Orthotics – What are they?

Inserts, arch supports, foot beds are some names. There are also many forms – Custom made, ‘out of a packet’, hard, soft, cheap, expensive. Some are effective, some are not.

I preach to my runners to not rely on their orthotics forever just use them as needed. In fact I regularly see runners wearing orthotics who don’t need them.

I’ve used them before with good success. A grumbling sesamoid bone injury (under the big toe joint) threatened to derail my running season but I was able to increase my running appropriately with their help- preventing further damage.

I don’t need them anymore as I have changed the way I run and am also a lot stronger now. Stronger in my feet and other key running muscles – something that everyone can achieve.

Do you need orthotics?

If you are pain free, running well and achieving your goals then probably not.

Are you having issues?There are many factors to consider and no simple answer.

My first piece of advice is a thorough examination from someone who specialises in running injuries.

Diagnosis = Prognosis. Or in layman’s terms we need to find out whats wrong before we can start treatment. Orthotics are ONE treatment option, make sure you consider the other options too. ie. Strength, mobility, proper movement, running technique, training modification etc etc.

Will orthotics make you faster?

No, not generally. The thickness of the orthotic might even have a negative effect on ground contact time (how long your foot is on the ground for each step), a key running metric which you would only want to reduce. However if you have an injury that usually flares up in the back end of a race and your orthotic helps you get to the finish line with less pain then I believe that would help your performance. It really depends what pathology we are dealing with and how far along in your rehabilitation you are.

As an example, last year a patient of mine was recovering from a small tear in a tendon on the inside of his ankle (tibilais posterior) but he was super keen to run the Berlin Marathon as he was fund raising. Due to the nature of the injury and time frame we had we made the decision to make and wear orthotics as he would not have been able to achieve the necessary training without them. It was touch and go for a while but he got there and finished the race very well with no further damage.

This year his tear has healed and we spent the off season gaining strength in his ankle, feet and glutes and improving technique. We also modified his training plan to reduce the risk of flare ups. His strength is now back and there is no need for the orthotics anymore.

If you do wear orthotics and they help with your pain – keep going, but consider your options from here. The real solution is discovering out ALL the contributing factors to your injury and addressing them.

Wear orthotics and want to get off them?

They are only some conditions that require orthotics for life. Most of the time with appropriate rehabilitation you can progress off them, but don’t do it cold turkey. A strength program and guided progression is key.

There is a long term solution for you –  all it takes is a an appetite for improvement.

Phil de Mestre – Sports Podiatrist and Runner, Running Science.