Custom orthotics are ubiquitous. Like the motion control shoe, orthotics have evolved to put an end to the evil pronation (arch collapsing) that happens to all of our feet. Sadly, pronation is a necessary part of our gait as it helps us to absorb shock from the ground and store energy for when we go to push off of our toes. In fact, eliminating pronation can cause as many problems as having too much!
So why would we need orthotics? Well, the fact is that most of us don’t. And, yes I make custom orthotics for people all the time. But, even when someone pronates too much, it’s not always an orthotic that’s the best fix. Hip weakness, hip stiffness, foot weakness, ankle stiffness, calf inflexibility, weak core muscles, and over supportive shoes are just a few of the factors that can cause excessive collapse of your arch while walking and running. I’ve taken many more people out of orthotics in the last 3-5 years than I’ve put in new orthotics!
The ONLY reason I choose to make a custom orthotic for someone is when the have a STRUCTURAL reason for why their foot behaves badly. Even in those cases, I’ll generally try to work on some of the above variables first to make sure an orthotic is truly necessary. Structural problems are bony foot variations that you were either born with or the you’ve adapted to over a long period of time. These variations can only be teased out and identified after a thorough evaluation of your foot and leg.
If you either have an extreme structural issue, and/or you don’t have success with fixing the other variables, then I’ll recommend an orthotic. But, I have confidence that you either won’t need one at all, or that you’ll only need one temporarily while you heal up and change your biomechanics for the better.
All of my orthotics are made after a thorough biomechanical evaluation of your spine, leg, and feet. I make a plaster cast model of your foot with you lying on your stomach in non-weight bearing. It is the only way to truly capture your structural foot position and make a real custom orthotic. Without a good evaluation, a good model of your foot position, and a good lab fabricating the device, all you have is an expensive insole. Don’t invest in an expensive insole or even a truly custom orthotic without first making sure you really need one.