Seeking Orthotic/Shoe Harmony?

Posted by Filed Under: Running Tips

OrthoticsYou’ve just dropped $300-$500 US on brand spanking new orthotics, popped them into your $120 running shoes and ouch! It feels like you’re running with two planks strapped to your feet. Toe off—are you kidding? Tempo runs? No chance! And now you’re sore in areas that you never had problems in to begin with. Did you just waste big dollars on orthotics that are no good? Thankfully, the answer is usually “no,” but it is a bit complicated. To understand why this happens, we need to examine the function of orthotics and running shoes.
Orthotics, especially those prescribed for runners, are designed to correct biomechanical faults in the foot, provide shock absorbing capability and enhance proprioception—neurological feedback from the foot to the brain that allows for better coordination and control of movement. Running shoes are also designed for shock absorption and, in some models, provide biomechanical correction too.

Is the combination of a running shoe with biomechanical correction and an orthotic too much of a good thing? In some instances, yes. In other cases, maybe, maybe not.

Welcome to the gray area of matching orthotics to running shoes. This is the convoluted adventure of finding out which shoes work with your orthotics. Sometimes even when you’ve finally sorted it out, you then need a new orthotic with a different prescription or the shoe company has ‘upgraded’ the model you had once found worked with your orthotic. Either way, it may be back to trial and error.

To aid you on your quest, here are a few guidelines that may help you find the right combination:

  1. Get the orthotic first, and then try it in a new shoe. The orthotic is usually the bigger investment and it is made specifically for your foot. It is easier to switch shoes than orthotics.
  2. Test the orthotic/shoe combination on a treadmill or brief run before settling on the shoe purchase. If the gait feels unnatural or forced, try a different shoe.
  3. Avoid shoes with lots of motion control. Start with neutral or cushioned shoes since the orthotic is designed with biomechanical correction already built-in. A shoe designed for motion control combined with an orthotic may lead to overcorrection.
  4. Ask the running store staff for assistance. These folks usually know which shoes tend to be orthotic friendly. This may save you a lot of legwork in looking for the proper shoe.
  5. Adapt your foot to the orthotic. Roll a golf ball under the foot a few minutes per day to help speed up its ability to adapt to the new orthotic. Exercises such as picking up marbles with your toes help to strengthen the intrinsic foot muscles.
  6. I recommend a semi-rigid orthotic for running. This type of orthotic provides the biomechanical correction needed in most cases and also allows the foot to have normal movement and function without transmitting extra stresses up through the rest of the body.
  7. If these guidelines do not work, let your body be your guide. If you cannot get comfortable with your orthotics, there may be some other underlying condition that needs to be addressed and, in some instances, the orthotic may need to be adjusted.

Hopefully these tips will point you in the right direction if you are one of the many orthotic wearers (like me) trying to find the right combination of orthotics and running shoes.

About Lee Miller D.C.

9536 - 87 Street Edmonton, Alberta T6C 3J1 Phone: (780) 426-6777 Fax: (780) 469-6930

  1. Anthony Curcuruto on January 24th at 1:05 pm

    How true. I have been wearing orthotics for over 35 years. I have found that running shoes with a flat foot bed work best. That is, a foot bed with little to no arch support or any shape what so ever. I do like a soft shoe. In some cases, I remove the foot bed and replace it with one from the drug store. My orthotic usually works well if the foot bed is flat!

  2. Anthony Curcuruto on January 24th at 1:09 pm

    One more thing … In some cases, the orthotic works well in the beginning and after a dozen or so runs, you start to have problems. I had a case where I was getting hip pain. After close examination of how my orthotic was sitting in my running shoe, I noticed that it was too high on the inside. After a little adjustment and some anti-inflamitory, I was fine. It took me a couple of months to get back to where I was!

  3. Lee Miller on January 24th at 2:19 pm

    Good points Anthony. I just want to add that it is a good idea to remove the insoles that come with the running shoes prior to putting in the orthotic, and make sure the orthotic is sitting flat in the shoe. Secondly, some orthotics have a “break in” period before they assume their final shape. In these cases it is recommended that you wear the orthotic for only about 2 hours a day for the first week and then build up an hour or so more of wear time each successive week.

  4. Jeanne on January 24th at 4:54 pm

    my orthotics cost a LOT of money! i went back to the foot doctor several times and he kept adjusting them but I finally gave up and stuck them in a drawer.

    I don’t know what the moral of my little story here is…maybe my feet are just … WEIRD?

  5. MJ on January 26th at 3:18 pm

    Jeanne –

    #1 – LOVE your blog – read it daily!

    #2 – Don’t give up, you may just need a different doc/orthotics/shoes or all of the above. After pushing too hard marathon training (3.5 years ago!!) I ran myself into bad posterior tibial tendinitis. I had 3/4 hard orthotics ordered by an ortho, made from plastic molds of my foot. Ok, but hurt when running. Found a place that does only orthopedic, orthotic, prosthetic work – and their doc’s wife is a distance runner so he had some spiffy substances he’d use. Those were made off hand-wrapped casts, hand applied and cut off. They were better but eventually not good enough (they’re now my cycling orthotics as I felt bad just pitching them as they were so pricey).

    Two things finally seem to be helping me….the first is that I hooked up with a company called eSoles (was FootFitting before) that does spiffy laser/computer scan analysis of your foot and custom makes many types of orthotics, running, cycling, dress, leisure (I have 3 pairs from them, and to me they’re worth the $$). They show up at big races to do free foot scans – you can check their web site to see if they’ll be where you will. (I don’t work for them or anything like that.) The second was help from Jamie the podiiatrist/shoe guy who posts a lot on the Runners World shoe forum – I always overpronated so ran in Saucony Hurricanes (strong stability) and liked them a lot. When I got orthotics, I figured they’d be enough, and went to the Asics Nimbus – a neutral shoe. Jamie suggested I go back to the Hurricanes, and it made a big difference – I need both supporting me.

    Sounds to me like you need a better set of orthotics and maybe an overall biomechanical assessment. (your insurance may only cover rx’d orthotics, if you have a health care reimbursement account, check if you can use it for non-rx ones). I’m using trigger point therapy to help with pain, and one of the things I’ve read explained to me how the pain can actually be from something other than the obvious, and sometimes tracing through the chain of movement and biomechanics can lead to the true cause. I’m not there yet, but I’m learning a lot and I find the techniques very helpful.

    Best of luck to you – it’s a real pain (and, it’s hard to find cute orthotic friendly shoes for non-athletic wear). Keep blogging, please! 🙂

  6. Larry Huppin, DPM on February 2nd at 1:14 pm

    As someone who has spent my professional life focused on orthotic therapy education and treatment, it is frustrating to hear of patients like Jeanne who end up with their orthoses in a drawer. No practitioner can guarantee a particular clinical outcome when prescribing orthotic therapy, but I strongly believe that comfort should always be guaranteed. For anyone looking for an orthotic therapy practitioner, one of the first questions to ask is whether they guarantee comfort. In our office, the standard rule is that if we cannot achieve comfort within three adjustments, then we redo the orthoses. If at any time the patient does not feel they are happy with the devices, they can be returned for a full refund. For a skilled and experienced practitioner this will be a rare occurance, so it should not be a problem to make such a guarantee. If a practitioner does not feel confident enough in their abilities to make such a guarantee you may want to look elsewhere.

    Larry Huppin, DPM
    Foot and Ankle Center of Washington

  7. Sarah on April 13th at 3:32 pm

    I have done sports my entire life and have had no arch pain until after last basketball season. (That whole season I wore shoes with terrible arch support-bad move.) So, I got adjustable inserts from my podiatrist. These worked well and I could run 5 miles everyday without pain. However, these inserts constantly had to be adjusted which was a huge hastle. My podiatrist told me to try out custom orthotics. So, I’m currently trying them out and the place that made them is very good in that if I have a problem with them, they’ll fix it. However, I’ve had to have them adjusted several times because my right foot’s orthotic didn’t quite feel like it should, were I to have perfectly fine arches. They have taken another mold of my right foot and should be giving me my new orthotic for my right foot any day. But I was wondering, how long will it take, if ever, for me to not feel pain or adjustment to the orthotics? Is it bad to wear them practically all day in order to get adjusted to them faster? And what brand of running shoe works best for orthotics? Do you ever think I’ll be able to run my 5 miles like I used to?

  8. Lee Miller on April 13th at 4:26 pm

    You may require a different style of orthotic. I would use the 3 strike rule with the orthotic- if after 3 adjustments the orthotic is not feeling good, that particular style may not suit your foot. If you wear them all day, you may be pushing your body to adapt faster than it is capable- not a good idea; that would be like having braces on your teeth and cranking them to the final position right away. There is no one specific brand of shoe that is best for orthotics. Ideally you take orthotics with you when trying on shoes and place them in the shoe and run for a bit to see how it feels. Most often you want a neutral shoe, with the insole removed, with a heel cup deep enough to accomodate the orthotic without your foot coming out of the shoe. It is trial and error with running shoes because the shoe companies keep changing their shoes. If you get the correct orthotic in the correct shoe, provided you have been assessed correctly, all should go well. Unfortunately, orthotics are not an exact science because of the many variables involved.