A healthy living blog from Marshfield Clinic

Insole advice for tired feet

Do you have pain in your feet that just won’t go away? Have a little room in your shoes? Insoles, or orthotics, may be right for you.

“About 50 to 75 percent of people who need orthotics have foot or ankle pain,” said Dave Smith, a Marshfield Clinic physical therapist. “The rest have knee, hip or back pain.”

Your foot type can help determine which type of orthotic you need, or if you even need one.

View this graphic to learn how feet and orthotics impact your overall health.

Who needs orthotics?

Some people’s feet are too stiff, while others are too loose. Orthotics should help your foot and body accept the stress and strain of standing and walking.

“When the heel hits the ground while walking, the first thing the foot tries to do is get flat to the ground for stability,” Smith said. “When we’re born, our feet aren’t made to do that. The foot starts turned outward, but over time is able to move flat to the ground.”

Two types of feet usually require orthotics.

People who have too much motion in their foot over pronate, or have flat feet. Pronation occurs as the foot rolls inwards and the arch of the foot flattens. Orthotics provides stability so the foot can’t move far.

People with really stiff feet won’t pronate enough. Pressure goes to feet, knees, hips and back and causes problems. An orthotic builds the ground up to the foot.

Try the paper test to learn your foot type.

If you have diabetes, you may need orthotics to provide more cushion to prevent ulcers. Diabetes can cause you to have no sensation in your feet and not feel the bottom of your feet. An orthotic provides a surface that doesn’t cause skin breakdown.

Some kids need orthotics, especially small children with developmental delays, may need orthotics to their turn the feet into certain positions.

What type of orthotic should I get?

Smith says the type of orthotic you need depends on your body type and the type of activities you do.

“Heavier people need stiffer materials, and lighter people need lighter materials,” he said. “Also, if you’re working on your feet all day, you’re going to need a stiffer material to prevent breakdown of the orthotic, but enough cushion to provide shock absorption.”

The shell of the orthotic supports the arch and is usually hard plastic, but cork and other synthetic materials also can be used. Softer materials are on top for cushion. A stiffer orthotic also can be made of leather.

Orthotics also can be custom for athletes. They support the foot and are specifically designed to fit in an athletic shoe. They also take pressure off the ankles, knees, hips and back.

Over-the-counter vs. custom

Few differences exist between over-the-counter (OTC) and custom orthotics. OTC products are usually one type of shape and material.

“With an over-the-counter orthotic, a person has to blindly buy one,” Smith said. “They are cheaper. A decent one is around $50. If your foot doesn’t need a lot of correction, an over-the-counter product may work for you. But it all depends on the type of foot you have.”

OTC orthotics usually are made for flat feet, not stiff feet. However, since they are not made with as good of materials, they wear out in about three to six months. Wear also depends on your activity level.

A custom-made orthotic will last much longer and perfectly fit to your foot. The materials also will support your foot properly. They are, however, more expensive and may cost several hundred dollars.

Marshfield Clinic physical therapists have OTC orthotics and also can make custom ones.

If you think you need orthotics, talk with your doctor or ask for a referral to physical therapy.

Feet and Orthotics graphic

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