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Let's Talk About Foot Orthotics

Good spinal health is built from the ground up, starting with the feet.  For years medical researchers and healthcare providers have recognized that problems in the foot and ankle can cause posture changes that eventually trigger a variety of musculoskeletal issues in other parts of the body (particularly the ankle, knee, hip and back).  Studies have also shown that even slight foot problems can negatively affect athletes’ performance and predispose them to a broad range of sports-related injuries.  

What Are Orthotics and How Can They Help?

Orthotics are shoe inserts that are specially designed and manufactured to correct an abnormal or irregular walking pattern by promoting proper alignment and balance.  They’ve improved the quality of life for millions of people, and it’s become very common for physicians to recommend them to address many different patient needs:

  • Reducing pain and/or fatigue
  • Providing targeted foot support
  • Relieving pressure or stress on an injured or sensitive area
  • Preventing or limiting deformity
  • Improving foot positioning and function
  • Restoring balance
  • Reinforcing or supplementing other therapies (particularly chiropractic adjustments)

Foot orthotics are medical devices that can significantly change the way a person stands, walks and runs (and therefore the way his or her body absorbs and distributes related forces).  For this reason, it’s important that the person wearing them clearly understand their benefits, risks and limitations.  It’s also important that the person use them correctly.   

What Every Patient Should Know About Orthotics

  1. There is no “one-size-fits-all” answer when it comes to orthotics.  What works for another family member or neighbor will probably not work for you!  Getting the right prescription for your particular needs is all about working effectively with your healthcare provider to define your own goals and develop a complete understanding of your foot’s unique structure and function.  For instance, orthotics can be very sport-specific—the performance requirements of a hiker will not be the same as those of a skier or a football player.    
     
  2. Not all orthotics are created equal, and the differences matter.  The prefabricated orthotics that can be purchased at shoe stores, pharmacies and sporting goods stores are not the same as the custom orthotics prescribed by a healthcare provider.  Do not confuse them!  Mass-produced products are tailored for the “typical” foot and are unlikely to address problems specific to any one individual’s foot.  In some situations, such products can actually make a medical condition worse, cause new problems or increase the risk of injury.  So while they’re usually less expensive than custom orthotics, they may not actually solve your particular problem.
         
  3. Orthotics don’t actually correct foot or ankle problems.  They are intended to realign the structures of the foot to improve function, reduce pain and decrease the risk of injury.
     
  4. Needs can change over time and your orthotics should too.  The structure and function of the foot can change as people age.  So too can people’s lifestyle and priorities.  Your healthcare provider can work with you to ensure that your prescription is still the right one for you.
     
  5. Long-term use of orthotics may pose its own risks.  Any time that you provide outside help to the structures normally responsible for supporting and moving parts of your body (casts or braces are good examples), you are essentially asking them to do less.  And if you provide that help over a sufficiently extended period, you run the risk that your bones, muscles and connective tissues may become weaker as a result.  The unintended consequence is that you may actually become less capable and more reliant on your devices to do the work your body used to do.  Your healthcare provider will talk with you about how to use your orthotics correctly and manage any long-term risk that he or she believes may exist.                                                                                                                                   
  6. Prescribing orthotics is arguably as much an art as a science.  Don’t underestimate the role of professional judgment in prescribing orthotics.  Experts acknowledge that there are few widely-accepted standards and that we can’t always predict successfully how an individual will respond to a particular prescription.  In fact, recent research has demonstrated that individuals with the same condition can respond very differently to identical orthotic therapy.  There’s even evidence that the same patient can respond to a prescription inconsistently or can respond just as favorably to two entirely different (even contrary) prescriptions.  This means that some trial and error may be necessary to get the results both you and your healthcare provider are looking for and that good communication is critical.  Without accurate and timely feedback from you about how well your orthotics are doing their job, it’s impossible for your healthcare provider to make the adjustments that will eventually lead to success.

How Your Chiropractor Can Help

There’s a close relationship between the way your feet work and the way the rest of your musculoskeletal system supports your body.  So even if your feet themselves don’t actually hurt, they could be contributing to other health problems that you’re experiencing.  After your chiropractor has examined you carefully and talked with you about your situation, he or she can help you decide whether foot orthotics should be part of your broader treatment plan.  Call our office today to learn more.



References and Resources

Gina Kolata, Close Look at Orthotics Raises a Welter of Doubts.  Orthotic Shoe Inserts May Work, but It’s Not Clear Why.  New York Times Fitness and Nutrition.  January 17, 2011.  Accessed August 2011.
http://www.nytimes.com/2011/01/18/health/nutrition/18best.html?pagewanted=all

Nigg, BM et. al., Effect of Shoe Inserts on Kinematics, Center of Pressure, and Leg Joint Movements During Running.  Medicine & Science in Sports & Exercise.  February 2003.  Accessed August 2011.
http://journals.lww.com/acsm-msse/Abstract/2003/02000/Effect_of_Shoe_Inserts_on_Kinematics,_Center_of.21.aspx

 Best Foot Forward with Chiropractic.  Journal of the American Chiropractic Association.  January 2001.  Accessed August 2011.

http://www.acatoday.org/pdf/focus_january2001.pdf

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