Runners and how to choose a foot orthotic that eases, not causes, pain

When it comes to how to choose a foot orthotic, a wrong choice could exacerbate pain and even develop new injuries up the legs and back

Almost 60 million people in the U.S. are runners. Roughly 80% say they use this form of exercise to help them stay healthy and fit. Just over one-third take their passion for the road and trails and use it to compete in organized races like 5k runs and marathons.

When working with these types of patients, a foot orthotic may be advised to assist with function, correct a deformity, or provide cushion and support. Choosing the right one is critical because using the wrong orthotic can lead to a number of problems.

How to choose a foot orthotic that is right

One of the most obvious issues created by using the wrong foot orthotic is increased pain in the foot. This pain may be caused by not effectively correcting the original issue, or it may occur due to instigating a whole new issue by changing the structure or function of the foot.

The pain might not stop there either. If the foot is misaligned or not properly supported, pain can travel upward and appear in the knees or hips. In some cases, discomfort can also be felt in the lower back.

If the patient isn’t wearing the right shoes for the orthotics, this can present issues as well. The foot or toes can become more cramped when the orthotic is inserted or worn, leading to other issues. If the shoe is worn out, the orthotic may not be able to provide enough support.

Helping patients pick the right orthotic

One way for patients to avoid these issues and choose a foot orthotic to correct their foot’s structure or function is to be fitted for a custom orthotic. This helps ensure that the orthotic will not only help correct the original issue, but also that it won’t inadvertently lead to any others.

Another option is an over-the-counter shoe insert. There are four basic types:

• Insoles. Insoles can also help ease pain by providing the foot more cushioning. Studies have also linked the use of insoles to reduced knee pain caused by osteoarthritis.
• Arch supports. Research shows that wearing arch supports assists with balance and functional mobility. These supports also help reduce pain in the back and lower extremity joints.
• Heel liners. If a patient has thinning in the pads on their heels — whether due to age, illness, or overuse — heel liners can provide more cushion to this area of the body. This reduces pain by reducing the force placed on that area of the foot.
• Foot cushions. One advantage of using foot cushions is that they can be placed anywhere on the foot where the patient is experiencing pain. Like heel liners, they reduce pressure placed on the pained area.

Orthotics and specific foot issues

Some studies have found that certain type of inserts help with specific foot issues. For example, in September 2015, the journal Clinical Research on Foot & Ankle published a study involving 40 subjects with plantar fasciitis. Some of the participants were asked to use silicone heel pads. The remainder wore soft insoles with arch supports.

Each participant was assessed before the study, as well as six weeks after. Both the heel pad group and the arch support group reported a significant improvement in foot function. They also indicated that they had lower levels of heel pain.

A 2016 study in the Journal of Physical Therapy Science notes that use of insoles is beneficial to people with flexible flatfoot. This is when the foot becomes flat when weight is placed on it. Otherwise, it has a normal arch. After three months of wearing insoles while walking around and going up and down stairs, the plantar pressure of the flatfoot significantly improved.

Tips for choosing the right orthotic

The American Podiatric Medical Association (APMA) offers a few tips for helping patients find the best foot orthotic for their specific needs. These can help your patients keep their running regimen by reducing any foot-related issues. They include:

• Consider their current health status. If the patient has other health issues, such as diabetes or poor circulation, the APMA recommends that they see a podiatrist versus choosing an over-the-counter insert. This reduces the likelihood that the orthotic will create any additional issues.
• How they plan to use the orthotic. Will the orthotic be used only in the patient’s running shoes, or in their work shoes as well? It’s important for the orthotic to be able to support the level of activity the client will engage in when wearing that type of shoe. So, different orthotics may be needed for different shoes.
• Paying attention to how they feel. If the patient feels like the orthotics don’t fit right in their shoes, don’t offer the needed support, or are causing pain or discomfort in any way, they may not be the right ones. Instead of telling them to wait it out and potentially doing more damage, encourage them to choose a foot orthotic that is different to see if that corrects the issue.