If you are having pain in your feet, legs, hips or back, you may require orthotics to improve your foot position and function during activity.
What are orthotics?
Orthotics are insoles that are issued by Podiatrist’s, and are worn in shoes to redistribute pressure, and reduce stress on certain structures in the foot and lower leg. They are used for both the treatment and prevention of injuries. They should only be issued after a full biomechanical assessment has been conducted, which looks at a person walking, running, the movement of their joints, strength in their muscles, and checking the wear pattern on their footwear. Orthotics are used in a variety of foot types (flat or high arched feet) and are worn by participants in a variety of sports. They can be fairly rigid, or very flexible/soft, depending on foot type, activities and footwear.
When designing and manufacturing an orthotic, the Podiatrist takes into account:
Foot type
A higher arched foot needs a more flexible orthotic(a rigid orthotic under a high arched foot is very uncomfortable). A lower arched foot needs a slightly stiffer orthotic so it doesn’t compress too much when they walk on it, to ensure good support.
Weight
Heavier people need a stiffer material, or it just squashes underneath them and doesn’t give enough support.
Activities
Sports that require directional changes will need a more flexible orthotic. Some sports also require light-weight orthotics, or low bulk orthotics to fit into football boots and running spikes.
Surfaces
Harder training surfaces will need a more flexible orthotic to improve shock absorption.
Footwear
Football / soccer boots, racing spikes and racing flats may require lower bulk orthotics for shoe fit. Most of the time, a full length cover is added to the top of the orthotic for comfort, but sometimes a smaller cover works better in spikes and flats. Ballet shoes are difficult to fit orthotics into, but sometimes a very low bulk pair can fit, although often dancers are just better off strapping their feet (a Podiatrist can show you how to do this).
Do I need a custom-made orthotic or an off-the-shelf orthotic?
Custom-made orthotics are generally more durable, and can be made specifically for a foot type. Off-the-shelf orthotics don’t fit every foot type. Some feet need increased tilt at the heel or more specific support, and others just don’t suit a generic device because their arches are too high or too low. Custom-made orthotics are more expensive, but they last longer. For short term injuries, where you may not be required to wear orthotics long term, off-the-shelf orthotics (if they are suitable for your foot) are perfect. They can be issued on the day of consultation, and once your injury has settled, they no longer need to be worn. I normally try to issue off-the-shelf orthotics for children with injuries or biomechanical concerns if appropriate, as their feet are growing rapidly and changing shape. Sometimes, athletes might prefer an off-the-shelf orthotic for their sports shoes, and a custom-made orthotic for their everyday shoes or vice-versa.
How long do they take to get used to?
It will take you 1-2 weeks to adjust to wearing orthotics, although I normally give people 4 weeks to fully get used to wearing them, so they can run in them for a few weeks before I review them. They should be comfortable within one week of wearing them for daily activities, and you should be comfortably playing sport in them 2 weeks later. If this is not the case, then you should see your Podiatrist, as they may need a minor adjustment. Often stretching and strengthening exercises are given when orthotics are issued, and you should make sure you adhere to these, as orthotics are usually only part of your treatment plan.
How often should I wear them?
Your Podiatrist will advise you how much you need to wear your orthotics. Some people just need to wear them for activity, others need to wear them for about 80% of the day or more. This will depend on the reason you were given orthotics (to settle an injury, to prevent the progression of a foot deformity such as a bunion, or to improve walking and running style).
How long do they last?
Custom-made orthotics normally last an average of 5 years. During this time, the cover often needs replacement once or twice (depending on the amount and type of activity – some AFL players need several recovers in a season). Off-the-shelf orthotics usually last about 12 months.
How often should I have them checked?
You should have your orthotics reviewed by a Podiatrist every 1-2 years, to ensure they are still supporting your feet adequately. If you start to have any pain in your feet or legs or feel like the orthotics are not supporting you as well as they were, then have them checked earlier.