Orthotics - Yay or Nay?

Are orthotics (inserts that support your feet) actually beneficial or are they a phase that will turn out to be detrimental in the long run?! You may have heard a lot about "minimalist shoes" and barefoot running of late and although it may appear to be a trend at the moment, it's an issue that has been around for years. Should we be relying on man-made supports to "correct" our foot biomechanics or are our feet doing exactly what they're meant to be doing?

Here's my opinion.

Barefoot movement, is the ideal. Strengthening your foot intrinsics and increasing sensitvity and awareness to your feet, relying on the elastic recoil and release of energy unhindered is the way we were made to function. HOWEVER, if you think back to the way we originally moved, we spent our time on all fours (think 'monkey') sitting on our haunches, walking on our toes rather than holding all our weight vertically on these two stumps. When minimalist runners suggest you change to more minimal shoes, they suggest a few tests to see whether you are ready. These include testing your achilles length and big toe mobility and balance and dexterity (can you move your big toe independently of the rest of your toes?) all of which anyone would have surpassed had we been spending day to day sitting on our haunches and moving the way we used to move (as monkeys). These days, we spend majority of our waking hours either sitting on a chair or walking completely upright in high heels or built up, padded shoes, and we have done since we were able to walk. So the odds of us passing those tests are very low. It just is not our norm anymore.

So if someone walks into my office with foot, ankle, knee, low back pain, and what I would deem as "poor foot biomechanics" for the way our bodies work today - my first port of call is generally NOT going to be to suggest they start training barefoot. Because this is not the norm for our bodies anymore. I am more likely going to suggest that they get customised orthotics. If you had the time and patience you could re-train your foot biomechanics, spending majority of your time barefoot or in minimal shoewear to re-adapt. But to re-train in time for that marathon coming up in a couple of months or in order to be able to continue your normal sporting activity without any pain, it isn't realistic for the general population. Undoing 30years of habit isn't easy to do at all. So for the majority of the normal population who spend time standing on two feet (and not on their haunches) and who have poor foot biomechanics I WOULD encourage the use of orthotics to provide an easy /realistic way to strengthen and stabilise from the base up.

Who knows what will happen, with the emergence of more animalistic and functional-style training (such as ZUU etc) becoming more and more popular we may end up moving back towards our more functional positioning, in which case my opinion may change. Perhaps our focus needs to shift from trying to re-train adults to giving our kids more barefoot playtime. Forget about clean feet and encourage them to play barefoot and walk barefoot and run barefoot. But for now, for the average Joe, who just wants to be able to walk from the train to work without knee pain, or continue playing tennis without constantly rolling their ankles, then orthotics, is the way to go.

If you have a pain, injury or simply a question - give us a call on (08) 9448 2994, or book an appointment online here!

#physiotherapy #physio #doctororphysio #orthotics

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