orthotics
Foot pain is common and 1in 4 adults will have problems with their feet.
Foot problems can cause knee, hip & back pain particularly flat or pronated feet.
Foot problems can cause knee, hip & back pain particularly flat or pronated feet.
Who would benefit from orthotics?
Occupations involving long periods on your feet
Many occupations such as nursing or military involve long periods on their feet . Those that involve above normal levels of walking such as postal deliveries or warehouse jobs will have different demands to those who spend longer times standing such as those who work in retail or on a production line.
Routinely that is prolonged pressure on the feet on hard surfaces which puts a strain on the plantarfascia and spring ligament which support the medial arch of the foot causing fatigue and pain which can be helped with orthotics.
Routinely that is prolonged pressure on the feet on hard surfaces which puts a strain on the plantarfascia and spring ligament which support the medial arch of the foot causing fatigue and pain which can be helped with orthotics.
walkers & hikers
Depending on your height & leg length the target of 10,000 steps a day equates to 4-5 miles in distance. Since much of this can be on hard ground the plantarfascia absorbs a huge amount of impact, particularly if you are a fast walker. I regularly meet people who regular exceed these distances, 20, 25 or even 40 miles plus the sponsored ultra challenges of 100km.
Any experienced hiker will ensure they have good footwear and socks but good insoles will prevent uneven foot pressures leading to foot pain or blisters and aid fatigue.
Any experienced hiker will ensure they have good footwear and socks but good insoles will prevent uneven foot pressures leading to foot pain or blisters and aid fatigue.
runners
Running has become one of the biggest forms of exercise and not just limited to 5km park runs. Last year 350,000 people applied to run the London Marathon. I have also treated runners who have completed 100km ultra-marathons.
The main difference between walking and running is that both feet can be off the ground and the impacts on each leg are far greater. At the heel this can be 3-4x your bodyweight whilst at your knees this can anywhere between 4-7x.
Having strong quadriceps, calf, hamstrings and glutes is critical but the arch of the foot is an amazing structure which allows it store energy and then release mechanical energy for propulsion. The right orthotics help support the foot and heel to allow this function, and aid performance whilst preventing injury.
The main difference between walking and running is that both feet can be off the ground and the impacts on each leg are far greater. At the heel this can be 3-4x your bodyweight whilst at your knees this can anywhere between 4-7x.
Having strong quadriceps, calf, hamstrings and glutes is critical but the arch of the foot is an amazing structure which allows it store energy and then release mechanical energy for propulsion. The right orthotics help support the foot and heel to allow this function, and aid performance whilst preventing injury.
long term use of orthotics
Unfortunately some people do need to use orthotics in the same way as someone who is short sighted will need spectacles. Your eyes won't improve and neither will your feet and you will always need to use them. Usually if you wear glasses you will have a prescription but in most cases this isn't the case with those who need orthotics.
Having flat feet is an example. Our arched foot, which is not a characteristic of other primates, is a unique feature crucial for human bipedalism. The arch provides the foot with the stiffness necessary to act as a lever that transmits the forces generated by leg muscles as they push against the ground. There have been successful marathon runners with flat feet but these athletes have typically strong and flexible leg muscles with an efficient running style that compensates.
Having flat feet is an example. Our arched foot, which is not a characteristic of other primates, is a unique feature crucial for human bipedalism. The arch provides the foot with the stiffness necessary to act as a lever that transmits the forces generated by leg muscles as they push against the ground. There have been successful marathon runners with flat feet but these athletes have typically strong and flexible leg muscles with an efficient running style that compensates.
diabetics
People with diabetes are at a higher risk of developing foot problems that can lead to ulcerations and even amputation? In England alone, 28 people a day, 10,000+ a year, have a toe, foot or leg amputated
The biggest risk to the feet in diabetics is ulceration caused by excessive pressure on areas of the foot. This can cause long term damage and can require extensive NHS treatment to treat. If peripheral neuropathy is present the individual may not even feel the damage being done. Most diabetics place excessive pressure to the heel and metatarsals.
Orthotics are highly recommended to distribute the pressure evenly across the foot to prevent this condition.
The biggest risk to the feet in diabetics is ulceration caused by excessive pressure on areas of the foot. This can cause long term damage and can require extensive NHS treatment to treat. If peripheral neuropathy is present the individual may not even feel the damage being done. Most diabetics place excessive pressure to the heel and metatarsals.
Orthotics are highly recommended to distribute the pressure evenly across the foot to prevent this condition.
osteoarthritis
Osteo-arthritis tends to affect the knees, hips, fingers & thumbs more than other joints but degenerative changes to joints of the foot, ankle or big toe are still common.
Typically an osteoarthritic ankle will be very restricted in movement and painful with weight-bearing, causing the individual to limp or turn the foot out which has knock on effects for the knee, hip or back. Orthopaedic options are limited to fusions or ankle replacements, neither a satisfactory option for walking. Good quality orthotics can aid with support, comfort and compensate for the lack of flexibility.
The big toe is often affected with either hallux valgus where the toe deviates inwards(commonly known as a bunion) or hallux rigidus, which needs no explanation. This typically adversely affects the arch of the foot and puts increased pressure on the metatarsals, 2nd and 3rd toes. Exercise and orthotics can help, failing that surgical options depending on the extent.
Typically an osteoarthritic ankle will be very restricted in movement and painful with weight-bearing, causing the individual to limp or turn the foot out which has knock on effects for the knee, hip or back. Orthopaedic options are limited to fusions or ankle replacements, neither a satisfactory option for walking. Good quality orthotics can aid with support, comfort and compensate for the lack of flexibility.
The big toe is often affected with either hallux valgus where the toe deviates inwards(commonly known as a bunion) or hallux rigidus, which needs no explanation. This typically adversely affects the arch of the foot and puts increased pressure on the metatarsals, 2nd and 3rd toes. Exercise and orthotics can help, failing that surgical options depending on the extent.
rheumatoid arthritis
The prevalence of foot involvement and foot pain in Rheumatoid Arthritis (RA) is well documented, with an estimated 80%–90% of patients suffering foot pain in their lives. In about 20% of patients, foot & ankle symptoms were the first signs of the disease.
Problems like bunions, claw toes, or pain under the ball of the foot called metatarsalgia can be more common. In very bad cases, your joints and bones could become deformed.
A Cochrane Review, which provided a systematic analysis of several randomized-control trials, found gold- and silver-level evidence that custom-made orthotics reduce foot pain in people with Rheumatoid arthritis.
Orthotics can help:
Distribute your body weight evenly
Problems like bunions, claw toes, or pain under the ball of the foot called metatarsalgia can be more common. In very bad cases, your joints and bones could become deformed.
A Cochrane Review, which provided a systematic analysis of several randomized-control trials, found gold- and silver-level evidence that custom-made orthotics reduce foot pain in people with Rheumatoid arthritis.
Orthotics can help:
Distribute your body weight evenly
- Ease or reduce pressure on the feet and arthritic joints
- Provide cushioning for the balls of your feet
- Reduce stress on the hips and lower legs
- Correct gait or balance
- Improve overall posture
- Slow down or prevent RA progression in the long term
- But they may help enough that you can get by with fewer pain medications or to strengthen your muscles.
- One study found that orthotics made from softer materials were more helpful for foot pain than orthotics made from harder stuff like plastic, especially if your issues are at the front of the foot.
And if you need orthotics what are the options?
cheap orthotics online
Yes, there is a pair on Amazon for less than a £4 actually
Orthotics under a tenner are either an absolute bargain or a waste of money.
They are made of cheaper materials, have limited options and sometimes are not even available for a specific shoe size. Do you know if you even need these orthotics? They are a bit of a gamble.
The equivalent of buying a pair of non-prescription spectacles for reading the small print on a label. More convenient than using a magnifying glass perhaps, but they certainly wouldn't be suitable for say driving.
Simple arch supports might be a budget way of easing some recent foot pain but walking any distance or heavier use risks injury to your ankles, knee, hips or even your back if they aren't right for you.
More expensive orthotics have more options such as for metatarsal support or big toe problems. However you need to know the problems with the feet to make an educated purchase.
Orthotics under a tenner are either an absolute bargain or a waste of money.
They are made of cheaper materials, have limited options and sometimes are not even available for a specific shoe size. Do you know if you even need these orthotics? They are a bit of a gamble.
The equivalent of buying a pair of non-prescription spectacles for reading the small print on a label. More convenient than using a magnifying glass perhaps, but they certainly wouldn't be suitable for say driving.
Simple arch supports might be a budget way of easing some recent foot pain but walking any distance or heavier use risks injury to your ankles, knee, hips or even your back if they aren't right for you.
More expensive orthotics have more options such as for metatarsal support or big toe problems. However you need to know the problems with the feet to make an educated purchase.
more expensive off the shelf orthotics
Recognised makes of orthotics such as Vasyli typically cost £40 to £55, are well made and have a wide range of options. You can buy these online direct or through other websites including Amazon.
They are not bespoke for the individual so if there is a marked difference between your feet, such as if you have previously fractured your ankle or have a leg length difference, they might not be any more help than the cheap ones. It would be highly recommended that you undergo an assessment to identify what type of insole you actually need as the range of designs can be confusing.
They are not bespoke for the individual so if there is a marked difference between your feet, such as if you have previously fractured your ankle or have a leg length difference, they might not be any more help than the cheap ones. It would be highly recommended that you undergo an assessment to identify what type of insole you actually need as the range of designs can be confusing.
nhs orthotics
Over 10 years ago I remember a podiatrist would run a clinic once a week at the hospital I worked in. One patient saw me and then I managed to arrange a podiatry assessment 30 minutes later! Maybe not routine but NHS podiatry services are increasingly overstretched and underfunded with long waiting lists. However in most cases the first pair of orthotics are free and can usually be altered.
The orthotics are custom designed for the patient either hand made by a qualified podiatrist or sent away to be made elsewhere. Assessments however, are limited to old school techniques such as foam impression boxes to give a static impression of the foot and watching a patient walk rather than any modern technology. I have had patients tell me that previously they had their feet drawn around on a piece of card or walking with wet feet over some paper.
A
The orthotics are custom designed for the patient either hand made by a qualified podiatrist or sent away to be made elsewhere. Assessments however, are limited to old school techniques such as foam impression boxes to give a static impression of the foot and watching a patient walk rather than any modern technology. I have had patients tell me that previously they had their feet drawn around on a piece of card or walking with wet feet over some paper.
A
custom orthotics
Custom orthotics are typically much more expensive than off the shelf orthotics, are designed specifically for your feet so should support vulnerable parts of your feet and so reduce pain. They should be durable and fit well in your shoes.
The quality of custom orthotics and their prices however can vary widely.
Typically they can cost from £200 to £400 plus the assessment cost.
A few years ago a patient of mine showed me the orthotics that they had purchased from a private hospital. They had seen a consultant, undergone a video assessment and been prescribed bespoke orthotics. The orthotics themselves were £400 with a £100 handling charge plus the not insignificant cost of the assessments. The orthotic was a rock hard shaped piece of material that the patient found too uncomfortable to wear.
The orthotics are often let down by:
1. The assessment process
2. The materials used
3. Rigid inflexible construction
Custom made orthotics are an investment in your health and should aid your foot biomechanics and reduce your pain.
Custom orthotics are typically much more expensive than off the shelf orthotics, are designed specifically for your feet so should support vulnerable parts of your feet and so reduce pain. They should be durable and fit well in your shoes.
The quality of custom orthotics and their prices however can vary widely.
Typically they can cost from £200 to £400 plus the assessment cost.
A few years ago a patient of mine showed me the orthotics that they had purchased from a private hospital. They had seen a consultant, undergone a video assessment and been prescribed bespoke orthotics. The orthotics themselves were £400 with a £100 handling charge plus the not insignificant cost of the assessments. The orthotic was a rock hard shaped piece of material that the patient found too uncomfortable to wear.
The orthotics are often let down by:
1. The assessment process
2. The materials used
3. Rigid inflexible construction
Custom made orthotics are an investment in your health and should aid your foot biomechanics and reduce your pain.
Now there is an exciting alternative
3D-PRINTED CUSTOM ORTHOTICS