Dr. Michael G. Krynski
The Truth About Orthotics and Your Feet
Do you experience tired feet that only feel good when your end your day and take off your shoes? - AHHHHHHHH!
Do you have foot pain or soreness that is part of your daily life?
You may benefit from a pair of custom orthotics.
Orthotics are inside the shoe “inserts” that support your foot and help to heal a problem or prevent a problem from developing. Orthotics are all around us. They may be found on the shelves of stores in the pharmacy sections, you can even find "custom" solutions where you stand on a large device in which the computer inside will guesstimate at which of several generic inserts are right for your feet. Some stores even have “professional“ staff members who will sell you a pair in a fancy box for several hundred dollars.
Will these help your feet? Perhaps.
Were they made specifically for your feet and life? Definitely not.
Here’s what I know:
I spent four years after college studying the foot and ankle and how it functions. I spent 3 years in post graduate residency training and performing surgeries types of feet and foot pain. I’ve been in medical practice for over 10 years now and have made hundreds of custom orthotics and after all of this experience what I found out is very interesting.
Custom orthotics are made from molds of your feet performed by a podiatrist. These molds are made with your foot held in a neutral position (the corrected position in which your foot should hit the ground during walking, running or cycling. ) Next, the doctor writes a prescription which tells the lab how to make this orthotic. To do this, the doctor, uses the foot exam he or she performed, your x-ray, your weight, your shoe style, your activity level, and the condition that causes you pain or the condition that we’re trying to prevent.
There are many conditions that can be treated such as
-flat feet, plantar fasciitis, bunions, hammertoes, neuromas, metatralgia, tendinosis of posterior tibial tendon, Achilles tendinitis and tendinosis, shin splints, arthritis
OK so let's say you're a healthy 25 year old who regularly works out and runs a lot, but have no foot pain.
Do you need orthotics?
Here’s why. The cause of your flat foot has to be diagnosed and evaluated on xrays.
This mainly has to do whether your flat foot is rigid or flexible. The majority are flexible which means that it can be repositioned with an orthotic. Why is this important? What happens in a flat foot is that part of the foot unlocks allowing too much motion in mid foot and rear foot joints. This leads to the talus (ankle bone) to partly “slide off” the calcaneus (heel bone) and exert a lot of pressure on your posterior tibial tendon. This tendon supports your arch. It suppinates your arch, the opposite of pronation. So in such a flat foot there is hyperpronation and the tendon is not able to counteract it, therefore your foot functions out of alignment and will “wear out “ over time. When this becomes painful and swollen there is often tendonitis leading to tendinosis and tendon rupture which requires reconstructive surgery. This is not fun. With orthotics one can at least have a chance of preventing it. Sure you can stop running, but can you stop walking? Often patients tell me, “You know doc, I never realized how important feet are, but when they hurt you cannot do anything!”
Not all feet are the same, and this is why over the counter orthotics or custom fit may not work and definitely do not work as well. This is why custom foot orthotics are most likely to help.