Orthotics (shoe inserts for abnormal foot form and function)
Clinical studies show orthotics can be helpful for a variety of foot problems, including plantar fasciitis, Achilles tendinitis and knee pain. Orthotics may also help prevent injuries. For hundreds of members of the military in one study, use of orthotics showed a 50% less likely occurrence of overuse injury. (1)
Orthotics can be helpful in the care of chiropractic patients and I tend to recommend them to between 10 to 20 percent of my patients. Most are really not ‘orthotics’ per se, and are the over-the-counter type of in-shoe arch supports that are inexpensive. However, some need more custom orthotics.
The common belief was that the main reason orthotics are helpful was because they help align the foot and ankle. However, more recent studies show that the likely reason orthotics are helpful is because they eliminate some of the injurious speed of movement from abnormal foot function and structure when we step through our paces and support the body’s weight on the foot while walking and running. They mainly work because they decrease the inversion moment of the ankle which reduces muscle strain in the leg. Orthotics also decrease the eversion (what happens to the rear-foot with over-pronation of the fore-foot) velocity of the heel bone while running. The effect of these reduced forces help the foot recover from injury and helps to prevent further injury. (2)
In addition to altering the velocity of certain foot and ankle motions, other research suggests orthotics improve your position sense or ‘proprioception’. Orthotics have been shown to increase the activity of muscles in the thigh and buttocks while doing certain exercises. The control of those movements should be enhanced with the use of orthotics given that these muscles are more active with than without them. The results of the study suggested that the orthotics enhanced position sense by improving sensation in the bottom of the foot. (3)
Orthotics have been shown to help a variety of musculo-skeletal problems in the legs and feet. When it is appropriate, an orthotic can be a useful tool if applied correctly. That is why it has been a part of my chiropractic approach for over 30 years and I still suggest them to patients here in my Chico chiropractic practice.
Franklyn-Miller A, Wilson C, Bilzon J, McCrory P. Foot orthoses in the prevention of injury in initial military training : a randomized controlled trial. Am J Sports Med, 2011;39:30.
Williams D, McClay I, Baitch S. Effect of inverted orthotics an lower extremity mechanics in runners. Med Sci Sports Exerc, 2003;35:2060-2068.
Hertel J, Sloss B, Earl J. Effect of foot orthotics on quadriceps and gluteus medius electromyographic activity during selected exercises. Arch Phys Med Rehabil, 2005;86:26-30.