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To buy orthotics, or not?

should i buy orthothics?

The importance of foot mobility

I hear a lot about people wanting orthotics, and how that will “fix their alignment issues”.

But you see I don’t get that at all. As humans we have evolved from being always barefoot, to now having shoes on for most of our days.

Do you really think that whilst we were in the wild, hunting and gathering for our meals that arch support in any way bothered us?

In my opinion; the fact is, supportive shoes are not the be all and end all for many of my clients with foot and lower limb complaints. I believe they can cause the foot to become more rigid and indeed contribute to developing leg pain.

Pros for orthotics

  • Orthotics provide support and stability to the feet, helping to correct biomechanical imbalances and alleviate pain.
  • They can improve foot alignment, helping to distribute pressure evenly across the feet and reduce excessive stress on specific areas.
  • Orthotics can enhance overall body alignment, as they can help correct issues in the feet that may be causing misalignment in other parts of the body.
  • They can help manage conditions such as plantar fasciitis, flat feet, high arches, and bunions by providing cushioning and support where needed.
  • Orthotics can improve comfort during physical activities and reduce the risk of injuries by providing additional shock absorption and reducing excessive foot movement.
  • They can help improve balance and stability, particularly for individuals with weak or unstable ankles.
  • Orthotics can promote proper foot function and prevent the progression of certain foot deformities.
  • They can be customised to fit an individual’s unique foot shape and specific needs, ensuring optimal support and comfort.
  • Orthotics can alleviate pain in the feet, ankles, knees, hips, and lower back that may be caused by poor foot mechanics.
  • They are a non-invasive option for managing foot-related issues, offering an alternative to more invasive treatments or surgeries.

Cons for orthotics

  • Improperly fitting orthotics can cause discomfort and pain, especially if they are not customised or adjusted correctly.
  • Over-reliance on orthotics can lead to weakened foot muscles and decreased natural arch support, potentially worsening foot conditions over time.
  • Some individuals may experience an adjustment period when first using orthotics, during which they may experience temporary discomfort.
  • Depending on the design and material of the orthotics, they may add bulk or weight to footwear, making it less comfortable or less suitable for certain activities.
  • Orthotics can be expensive, especially custom-made ones, which may not be accessible or affordable for everyone.
  • In some cases, reliance on orthotics may prevent individuals from addressing the root cause of their foot issues and seeking alternative treatments or therapies.
  • Incorrectly prescribed orthotics or improper use can exacerbate existing foot conditions or lead to new problems.
  • Regular cleaning and maintenance of orthotics can be time-consuming and require additional effort to keep them in good condition.

A physio’s opinion on orthotics

I am not suggesting that there is not a place for orthotics in the medical world of musculoskeletal conditions (indeed I have used them myself at certain periods), but that a true analysis of the entire lower limb is required.

Let’s take shin splints. It is a given that this is related to loading going up the leg, and the foot is a main component of which. But in my opinion without a thorough analysis of what is happening from the big toe to the thoracic spine, and possibly above, then orthotics very well might be a waste of your hard earned cashola.

If, for example, someone is not activating well through their deep hip muscles (which control rotation of the femur bone when we walk) then this might allow rotation inwards of the femur and then rotation of the tibia. This then presents as a rolling inwards of the foot, and may even develop foot pain. Thus, the functional pronation may be a symptom rather than a cause –  which is simplistically what most orthotics are trying to fix.

Suddenly that $600 for your custom orthotics sounds pretty steep.

Written by Morgan Deegan, Physiotherapist and Director of Physio and Fitness Clinic. Morgan focuses on treating each client with an individual, goal oriented approach. She is an expert at looking at the body holistically and ensuring that each step of the process to recover is managed and thoroughly understood by the client.

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