessen the pressure. It’s more of a ‘goldi-locks approach’ akin to a pull up machine. Rigid orthotics simply make the movement to easy, like a pull up machine with all the weight put on.
Wearing no orthotics and barefoot shoes make walking unbearable as the arch has no support – like a pull up machine with no weight assistance. Stride Soles act in the middle, allowing just enough support to reduce pain but not enough to make the foot not need to engage its own muscles. As the foot strengthens itself the need for more assistance decreases.
