What's True - and Not True - about Custom Orthotics

Given that the feet contain 25% of the total bones in the body, it should be no surprise that about 75% of Americans have foot problems of some kind during their lives. But those problems are sometimes more severe and far-reaching than occasional pain, especially when people with structural problems in their feet engage in sports or strenuous activity.

For these people—such as the 60 million or so Americans that have flat feet—one of the most commonly recommended solutions is a set of custom orthotics.

But not everyone agrees on the value of orthotics, and some people who aren’t really qualified often weigh in. Let’s fact-check some of the most important claims, both positive and critical, made about orthotics:

Orthotics Can Be Highly Effective

Verdict: True. Orthotics compensate for imbalances or abnormalities in the structure of the foot (or lower body, such as one leg being longer than the other). They support the longitudinal arch of the foot, which can relieve joint pain, and promote better placement, which can prevent future injuries. These positive effects have all been demonstrated in multiple clinical studies.

Orthotics Train Feet to be Weak

Verdict: False. Critics of orthotics often claim that they enable weak muscles, training the tissues that are supposed to support proper foot placement to rely on the orthotics. There’s certainly no downside to doing some foot exercises and seeing if strengthening muscles can relieve painful symptoms without orthotics. But orthotics are often intended to correct structural defects that no exercises can affect, so the argument as a whole doesn’t hold up. Wearing a supportive orthotic doesn’t support lazy muscles any more than a well-fitted running shoe does.

Podiatrists Should Prescribe Orthotics

Verdict: True. First, it’s important to distinguish between off-the-shelf shoe inserts and podiatrist orthotics. The former simply cushion the feet, and may be sufficient for patients who simply want to relieve pressure or make a certain pair of shoes more comfortable. Podiatrist orthotics, on the other hand, are custom fitted to account for structural abnormalities in the feet, lower limbs and even pelvis. Since a podiatrist is an ankle and foot doctor, and the only kind of practitioner who focuses on treating this area of the body, then a podiatrist should be the one to help a patient decide if orthotics are the best option.