Proper footwear is essential when exercising. Today many shoes are  made to look cool and flashy, but they are unfortunately making foot function worse. There are numerous shoes with anti-pronation devices, arch supports, ankle supports, and motion control devices & stabilizers. These are often causing problems in a lot of people. Take, for example, the hype behind the anti-[over]pronation shoes. Pronation is a necessary motion and function of the foot. It is supposed to happen -- it is the major way you absorb shock when walking or running. However, many people are being told they overpronate or they think they overpronate so they wear these anti-pronation shoes and problems occur – foot, knee, hip, or back aches – all from the shoe. Many people do overpronate, but it’s because of muscle imbalances in the lower leg and foot. You can read more about this in the injury section. In basketball players it has been shown that many of the hi-top shoes worn actually decrease vertical jump height while increasing injury rates.

Wear shoes that keep your feet close to the ground, don’t have a lot of support, aren’t too rigid, and have a “neutral” design.

Now, let’s talk a bit about orthotics.

There’s a lot of hype behind orthotics. Many doctors, therapists, and salespersons who make and sell them think they’re the greatest thing since sliced bread. Well, since I’m not a big fan of bread, I’m not a big fan of orthotics. (I’m kidding about the analogy part; I like bread a lot more and it tastes better anyway.) Orthotic supporters (no pun intended) claim that the inserts will fix every structural pain from your head to your toe. The majority of these people make what I’ll call a pathological orthotic, where they are making a cast (mold) of your foot in its already incorrect position. Since you wouldn’t want a broken arm put in a cast without setting the bone, you don’t want a cast of your foot made without making sure that the muscles are balanced and the bones are in the right place. Making a cast of your foot without addressing the issues of the foot isn’t fixing anything – it’s just going to support a problem you already have. Your orthotic is supporting dysfunction. Your pain may go away, but a new one will pop up later, probably somewhere else in your body. By figuring out why the muscles and bones of the foot (as well as everything affecting the foot) are not functioning properly, the problem at hand (or is it foot?) can be resolved. Since you have to walk, an injured muscle may need to be supported as it heals...and this is where orthotics become very valuable – when they are used to help hold a correction in its place so function may be restored. However, as I write this, now going on my 12th year in practice, I have never once needed to have a patient go and get an orthotic made to help stabilize or correct their foot. Maybe that will change tomorrow.

I estimate that 75% of the time I need a patient to stop wearing their orthotics that were made for them by another physician because they are either causing a disturbance in their gait (the way you walk) or creating a foot dysfunction. About 22-23%% of the time I'd say the orthotic is neither helping them nor hurting them. That leaves around 2-3% of the time they are actually benefiting from their orthotic, and that's being very reasonable. If you were told that there was a <5% chance of success with any treatment, you probably wouldn’t go and pay $250-$400 for it.