Orthotics, part of the plan, but not the whole plan.
If you’re wondering if you need orthotics, or currently have orthotics in your shoes, please ask yourself this:
Is wearing orthotics a short, medium or long term strategy?
If you’re unsure of the answer, then read on, this is for you.
What is an orthotic?
An orthotic (also known as an innersole, orthoses, insert) is a device utilised to aid in foot and ankle pain and function.
In its simplest form, an orthotic is a load management tool
An underlying principle of foot and ankle management is finding the balance between load and capacity. We wrote a popular blog on the topic, you can check that out here.
The way we approach orthotics at Foot & Ankle, is that an orthotic can be used to modify load throughout the foot. What does this mean?
There are three main functions of the foot during walking or running:
Shock absorption/landing (pronation)
Stability on one foot
Propulsion/step off (supination)
The foot has 33 joints, 26 muscles and over 100 ligament and tendon attachments. Feet have an incredible capacity to handle the above three functions. But, at times, the amount of load going through the foot, or a particular part of the foot, exceeds the capacity of the tissue (tendon, bone, fascia, ligament). This might cause pain or injury. We say might because the body is very robust!
Does an orthotic help with pronation?
An orthotic can impact on the foot’s movement into both pronation and supination. If a foot is sensitive in its movement into pronation or supination, an orthotic might be able to help reduce loading in those areas.
A common misconception is that pronation is something to be feared. Something we frequently hear in the clinic is: “I’m a pronator”, or “my foot pronates too much”.
Pronation is a normal part of foot function. An orthotic is not designed to stop pronation.
How does an orthotic work?
What an orthotic can do:
Reduce load or pressure through a particular area of the foot
What an orthotic does not do:
Correct foot posture or alignment
Fix arch heights
Orthotics come in all shapes and sizes. There is variation between material firmness or softness, shoe fitting, arch heights and fills, and the list goes on and on.
We like to talk about orthotic prescription as ‘dosage’ (thanks to Ian Griffiths for this analogy!). Just like medication (such as panadol), too little and we may not notice a change in symptoms, too much and we may notice a worsening in symptoms or comfort.
What makes our orthotics different?
At Foot & Ankle, we have a non-negotiables when it comes to orthotic prescription:
Comfort: we achieve comfort by utilising an orthotic that moves and flexes with the foot. Quite commonly, orthotics with increased firmness and hardness can cause discomfort. We want an orthotic that works with the foot, as opposed to against. How do we achieve this? We work with an orthotic company called Doc Sols (you can check them out here www.docsols.com.au). These 3D printed devices allow us to control the flexibility in any part of the orthotic, which allows for incredible comfort.
Slim fitting: we want you to still be able to access the full range of footwear. Increased bulk and size can really limit footwear. We reduce bulk through the orthotic as much as possible to allow fit into most common footwear (without going up a shoe size!).
Do you have to wear orthotics forever?
At Foot & Ankle, we like to work towards timelines in regards to how long we envision wearing orthotics for. We like to break it down into the three following categories:
Short term: Less than 6 months
Medium term: 6-12 months
Long term: Greater than 12 months
Orthotics don’t have to be worn long term
The factors that come into the timeline include foot and ankle capacity, load management, previous history with orthotics, exercise or sporting goals and diagnosis.
Orthotics can be a very effective tool to aid in foot and ankle pain management, but there is more to the story. If you’d like an orthotic assessment or you have foot or ankle pain, we’d love to help!