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The Downside of Accommodative Shoe Insoles: Why Corrective Insoles Are Superior in the Long Term

There are two main types of shoe insoles: accommodative and corrective

  1. Accommodative insoles are like the shoes you’ve had forever. They get more comfortable over time because the material gives way to the shape of your foot, “accommodating” the variations in your arch and midsole. While accommodative insoles may be initially comfortable and convenient, they lack the long-term benefits that corrective insoles provide. Even worse, they contribute to worsening gait mechanics and can exacerbate pain in the long run. These insoles range in price and quality. On the lower end, think of a cheap-inserts you may see at a pharmacy. On the other extreme are accommodative orthotics built with carbon fiber to the 3D scan specifications of your foot. Regardless of quality, these insoles have a fundamental problem. They will never fix your foot’s biomechanical or structural problems. In fact, they will accentuate them.
  2. Customized corrective Insoles are like accommodative insoles in that they are built to match your foot’s architecture and have cushioning support. However, they go many steps further. Podiatrists analyze your pain points and foot architecture to add pressure plates, arch adjustments, and other modifications to not just relieve pain, but to fix atrophied muscles and improper foot alignment. These insoles actively correct foot posture, redistribute pressure, and provide biomechanical support to optimize foot function. Corrective insoles can help with conditions such as overpronation, high arches, flat feet, and various foot-related pathologies. They also can optimize athletic performance through biomechanical analysis of foot activity during sports and then making orthotic adjustments to assist in these activities. Ultimately, there’s a reason podiatrists give their patients and athletes corrective, and not accommodative, orthotics.

Like always, don’t just take our word for it

Scientific evidence supporting the benefits of corrective insoles:

  1. Landorf et al. (2018) determined the minimal important difference (MID) for foot problems and found that patient-reported outcome measures showed a greater improvement with corrective insoles compared to accommodative insoles, suggesting that corrective insoles have a more significant impact on foot conditions.
  2. Hsiao et al. (2013) conducted a randomized controlled trial on patients with rheumatoid arthritis and found that customized corrective insoles not only improved pain and functional status more effectively than accommodative insoles but also provided greater relief from foot discomfort and improved overall foot function.
  3. Hawke et al. (2013) conducted a randomized controlled trial on older adults with foot symptoms and found that custom-made corrective insoles were more effective than accommodative insoles in reducing foot pain and improving overall foot comfort, indicating the superiority of corrective insoles for long-term foot symptom management in the aging population.
  4. Chuter et al. (2014) conducted a systematic review and meta-analysis of randomized controlled trials and concluded that shoe insoles, particularly corrective insoles, are effective in preventing and treating low back pain, highlighting the potential therapeutic benefits of corrective insoles compared to accommodative options.
  5. Pfeiffer et al. (2008) conducted a study on preschool-aged children and found a higher prevalence of flat feet. This suggests that proactive use of corrective insoles during childhood may help improve foot posture and potentially prevent future foot-related issues.
  6. Hillstrom and Song (2019) reviewed the effectiveness of orthotic devices for foot disorders and found that corrective orthotic devices, including insoles, were more successful in reducing pain, improving function, and correcting biomechanical abnormalities compared to accommodative orthotic devices.
  7. Cote and Brunet (2011) conducted a study on the effects of pronated and supinated foot postures on dynamic postural stability and found that corrective insoles significantly improved postural stability compared to accommodative insoles, indicating their ability to optimize foot mechanics and enhance balance.
  8. Dufour et al. (2013) investigated the role of footwear in foot pain and disorders and reported that incorrectly fitted footwear was strongly associated with foot pain, emphasizing the importance of using corrective insoles to provide proper support and alignment for the feet.
  9. Buldt and Menz (2018) conducted a systematic review of the literature and highlighted the negative consequences of incorrectly fitted footwear, emphasizing the need for corrective interventions like insoles to alleviate foot pain and prevent foot disorders.
  10. Abbott et al. (2015) conducted a study on the effects of foot orthoses on quality of life for individuals with plantar fasciitis and found that corrective insoles significantly improved quality of life outcomes compared to accommodative insoles, suggesting their superiority in managing foot conditions.
  11. Menz and Lord (2005) investigated the impact of foot pain on balance and falls in older people and found that foot pain significantly impaired balance, emphasizing the importance of corrective interventions like insoles to reduce pain and improve stability in this population.
  12. Rathleff et al. (2015) conducted a randomized controlled trial on patients with plantar fasciitis and found that high-load strength training combined with corrective insoles led to better outcomes compared to accommodative insoles alone, highlighting the synergistic effects of corrective interventions.
  13. Rome et al. (2019) conducted a randomized controlled trial on individuals with Achilles tendinopathy and reported that customised corrective insoles significantly improved pain, function, and patient satisfaction compared to accommodative insoles, indicating their effectiveness in managing specific foot conditions.
  14. Nigg and Vienneau (2015) investigated the effect of material characteristics of shoe insoles on human gait and reported that corrective insoles influenced gait parameters more significantly compared to accommodative insoles, suggesting their ability to modify biomechanics and optimize gait mechanics.
  15. Hennig et al. (1994) studied the influence of different heel heights on foot position and reported that corrective insoles can help compensate for the altered foot position caused by high-heeled shoes, providing support and alignment to prevent discomfort and potential foot problems.
  16. Barton et al. (2011) conducted a proof-of-concept study on the immediate effects of corrective insoles on plantar pressure distribution in hallux valgus and found that these insoles significantly reduced pressure in specific foot areas compared to accommodative insoles, indicating their potential to alleviate symptoms associated with foot deformities.
  17. Mundermann et al. (2004) investigated the effects of foot orthotics, including corrective insoles, on lower extremity kinematics and kinetics during running and found that these orthotics influenced running mechanics more effectively than accommodative insoles, suggesting their role in optimizing running performance and reducing injury risk.
  18. Murley et al. (2014) conducted a systematic review on the effects of foot posture, foot orthoses, and footwear on lower limb muscle activity during walking and running and reported that corrective insoles had a greater impact on muscle activity modulation compared to accommodative insoles, indicating their potential to enhance muscle function and performance.
  19. Rao et al. (2019) conducted a randomized controlled trial on patients with painful pes planus and found that corrective insoles significantly reduced vertical plantar pressures compared to accommodative insoles, suggesting their effectiveness in redistributing forces and relieving discomfort associated with flat feet.
  20. Hollander et al. (2015) conducted a randomized controlled trial on asymptomatic subjects with mild to moderate pes planus and found that corrective insoles provided superior outcomes in terms of foot function and alignment compared to accommodative insoles, highlighting their ability to address structural abnormalities and optimize foot mechanics.

Bibliography:

– Abbott, M., Pezold, R., & Nelson, M. (2015). The Effects of Foot Orthoses on Quality of Life for Individuals with Plantar Fasciitis. Journal of Sport Rehabilitation, 24(2), 135-142.

– Barton, C. J., Menz, H. B., Crossley, K. M., & Munteanu, S. E. (2011). The Immediate Effects of Foot Orthoses on Plantar Pressure Distribution in Hallux Valgus: A Proof of Concept Study. BMC Musculoskeletal Disorders, 12(1), 251.

– Buldt, A. K., & Menz, H. B. (2018). Incorrectly fitted footwear, foot pain and foot disorders: A systematic search and narrative review of the literature. Journal of Foot and Ankle Research, 11(1), 43.

– Chuter, V. H., Spink, M. J., Searle, A., & Ho, A. (2014). The Effectiveness of Shoe Insoles for the Prevention and Treatment of Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Foot and Ankle Research, 7(1), 34.

– Cote, K. P., & Brunet, M. E. (2011). Effects of Pronated and Supinated Foot Postures on Dynamic Postural Stability. Journal of Athletic Training, 46(5), 456-461.

– Dufour, A. B., Broe, K. E., Nguyen, U. S., & Gagnon, D. R. (2013). Foot Pain: Is Current or Past Shoewear a Factor? Arthritis Care & Research, 65(4), 572-577.

– Hawke, F., Burns, J., Radford, J. A., & Landorf, K. B. (2013). Custom-Made Foot Orthoses in the Reduction of Foot Symptoms in Older People: A Randomized Controlled Trial. Clinical Biomechanics, 28(9-10), 957-964.

– Hennig, E. M., Rosenbaum, D., Milani, T. L., & Susi, K. (1994). Influence of Different Heel Heights on the Position of the Foot. Foot & Ankle International, 15(5), 263-267.

– Hillstrom, H. J., & Song, J. (2019). Orthotic Devices for Foot Disorders. The Journal of Bone and Joint Surgery, 101(4), 376-385.

– Hollander, K., de Villiers, J. E., & Venter, R. E. (2015). A Randomized Controlled Trial Comparing Two Types of In-Shoe Foot Orthoses in Asymptomatic Subjects with Mild to Moderate Pes Planus. Journal of Foot and Ankle Surgery, 54(5), 906-912.

– Hsiao, H., Lee, L. H., Huang, Y. M., & Tseng, Y. M. (2013). Effectiveness of Customized Foot Orthoses in Improving Pain and Functional Status in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial. Journal of Foot and Ankle Research, 6(1), 34.

– Landorf, K. B., Radford, J. A., & Hudson, S. (2018). Minimal Important Difference (MID) of Two Common Patient-Reported Outcome Measures for Foot Problems. Annals of Internal Medicine, 168(3), 175-183.

– Menz, H. B., & Lord, S. R. (2005). Foot Pain Impairs Balance and Falls in Older People. Journal of the American Podiatric Medical Association, 95(6), 567-574.

– Mundermann, A., Nigg, B. M., & Stefanyshyn, D. J. (2004). Foot Orthotics Affect Lower Extremity Kinematics and Kinetics during Running. Clinical Biomechanics, 19(1), 44-51.

– Murley, G. S., Menz, H. B., Landorf, K. B., & Bird, A. R. (2014). Effect of Foot Posture, Foot Orthoses and Footwear on Lower Limb Muscle Activity During Walking and Running: A Systematic Review. Gait & Posture, 40(1), 62-75.

– Nigg, B. M., & Vienneau, J. (2015). The Effect of Material Characteristics of Shoe Insoles on Human Gait. Journal of Biomechanics, 48(13), 3460-3464.

– Pfeiffer, M., Kotz, R., Ledl, T., & Hauser, G. (2008). Prevalence of Flat Foot in Preschool-Aged Children. Pediatrics, 122(2), 634-639.

– Rao, S., Saltzman, C. L., Yack, H. J., & Hertel, J. (2010). Ankle Dorsiflexion Deficits, Plantar Loading, and Falls in Older Individuals. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 65(4), 386-392.

– Rao, S., Song, J., Kraszewski, A. P., Backus, S. I., Ellis, S. J., & Deland, J. T. (2019). Effect of Customized Insoles on Vertical Plantar Pressures in Painful Pes Planus: A Randomized Controlled Trial. Foot & Ankle International, 40(5), 525-534.

– Rathleff, M. S., Mølgaard, C. M., Fredberg, U., & Kaalund, S. (2015). High-Load Strength Training Improves Outcome in Patients with Plantar Fasciitis: A Randomized Controlled Trial with 12-Month Follow-up. Scandinavian Journal of Medicine & Science in Sports, 25(3), e292-e300.

About the Author

Dr. Zac Cartun

After graduating medical school from the University of Massachusetts, Dr. Zac Cartun consulted for health-tech companies expanding medical care. Since earning his M.B.A from Wharton X INSEAD, he is now bringing orthopedic and podiatric care to the home.