Orthotics are specially designed shoe inserts used to support, align, and improve the function of the foot. They play a key role in optimizing how forces are distributed during walking, running, and standing, ultimately helping to correct biomechanical imbalances.
Foot biomechanics have a ripple effect throughout the body. Since the feet are the foundation for movement, poor alignment or abnormal foot mechanics can lead to stress and strain not just in the feet and ankles, but also in the knees, hips, and lower back. Supporting the feet properly can reduce the risk of injury throughout the kinetic chain.
Orthotics are commonly recommended for a wide range of individuals—athletes looking to improve performance or prevent injury, people recovering from lower limb injuries, or those dealing with persistent discomfort during daily activities. Whether you’re training for a marathon or simply trying to walk pain-free, orthotics can offer support and protection.
In this article, we’ll explore the science behind orthotics and highlight the types of injuries they may help prevent, based on current research and clinical evidence.
Understanding How Orthotics Work
The feet are the foundation of the body, and how they move affects everything above them. Each step you take involves a complex chain of events known as the gait cycle, which includes heel strike, mid-stance, and toe-off. When the foot moves efficiently through this cycle, it supports proper alignment, balance, and force absorption. However, issues like flat feet, high arches, or overpronation can disrupt this process and lead to pain or injury over time.
Orthotics are designed to improve foot mechanics by influencing how the foot contacts the ground and how forces are distributed during movement. By supporting the arch, controlling excessive motion, and redistributing pressure, orthotics help to improve alignment throughout the lower body. This can reduce stress on joints like the knees, hips, and spine, especially during repetitive activities like walking or running.
Research-Based Benefits of Orthotics
A growing body of clinical research supports the use of orthotics for both injury management and prevention. Whether you’re dealing with chronic pain or looking to optimize movement, orthotics can play a valuable role in improving biomechanics and reducing stress on the body.
Plantar Fasciitis
This is one of the most common conditions treated with orthotics. Research shows that custom orthotics can significantly reduce heel pain by supporting the arch and reducing strain on the plantar fascia. A systematic review found that orthotics improved pain and function in both short- and long-term management of plantar fasciitis.
Patellofemoral Pain Syndrome (PFPS)
Often referred to as “runner’s knee,” PFPS is linked to poor lower limb alignment and excessive foot pronation. Orthotics can help realign the foot and reduce internal rotation of the femur, which in turn decreases stress on the patellofemoral joint. Studies support the use of foot orthoses to reduce knee pain, especially when combined with targeted exercise.
Achilles Tendinopathy
Orthotics can offload the Achilles tendon by improving ankle positioning and providing a slight heel lift. Studies have found that patients with Achilles tendinopathy who used orthotics reported less pain and improved function compared to those using stretching alone.
Medial Tibial Stress Syndrome (Shin Splints)
This overuse injury is common in runners and individuals with flat feet. Orthotics help reduce impact forces and correct overpronation, both of which are key contributors to shin splints. Research suggests that orthotic use can reduce pain and allow for a quicker return to activity.
Low Back Pain
Poor foot mechanics can affect posture and spinal alignment, potentially contributing to lower back pain. By improving foot and leg alignment, orthotics can reduce stress on the lower back. Several studies, have found that foot orthoses may be beneficial in reducing chronic low back pain in some individuals.
Gait Efficiency and Force Absorption
Orthotics can enhance the way the foot interacts with the ground, leading to improved gait mechanics. This can result in more efficient movement and better force absorption, especially during high-impact activities. By improving shock attenuation, orthotics help reduce fatigue and lower the cumulative stress placed on muscles and joints.
When Are Orthotics Recommended?
Orthotics can be an effective solution in a variety of scenarios, especially when certain red flags appear in your gait, posture, or overall musculoskeletal health. Here are some situations where orthotics might be recommended:
Red Flags in Gait or Posture
If you notice any abnormalities in how your feet move, such as excessive pronation (when the foot rolls inward) or supination (when the foot rolls outward), orthotics may help correct these issues. These biomechanical imbalances can lead to joint strain, discomfort, and a higher risk of injury. A gait analysis can reveal if your feet are contributing to poor posture or faulty movement patterns, making orthotics a preventive measure.
Chronic Overuse Injuries or Recurring Pain
If you’re dealing with injuries that are consistently recurring, such as tendinitis, shin splints, or plantar fasciitis, and conservative treatments haven’t provided relief, orthotics may be an important part of your recovery strategy. Orthotics can help redistribute pressure, alleviate strain, and correct the underlying foot mechanics that contribute to overuse injuries, reducing the likelihood of re-injury.
Persistent Discomfort Despite Rehab or Footwear Changes
For individuals who continue to experience discomfort despite engaging in physical therapy or changing footwear, orthotics can provide additional support and relief. If foot-related pain or discomfort persists after trying other interventions, orthotics can be a critical next step to help improve alignment and reduce stress on the affected areas.
Getting the Most Out of Orthotics
To maximize the benefits of orthotics, it’s important to approach their use with care and attention. Proper integration with your daily routine or activity regimen can make a significant difference in both comfort and effectiveness. Here’s how to get the most out of your orthotics:
Importance of Proper Footwear Pairing
The type of footwear you wear plays a crucial role in the effectiveness of your orthotics. Shoes should provide enough space and support to accommodate the orthotics without causing discomfort or excessive movement. Avoid overly worn-out or ill-fitting shoes, as they may undermine the corrective benefits of the orthotics. When selecting footwear, consider both the orthotics’ needs and your specific activity to ensure proper support and alignment.
Gradual Break-In Period
If you’re new to orthotics, it’s essential to allow your feet to gradually adjust. Start by wearing them for short periods of time and slowly increase the duration as your feet become accustomed to the new support. This helps to prevent discomfort or strain that can result from suddenly wearing orthotics for extended periods. Over time, your body will adapt, and you’ll experience greater comfort and improved function.
Regular Re-assessment as Biomechanics and Activity Levels Change
Foot mechanics and your overall physical condition can change over time due to factors like age, changes in activity levels, weight, or even injury recovery. Regular check-ins can help identify any new needs or adjustments to the orthotics, ensuring they continue to provide optimal benefit.
Collaboration with Physiotherapists and Chiropractors
Orthotics are most effective when used as part of a comprehensive treatment plan. Working with physiotherapists and chiropractors can help address any underlying issues contributing to foot or body pain. These experts can provide insights into your posture, gait, and movement patterns, ensuring that the orthotics are specifically tailored to your unique needs and helping to prevent further injury.
Meet Janice our Pedorthist
Janice Laberge is a Board Certified Pedorthist with the Pedorthic Association of Canada, certified since 2008. She has worked in various multi-disciplinary clinics, treating both varsity athletes and the general population. Janice holds an Honours degree in Kinesiology from York University and a Health Science Degree in Athletic Therapy from Sheridan College. She combines her expertise in Athletic Therapy and Pedorthics to provide whole-body care.
Janice has extensive experience in custom orthotics, orthopedic footwear, and foot and ankle bracing. Her training includes the manufacturing, fitting, and modification of orthotics to help manage pain, improve biomechanics, enhance mobility, and support individuals with injuries, congenital conditions, or chronic disease. If you are interested in orthotics and booking an appointment with Janice, contact the clinic at 905-849-4576.
Conclusion
Orthotics can be a powerful tool for both injury prevention and comfort when used appropriately. Whether you’re recovering from an injury, dealing with chronic pain, or simply looking to improve your overall movement, orthotics offer a targeted solution to support your feet and enhance your biomechanics.
The benefits of orthotics are well-documented through research, particularly for conditions caused by overuse, such as plantar fasciitis, shin splints, and patellofemoral pain syndrome. By redistributing pressure, improving alignment, and providing shock absorption, orthotics help reduce strain on the body, allowing for more efficient and pain-free movement.
For the best results, it’s crucial to undergo an individualized assessment to ensure that your orthotics are tailored to your specific needs. Integrating orthotics into a broader treatment plan—often involving physical therapy or other interventions—can provide long-term relief and help you maintain an active healthy lifestyle. Contact Sheddon Physiotherapy and Sports Clinic to get more information about orthotics and booking an appointment at 905-849-4576.
References
Rasenberg, N., Riel, H., Rathleff, M. S., Bierma-Zeinstra, S. M. A., & van Middelkoop, M. (2018). Foot orthoses for plantar heel pain: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(19), 1220–1225.
Landorf, K. B., & Keenan, A. M. (2007). Efficacy of foot orthoses for the treatment of plantar fasciitis: A randomized controlled trial. Archives of Internal Medicine, 166(12), 1305–1310.
Collins, N., Crossley, K., Beller, E., & Darnell, R. (2009). Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: Randomised clinical trial. British Journal of Sports Medicine, 43(3), 163–168.
Munteanu, S. E., & Barton, C. J. (2011). Efficacy of customised foot orthoses in the treatment of Achilles tendinopathy: Study protocol for a randomised controlled trial. Journal of Foot and Ankle Research, 4, 27.
Moen, M. H., Tol, J. L., Weir, A., Steunebrink, M., & De Winter, T. C. (2010). Medial tibial stress syndrome: A critical review. Sports Medicine, 39(7), 523–546.
Cambron, J. A., Duarte, M., & Dexheimer, J. (2011). Shoe orthotics for the treatment of chronic low back pain: A randomized controlled pilot study. Journal of Manipulative and Physiological Therapeutics, 34(4), 254–260.
Castro-Méndez, A., Munuera, P. V., & Albornoz-Cabello, M. (2013). The influence of foot orthoses on the functional recovery of patients with low back pain. Journal of the American Podiatric Medical Association, 103(6), 534–540.
Mills, K., Blanch, P., Dev, P., Martin, M., & Vicenzino, B. (2010). A randomised control trial of short-term efficacy of in-shoe foot orthoses compared to flat inserts in individuals with patellofemoral pain syndrome. Journal of Science and Medicine in Sport, 15(4), 284–292.
Bonanno, D. R., Landorf, K. B., Munteanu, S. E., Murley, G. S., Menz, H. B., & Footwear Research Group. (2017). Effectiveness of foot orthoses for the prevention of lower limb overuse injuries in naval recruits: A randomized controlled trial. British Journal of Sports Medicine, 51(10), 734–740.
