Comments on: Seeking Orthotic/Shoe Harmony?

By: Lee Miller

Lee Miller — Tue, 13 Apr 2010 23:26:53 +0000

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.

By: Sarah

Sarah — Tue, 13 Apr 2010 22:32:58 +0000

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?

By: Larry Huppin, DPM

Larry Huppin, DPM — Sat, 02 Feb 2008 20:14:28 +0000

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
http://www.FootAnkle.com

By: MJ

MJ — Sat, 26 Jan 2008 22:18:33 +0000

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!

By: Jeanne

Jeanne — Thu, 24 Jan 2008 23:54:47 +0000

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?

By: Lee Miller

Lee Miller — Thu, 24 Jan 2008 21:19:13 +0000

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.

By: Anthony Curcuruto

Anthony Curcuruto — Thu, 24 Jan 2008 20:09:39 +0000

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!

By: Anthony Curcuruto

Anthony Curcuruto — Thu, 24 Jan 2008 20:05:01 +0000

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!