65% of runners fall victim to an injury in any given year. Many a sports injury specialist will prescribe orthotics as part of treatment. These orthotics generally run $300-$500, but are they worth it? Do the results meet the claims? The concept of orthotics is full of controversy, with local proponents on each side of the argument. If you’d like my opinion, read on.
Today’s running shoes are the product of years of research, development, testing and perfection. The big shoe producers, like Asics, Nike and Saucony, have spent millions in studying running mechanics, developing materials and engineering shoe construction. In short, today’s running shoes ARE orthotics. In comparison, orthotic companies are infinitely smaller. They lack the research budget and cannot afford those considered leaders of the industry.
A common thing I hear runners doing is buying a neutral running shoe and putting their orthotic inside. They remove the shock absorbing insole so that their orthotic will lay flat. Problem is, the orthotic won’t lay flat as the shoe isn’t flat under the insole. It is built up for the arch of your foot. That’s not the only issue with orthotics. Many are far too hard for running. When you run, 2-3 times your body weight is brought down on your feet with each and every step. You need shock absorption, especially for running on asphalt. And here’s a little known secret of “custom” orthotics: many of them aren’t custom at all, but are “best-fit” selections from a library of pre-fabricated inserts.
I believe orthotics have absolutely no business being in a running shoe. I’m the worst pronator that I know of and I don’t need them. I just follow the 4 basic rules of injury prevention (coming in a future post) which includes getting the footwear right. If you have orthotics, take them out and throw them away. Might as well throw away the shoe, for that matter. It wouldn’t have been purchased for your given foot type, but rather bought to fit an orthotic.
The important thing is to be sure to buy the right shoe for your foot. I always advise my patients to avoid the big box stores when it comes to buying running shoes. Go to the small independently owned running store that is owned and operated by runners, those that understand the sport. You generally won’t pay any more for your shoes and your purchase will be an educated choice, backed by the knowledge of the salesperson. They’ll look at your feet. They may event watch or video you running bare-foot to watch your foot mechanics. Based on this, they will be able to give you a few options to try on for fit and feel. Listen to the sales person. They know what they’re doing.
Don’t believe me regarding orthotics? Let’s look at what the research has to say. This paper from the American Journal of Podiatric Medicine covers the questionable benefits of orthotics. It even reviews literature that suggests that they may increase the risk of injury. This paper from the American Journal of the Podiatric Medicine Association shows that orthotics made no significant difference to plantar fasciitis (for which custom orthotics are often recommended). Finally, this study found that pre-fab orthotics were a better choice than custom orthotics for the treatment of plantar fasciitis.
So are “custom” orthotics worth it? No way! That’s why you will NEVER find me recommending them to my patients. I promise that I will never waste your time or money. Tell me your experience with orthotics in the comments below. Until next time, I’m Dr. Jason Hare (chiropractor) from Pure Chiropractic, Nanaimo, helping you get back to life!