Orthotics are shoe inserts that are designed to
provide cushioning, support, stability, and/or relief to pressure areas of the
foot. They can be soft, semi-rigid, accommodative, or rigid; they can be
custom-made from a mold or impression of the foot or bought by size "off
Orthotics are used to treat foot and leg problems
caused by foot abnormalities or variations in foot structure, like a flat foot
or foot with a high arch. They can also be used to treat leg injuries where the
foot structure may be a contributing factor. How well an orthotic works depends
on the fit, the design, and if it is being used correctly. (Note: Other
treatments for the condition also may affect recovery.)
Mechanics of walking and running
When walking or running, the foot undergoes
pronation and supination. Everyone pronates and everyone supinates. However,
when pronation or supination is excessive, injury may occur.
Pronation occurs when the foot
lands on the ground. The arch flattens, the heel flares out, and the shin bone
rotates inwardly. This allows the foot to absorb shock and adapt to the
A flat foot pronates excessively. Even if the
foot appears to have an arch, excessive pronation results in the arch collapsing
with weight bearing. Due to the instability of a pronated (flat) foot, the leg
muscles have to work extra hard to stabilize the foot during walking or running.
This can cause shin splints and stress fractures. A flat foot also is associated
with increased internal tibial rotation (when the knee turns inward) and can
lead to patellar tracking problems and overuse injuries of the knee. An orthotic
that supports the arch can help treat these conditions.
Supination happens before pushing
off with walking or running. Supination raises the arch, inverts the heel, and
makes the foot more rigid to allow for push-off.
A foot with a high arch is rigid and supinates.
This foot type has stability and support but lacks flexibility for shock
absorption. This rigidity can lead to stress fractures or overuse injuries. A
rigid orthotic for this foot type is not recommended because it may actually
increase the risk of injury, but a shoe or insert that provides cushion may be
Is an orthotic right for you?
An orthotic is just a tool to be used in the
treatment of specific injuries. There is no clear evidence that it can prevent
injuries. However, an incorrect orthotic can cause or worsen an injury. An
orthotic will not change a flat foot to a normal foot over time.
In deciding if an orthotic is a useful part of
the treatment, you should ask
Is the injury caused by a problem with
the structure of the foot?
Can an orthotic correct this
What other options are available to
treat the condition besides orthotics? Is there a shoe or
over-the-counter product that would work?
What are the risks of using an orthotic?
Could it cause other injuries?
Photo courtesy of www.chicagopodiatry.com