Orthotics are custom-made inserts for your shoes that aim to address any biomechanical issues with your feet. In my clinical experience, orthotics can be highly effective in helping resolve pain in the back and lower limbs. However, prescription with orthotics is not a “quick fix” and makes up only part of the rehabilitation programme. Clients nearly always have to follow an exercise programme either before or after prescription with orthotics to fully resolve their symptoms.
In my opinion, orthotics have become over-prescribed in recent years with inappropriate prescription of high end devices. I regularly have clients visit my clinic who have spent in excess of €300 on orthotics that have not solved their problem and are too uncomfortable to wear. I feel that the key to successful prescription of orthotics is looking at every aspect of the client and their lifestyle, not just their feet. The following is an outline of the different products that can be used to address biomechanical issues in the feet:
Supportive footwear is the first most important aspect in addressing any biomechanical issues. For the non-sporting population or those who participate in low-level recreational exercise, proper footwear along with appropriate exercises from your physiotherapist may be sufficient to resolve your symptoms.
There are some excellent off-the-shelf insoles available at very reasonable prices. Off-the-shelf insoles can often be as effective as and more comfortable than higher end devices. Your physiotherapist will advise you on what type to purchase.
Soft orthotics, often known as simple insoles, are a soft custom-made orthotic. Simple insoles are superior to off-the-shelf insoles in that specific modifications can be made to address your individual requirements. These insoles are much more affordable than the more rigid higher end devices. In addition, they can be more comfortable to wear and some clients benefit from using a simple insole for several months before moving onto a more rigid orthotic, if required.
Semi-rigid orthotics are made from a foam with a thin, plastic shell laminated to it. Rigid orthotics are made from firm materials such as plastic, fiberglass and carbon fiber. Plaster moulds of the foot or computerized foot analysis are used to construct these custom-made orthoses. Semi-rigid and rigid orthotics last much longer and provide more support or correction. However, for these same reasons they also take longer to “wear in” and are considerably more expensive.
As you can see, high-tech, expensive orthotics are not the only option available if you have bio-mechanical issues with your feet. My advice is to get assessed by an experienced chartered physiotherapist or podiatrist who can discuss the most economical, yet appropriate, orthotic/insole for you.