03 Dec Why Do Orthotics Work For Some People And Not Others?
Your friends or family members swear by their orthotics. The guy at work says he wouldn’t be able to manage all day on his feet without them. Your aunt Susan got some – but said they didn’t work for her, and Dr. Google says that they may not be effective, either. So, what’s going on? How can people’s experiences be so different when it comes to foot orthotics?
Today, we’re debunking orthotic myths and setting the record straight on when – and if – orthotics work, including reviewing the current evidence and research on this topic, so you can gain a better insight about whether orthotics could be right for you.
The first key: Defining what is an orthotic, and what’s not
You know how when we talk about chocolate, the spectrum covers everything from premium swiss chocolates made of the most delicious and genuine ingredients to the discounted stuff that tastes a little like plastic? Orthotics have a spectrum too.
Many people refer to the gel footbeds you get from the pharmacy, or the cushioning insoles you get from the supermarket as ‘orthotics’ – when they are not.
Orthotics are highly specialised medical devices that are prescribed and created by a skilled podiatrist only after a comprehensive assessment of your feet and legs, clinical testing, a video gait analysis, discussing your history, attaining diagnosis, identifying the cause of your problem or injury, and more.
True orthotics do not employ a one-size-fits-all or every-foot-is-the-same mentality. They are made from a model or cast of your feet, accurately capturing the unique attributes that make your feet work the way they do – and which help create your unique set of problems or circumstances. Every foot is different, and they should be treated that way if we’re going to provide effective, personalised care that puts your foot health and best interest first.
Who you get your orthotics from matters
Just like how you go to an optometrist for your custom glasses because eyes and vision are their specialty, custom foot orthotics should be prescribed by your podiatrist as their sole focus is your feet, legs and the complex biomechanics between the two. And beyond this – the experience of your podiatrist and their confidence in using various features to prescribe your orthotics matters, too.
There are so many factors to consider when prescribing a pair of orthotics – and your podiatrist has to make all these decisions themselves. How thick should the orthotic base be? What about the top cover? And what material should the cover be? Should there be an extra liner? Do you need extra stability via a wedge in your forefoot? What are the best modifications for your specific shoes? And your job? And the sports you do? And your weight? How will adding feature x to your orthotic affect your ankles? And your knees? … We could go on, but you get it. The success of your orthotic is directly correlated to the prescription made by your podiatrist, and their consideration of all of the factors. This means you won’t get the same product from each podiatrist.
Now, some clinics excel at orthotics, while some have a greater focus on skin and nail care. Both are great podiatrists. But, a clinic’s focus on and experience with orthotics is an important question that you should be asking a clinic and your team at your appointment. And even beforehand if you’re looking to get a new pair of orthotics, or strongly suspect you need them.
Here at Masterton Foot Clinic, orthotics and sports medicine make up a large part of what we do. We focus on it, we invest in it, we upskill in it – because we understand the impact that effective recovery can have on your well-being and life.
We also make custom shoe modifications
The other thing about orthotics that many people don’t discuss, is the ‘team’ that your orthotics make with your shoes. After all, your shoes house your orthotics and influence the way they sit, while also influencing the way your foot functions. This is why our podiatrists will always discuss your footwear with you, particularly the ones that will be housing your orthotics.
Again – we can recommend the best shoe type for your feet, but given how unique both our feet and our foot problems or injuries can be, this may not be enough. This is where we can actually make custom shoe modifications, such as a rocker sole, to best support your recovery, your comfort, your foot health – and your quality of life.
Orthotic treatment also requires you to play a part
The next thing that influences the success of orthotics is recognising that they’re not a ‘set and forget’ kind of deal. They can help greatly by offloading painful joints and muscles, keeping your foot supported and changing the way your foot functions – but there are often other factors at play – the factors that have caused your injury or problem in the first place. And these factors must be addressed. This is why effective orthotic therapy often needs you to:
- Improve the strength and flexibility of your muscles and tendons (and hence manage any imbalances), as prescribed by your podiatrist
- Limit the wearing of shoes that may cause further harm to your feet and detract from what your orthotics are trying to do – such as high heels, flat sandals and other tight or narrow shoes
- Receive other therapies to help repair the damage, if you have tendon or joint damage. A good example of this is shockwave therapy for heel pain – while your orthotics will work to offload and support the plantar fascia that is often responsible for heel pain, shockwave treatment will help to repair the fascia itself
While some situations do warrant an orthotic alone – more often it is much more complicated and multifaceted, and we recommend caution if anyone advises you otherwise.
Back to Aunt Susan – why didn’t her orthotics help her?
Now that we’ve covered the background, it’s really quite simple. Did she have truly custom orthotics, or did she pop an insole she ordered online into her shoe and call it an orthotic? Did she have an assessment with a podiatrist that specialises in orthotics and foot biomechanics? Did she do her part of the treatment? Did she keep wearing her heels on the weekend and then complain that her pain kept returning?
Truly, there is so much to it, and we hope we’ve helped shed a light on why it’s impossible to make a judgement on why someone’s orthotics did work or didn’t work without knowing much more of the story.
Could orthotics help you?
No podiatrist can answer that without conducting a comprehensive assessment of your feet and legs, making a diagnosis, and understanding what has caused your problem. If your podiatrist or another health professional automatically says yes to orthotics without the above, consider that a big red flag.
Orthotics can’t solve every problem, and they aren’t for everyone, but we definitely have great success with orthotics for specific problems and pains, ranging from heel pain to knee osteoarthritis to growing pains in kids.
If you’re wanting a solution for your pain or problem, our team at Masterton Foot Clinic are here to help. Whether that’s with orthotics or another treatment, our experienced podiatrists will discuss all your options with you and what you can expect.
Book your appointment with us by calling (06) 370 4057 or book online here.
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