Footwear / Orthotics

Proper footwear is essential when exercising and even just walking throughout the day as you do your daily activities. 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, and they most likely don’t even know it. 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 a 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 they were advised to wear. Sure some people do overpronate, but it’s because of muscle imbalances in the lower leg and foot, not because they’re wearing the wrong shoe. Even worse, many people wear orthotics – casts of their feet that are supporting their gait dysfunction and imbalances which only support their problem and eventually cause other problems throughout the body. There’s a lot of hype behind orthotics. Many physicians, therapists, and salespersons who make and sell them think they’re the greatest thing since sliced bread. Well, 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 refer to as a  pathological orthotic, as they are making a cast (mold) of your foot in its current 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 pain may go away, but a new one will pop up later, perhaps somewhere else in your body. The goal is to figure out why the muscles and bones of the foot (as well as everything affecting the foot) are not functioning properly so 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 temporarily…and this is where orthotics become very valuable for a slight few people – when they are used to help hold a correction in its place so function may be restored. However, as I write this, now into my 13th 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.Foot muscles and lower leg muscles which play a major part in the gait of an individual are very responsive to stress in the body. Abnormal stress from thick-heeled, over-supportive shoes, and those wearing orthotics, further weaken the foot and lead to problems. Dietary stress from a poor diet (refined carbs, processed fats), emotional stress, and physical stress from other injuries as well as excessive exercise also lead to lower leg and foot problems.I estimate that 90% 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 10% of the time I’d say the orthotic is neither helping them nor hurting them. If you were told that there was very little chance of success with any treatment, you probably wouldn’t go and pay $250-$400 for it.

• Wear shoes that keep your feet close to the ground, are “low to zero-drop,” don’t have a lot of support, and aren’t too rigid (stiff).
• Remember, your orthotic is most likely supporting dysfunction.

A whole lot more on orthotics over at my Sock Doc site – click here.

And still even more about proper/improper footwear here by Sock Doc – here.

Read more about proper footwear selection by Dr. Mark Cucuzzella here. The article is for both kids and adults. Also, Barefoot Science has some good information and research related to the dangers of orthotics and “shod” footwear. Click here.