T Nation

Orthodics

To anyone who has them, or has used them,

Are orthodics meant to fix the problem so that you can go back to normal afterwards, or are they used to keep you comfortable and fix the problem WHILE you’re wearing them?

Thanks

EDIT: I noticed my question might not make sense so this might work better. If I get orthodics, are they suppose to fix the problem, or will I need to wear them forever?

I wear them. Got them because I over-pronate and it was part of the cause for my shin splints. Bought really good running shoes as well. Did dorsiflexion exercises, lots of stretching. Still get shin splints.

I’ve heard people say they eventually stopped wearing them after years but I have no idea how common that is.

[quote]BlakeAE wrote:
I wear them. Got them because I over-pronate and it was part of the cause for my shin splints. Bought really good running shoes as well. Did dorsiflexion exercises, lots of stretching. Still get shin splints.

I’ve heard people say they eventually stopped wearing them after years but I have no idea how common that is.[/quote]

I have been wearing them for 10 years. If I don’t wear them my knees hurt after standing for a while. I walk on the outsides of me feet so it helps me to walk correctly. I saw in article in here that may help me but for now I wear them.

Orthotics are completely inappropriate for most people. They should be reserved for people with true anatomical DEFORMITIES and not every person who develops common overuse injuries like shin splints, plantar fasciitis, and other proplems that the ignorant fucks in the medical community invariously attribute to “overpronation”.

Any time you go to a medical or rehab professional with such injuries it is likely that you will be offered orthotics whether you need them or not. Podiatrists especially will often insist that orthotics are the answer for everything and that you should wear them even if your feet are perfect. WHEN ALL YOU HAVE IS A HAMMER, EVERYTHING LOOKS LIKE A NAIL.

Orthotics are crutches- sort of like weight belts, but with far more potential to cause harm. This is your fucking feet we’re talking about.
Ambulation is the most basic and most important of human motor skills. Humans evolved to walk and run without the support of bulky plastic braces “correcting” (disrupting) the
(natural) motions of your feet.

If you brace your feet with such devices, you will inevitably become dependent on this artificial support. Your feet and lower legs will become less competent and less able to function without the support. If the support is removed, you will be at a high risk of developing a permanent joint injury.

And orthotics don’t just reduce pronation. The motions of your ankles, knees, hips, and spine are intimately related to the motion of your feet. Orthotics will therefore affect all of these joints as well.

Rather than using orthotics, I suggest that you adopt a “minimalist” philosophy; that is, to remove all forms of motion control and artificial support, including that provided by most athletic footwear. Instead, go barefoot as much as possible and only wear footwear that doesn’t have significant support features. There’s a significant body of research supporting the superiority of this approach but, since the shoe companies and podiatrists don’t profit from it, the public continues to be told that the human foot has serious design flaws which require correction with expensive footwear products.

[quote]BlakeAE wrote:
I wear them. Got them because I over-pronate and it was part of the cause for my shin splints. Bought really good running shoes as well. Did dorsiflexion exercises, lots of stretching. Still get shin splints.
[/quote]

So if you were told that overpronation was the cause of your shin splints, recived orthotics to correct the ‘problem’, and the ‘problem’ didn’t resolve, why are you still wearing the orthotics? I’d disregard them immediately and demand your money back.

[quote]vision1 wrote:
If I get orthodics, are they suppose to fix the problem, or will I need to wear them forever?[/quote]

First of all, what exactly is the problem?

I got some orthotics for plantar fasciitis and they worked great. I wore them constantly for a while, then less and less. The problem pretty much disappeared after a couple months. If I feel a problem coming on, I
wear them for few days until it goes away.

When I first got them, I had stabbing pains in my heel all the time. I traded the stabbing knife-like pain for the feeling of walking on a tennis ball, which is infinitely preferable. After a while I didn’t even notice that.

I was wary of the hype around orthotics, but they seemed to work as advertised.

Some people say that ART will help. I have not tried that.

As for shin splints, I seriously doubt orthotics will help that. A shin splint is a result of stress on the interosseous membrane between the tibia and fibula. Usually that comes from repeated sudden shocks to the leg; the example I always heard is running in grass and suddenly transitioning to concrete. In general, only ice and rest cures a shin splint. Of course, things might have changed since I learned about shin splints many years ago.

[quote]belligerent wrote:
Orthotics are completely inappropriate for most people. They should be reserved for people with true anatomical DEFORMITIES and not every person who develops common overuse injuries like shin splints, plantar fasciitis, and other proplems that the ignorant fucks in the medical community invariously attribute to “overpronation”.

Any time you go to a medical or rehab professional with such injuries it is likely that you will be offered orthotics whether you need them or not. Podiatrists especially will often insist that orthotics are the answer for everything and that you should wear them even if your feet are perfect. WHEN ALL YOU HAVE IS A HAMMER, EVERYTHING LOOKS LIKE A NAIL.

Orthotics are crutches- sort of like weight belts, but with far more potential to cause harm. This is your fucking feet we’re talking about.
Ambulation is the most basic and most important of human motor skills. Humans evolved to walk and run without the support of bulky plastic braces “correcting” (disrupting) the
(natural) motions of your feet.

If you brace your feet with such devices, you will inevitably become dependent on this artificial support. Your feet and lower legs will become less competent and less able to function without the support. If the support is removed, you will be at a high risk of developing a permanent joint injury.

And orthotics don’t just reduce pronation. The motions of your ankles, knees, hips, and spine are intimately related to the motion of your feet. Orthotics will therefore affect all of these joints as well.

Rather than using orthotics, I suggest that you adopt a “minimalist” philosophy; that is, to remove all forms of motion control and artificial support, including that provided by most athletic footwear. Instead, go barefoot as much as possible and only wear footwear that doesn’t have significant support features. There’s a significant body of research supporting the superiority of this approach but, since the shoe companies and podiatrists don’t profit from it, the public continues to be told that the human foot has serious design flaws which require correction with expensive footwear products.

This post is 100% garbage !!!

sorry guy

going barefoot with Plantar Fascitis caused excruciating pain for me .

providing mechanical support under the foot (whether artificial or not) is something to look into . I dont mean the crap you buy at the shoe store . I mean the custom-made piece obtained from a Podiatrist . wont cost an arm-and-leg (excuse the pun) compared to Rx drugs …BTW dont ever let a doctor get you on ANY Anti-Inflamitories without researching it yourself !!!

I fucked around with this shit for 9 months…nothing worked until the Orthotics were introduced . Today , about 98% of the pain is gone…no meds involved… done deal

[/quote]

This post was flagged by the community and is temporarily hidden.

Agreed, Bushy. I had numerous teamates in college I ran track with who did not have gross structural abnormalities. They had minor anatomical issues that needed some tweaking. Othodics were all that were necessary to end the recurrent injuries they kept getting.

[Note: orhtodics may or may not aid shinplints-shinsplints are an overuse injury that comes from doing too much too fast. And some are just much more prone to them than others But part of what makes something ‘too much, too fast’ is influenced by the way you stike your foot and gait. Othodics can help by addressing these issues]

[quote]bushidobadboy wrote:
It’s not the foot (usually) that has the design flaws, but rather our lifestyle in todays world. If we had all been running about hunting and gathering, in nothing more than a pair of deerskin moccasins, then there would probably be little need for orthotics.

Unfortunately, our modern lives sometimes require modern solutions to modern problems. Advocating to, say, the deskbound executive who likes to run semi-competitively at the weekends, that he “go barefoot as much as possible”, is a surefire way to worsen his existing problems IMO, not to mention being almost entirely impractical. Whilst I admire simple, elegant solutions to problems, I think your approach is far too ‘puritanical’ to be effective for 95% of people with complex biomechanical foot/lower leg issues.[/quote]

Well, in my opinion, there’s no reason to believe that there weren’t plenty among the cavemen that had anatomical issues that prevented them from running and walking the way they needed to to keep up and catch prey. What happened was, they died. Just like old people, who were no longer healthy enough to live the necessary lifestyle, often died.

Yes my anti-orthotics rant was a little zealous, but I don’t care. My athletic career was ENDED by a pair of orthotics that I didn’t need. While I fully recognize that my case represents the extremes of what can go wrong with orthotics, the same risks exist for everyone.

Yes, Bushi, there are some people who have a genuine need for orthotics, and no these cases are not just limited to those involving congenital deformities. I also agree that it is entirely possible to acquire anatomical and mechanical abnormalities as the result of
lifestyle influences. It would probably be more appropriate to use a broader term such as “gross structural problems” rather than “anatomical deformities”.

With that said, in my opinion, orhotics should not be used by people with normal anatomical and biomechanical characteristics who simply develop common overuse injuries. This probably represents, if not by far, the largest demographic of people who recieve orthotics. Podiatrists and other professionals dispense them carelessly, as if the devices have no potential to cause harm, because they don’t appreciate the drawbacks.

Did you know that virtually 100% of people who have midtarsal and/or subtalar fusion eventually develop arthritis in the ankle and the remaining joints of the midfoot/rearfoot? Granted, orthotics are less extreme than a fusion proceedure, but they do essentially the same thing- restrict motion in the vital joints of the foot. And any stress alleviated from one structure will inevitably be recieved by another! IT band problems being an extremely common complication in runners who recieve orthotics.

The fact that orthotics may relieve certain symptoms does not mean that they are an ideal or even a good solution for most people- any more than NSAIDs and cortizone injections are. In many cases they are just the proverbial “quick fix”.

Shin splints, plantar fasciitis, and tendonopathy are primarily overuse injuries. They also have important biomechanical elements, but this does NOT indicate a need for orthotics. There is a significant body of research indicating that modern athletic footwear, with all of its “bells and whistles”, is a causative factor with regard to things like overpronation. I believe that it is the mechanical problems caused by footwear, in conjunction with abnormal patterns of use and disuse, that are responsible for many of these common injuries. NOT innate biomechanical abnormalities that necessitate the use of external correction in the form of orthotics.

[quote]jsbrook wrote:
Well, in my opinion, there’s no reason to believe that there weren’t plenty among the cavemen that had anatomical issues that prevented them from running and walking the way they needed to to keep up and catch prey. [/quote]

In my opinion, there are in fact reasons to believe this. One being that modern barefoot populations have extremely low rates of common foot and lower leg problems. They develop strong, dextrous feet that are resiliant to injury and can lead extremely active lives without the support of footwear and orthotics. They don’t need podiatrists and chiropractors. This is what any serious athlete should strive for.

[quote]belligerent wrote:
Orthotics are completely inappropriate for most people. They should be reserved for people with true anatomical DEFORMITIES and not every person who develops common overuse injuries like shin splints, plantar fasciitis, and other proplems that the ignorant fucks in the medical community invariously attribute to “overpronation”.

Any time you go to a medical or rehab professional with such injuries it is likely that you will be offered orthotics whether you need them or not. Podiatrists especially will often insist that orthotics are the answer for everything and that you should wear them even if your feet are perfect. WHEN ALL YOU HAVE IS A HAMMER, EVERYTHING LOOKS LIKE A NAIL.

Orthotics are crutches- sort of like weight belts, but with far more potential to cause harm. This is your fucking feet we’re talking about.
Ambulation is the most basic and most important of human motor skills. Humans evolved to walk and run without the support of bulky plastic braces “correcting” (disrupting) the
(natural) motions of your feet.

If you brace your feet with such devices, you will inevitably become dependent on this artificial support. Your feet and lower legs will become less competent and less able to function without the support. If the support is removed, you will be at a high risk of developing a permanent joint injury.

And orthotics don’t just reduce pronation. The motions of your ankles, knees, hips, and spine are intimately related to the motion of your feet. Orthotics will therefore affect all of these joints as well.

Rather than using orthotics, I suggest that you adopt a “minimalist” philosophy; that is, to remove all forms of motion control and artificial support, including that provided by most athletic footwear. Instead, go barefoot as much as possible and only wear footwear that doesn’t have significant support features. There’s a significant body of research supporting the superiority of this approach but, since the shoe companies and podiatrists don’t profit from it, the public continues to be told that the human foot has serious design flaws which require correction with expensive footwear products.

[/quote]

I totally disagree. I can prescribe orthotics. I don’t often do it because I try to get people to try simpler, cheaper alternatives.

That being said, I use them myself an notice a great difference I regards to issues related to my knees.

Yes, people can get help in other ways, but orthotics can be a godsend to some.

[quote]bushidobadboy wrote:
belligerent wrote:
Orthotics are completely inappropriate for most people. They should be reserved for people with true anatomical DEFORMITIES and not every person who develops common overuse injuries like shin splints, plantar fasciitis, and other proplems that the ignorant fucks in the medical community invariously attribute to “overpronation”.

I agree that the term “overpronation” is bandied about a lot by people who sometimes don’t know what it means, and that can be irritating. Having said that, your idea that orthotics (or orthodics if you’d rather) should be “Reserved for people with true anatomical deformities”, is bizarre in my eyes. It could easily be argued that anyone with a ‘fallen’ medial longitudinal arch in their foot, has a true anatomical deformity, after all, the foot no longer looks or behaves in the way that it should, no?

I suspect though, that your narrow-minded view percieves a ‘deformity’ to mean gross abnormalities in structure due to congenital defects, or perhaps serious trauma. Ironically, these are the people who are least likely to benefit from corrective footwear inserts, but who need serious prosthetics instead…

Any time you go to a medical or rehab professional with such injuries it is likely that you will be offered orthotics whether you need them or not. Podiatrists especially will often insist that orthotics are the answer for everything and that you should wear them even if your feet are perfect. WHEN ALL YOU HAVE IS A HAMMER, EVERYTHING LOOKS LIKE A NAIL.

Orthotics are crutches- sort of like weight belts, but with far more potential to cause harm. This is your fucking feet we’re talking about.
Ambulation is the most basic and most important of human motor skills. Humans evolved to walk and run without the support of bulky plastic braces “correcting” (disrupting) the
(natural) motions of your feet.

Yes, and whether we like it or not, some people (for whatever reason) have lost or compromised that ability. Should we just condemn them, or try to sort the problem out by resorting to your luddite ways?

If you brace your feet with such devices, you will inevitably become dependent on this artificial support. Your feet and lower legs will become less competent and less able to function without the support. If the support is removed, you will be at a high risk of developing a permanent joint injury.

I disagree strongly with this ludicrous statement. The supports - if used correctly, ie as an aid to rehabilitation - simply function to ‘re-educate’ the musculoskeletal system. Once the supporting soft-tissue has become used to the correct alignment of osseous structures, and once the neuromusclular system has adapted to the change in demands placed upon it, the supports/orthotics can be progressively withdrawn, without detriment to the patient.

At least, this is what has happened to me, and to others I know. Of course, there are some, lazy people who will neglect the other facets of their recovery, relying instead upon the temporary relief offered by the orthotics, who will become reliant on such devices. However, this is a failing of the patient and his/her education, not a failure of the devices themselves.

And orthotics don’t just reduce pronation. The motions of your ankles, knees, hips, and spine are intimately related to the motion of your feet. Orthotics will therefore affect all of these joints as well.

Bravo. You have succinctly defined the entire reasoning for the correct use of orthotics.

Rather than using orthotics, I suggest that you adopt a “minimalist” philosophy; that is, to remove all forms of motion control and artificial support, including that provided by most athletic footwear. Instead, go barefoot as much as possible and only wear footwear that doesn’t have significant support features. There’s a significant body of research supporting the superiority of this approach but, since the shoe companies and podiatrists don’t profit from it, the public continues to be told that the human foot has serious design flaws which require correction with expensive footwear products.

It’s not the foot (usually) that has the design flaws, but rather our lifestyle in todays world. If we had all been running about hunting and gathering, in nothing more than a pair of deerskin moccasins, then there would probably be little need for orthotics.

Unfortunately, our modern lives sometimes require modern solutions to modern problems. Advocating to, say, the deskbound executive who likes to run semi-competitively at the weekends, that he “go barefoot as much as possible”, is a surefire way to worsen his existing problems IMO, not to mention being almost entirely impractical. Whilst I admire simple, elegant solutions to problems, I think your approach is far too ‘puritanical’ to be effective for 95% of people with complex biomechanical foot/lower leg issues.[/quote]

all so very true in regards to your opinion.

I think Belligerant is way off in most of his opinions. But correct in one.

A podiatrist said I needed orthotics too. Custom made from clay molds. Only $400. That’s all.

I went to a foot kinesiology clinic (which I’m sure you can find in your area too!). They had me want on a special treadmill that measured the pressure and just how my ankle was rolling inward and to what degree. Also showed me that was was walking with my toe pointed out, way out, which was half of my problem. So in essence I had to relearn to walk, keeping my feet facing forward.

Don’t fall for the simple step tests where they wet your feet and then have you step on paper to fake this true test!

Long story short - don’t need big, bulky, hard plastic orthotics. Definately need special sport insoles in every pair of my shoes (including my dress shoes) that absorb heel impact greatly, have a semi-rigid arch support and all around impact resistant. Best ones that work for me are made by New Balance. And they have to be replaced every 6 months in shoes I wear frequently. Those are $40 each. So it costs me about $200 a year. But I rarely have ankle, feet, knee or back pain anymore.

Orthotics if incorrectly prescribed can lead to worse problems than the existing condition. A body that is incorrectly alligned is just set for injury and possible lifetime problems.

Take proper testing of what’s really happening when you walk. Then choose the appropriate product.

Ignoring the problem with this “bare feet as much as possible” ideal is complete bullshit - A body out of allignment is set for injury and possible lifetime problems - period!

[quote]AllTraps wrote:
Ignoring the problem with this “bare feet as much as possible” ideal is complete bullshit - A body out of allignment is set for injury and possible lifetime problems - period![/quote]

How do you know that? Are you aware of the research indicating that many “alignment” problems, especially those related to pronation, are reduced when barefoot compared to during shod ambulation?

[quote]belligerent wrote:
AllTraps wrote:
Ignoring the problem with this “bare feet as much as possible” ideal is complete bullshit - A body out of allignment is set for injury and possible lifetime problems - period!

How do you know that? Are you aware of the research indicating that many “alignment” problems, especially those related to pronation, are reduced when barefoot compared to during shod ambulation? [/quote]

Since you brought it up, please list the studies so we can review them ourselves. Include that one about modern barefoot societies having fewer foot problems too. I knew a girl in college who always went barefoot; maybe she knew something we didn’t.

Thanks for all the replies,

I haven’t read them all yet (about to after I post), but I’d just like to say what’s wrong with me.

My left foot has become slightly flatter than my right, and the left ankle folds inwards slightly (foot outwards).

I think the reason to this is because I gained about 25 lbs in my off-season last year, then went straight into alot of running.

My doctor gave me a proscription for orthotics, but he didn’t really look at my foot at all. After a glance he said I’ll need orthotics, without examining.

The orthotics will cost me $500 if I need them, so I’m hoping I can fix the problem. I’m going to take the next 4-6 weeks off all heavy weights. I’ll also lower the amount of running I do. I’ll try and judge which muscles I need more mobility in, and which I need stronger and tighter(posterior tibial tendon I think). So any more info would be great.

Thanks again

[quote]yorik wrote:
Since you brought it up, please list the studies so we can review them ourselves. Include that one about modern barefoot societies having fewer foot problems too. I knew a girl in college who always went barefoot; maybe she knew something we didn’t.[/quote]

I read a study on it, but I don’t remember where. You could probably find it on google.

I’ll post if I find again.

[quote]belligerent wrote:
BlakeAE wrote:
I wear them. Got them because I over-pronate and it was part of the cause for my shin splints. Bought really good running shoes as well. Did dorsiflexion exercises, lots of stretching. Still get shin splints.

So if you were told that overpronation was the cause of your shin splints, recived orthotics to correct the ‘problem’, and the ‘problem’ didn’t resolve, why are you still wearing the orthotics? I’d disregard them immediately and demand your money back.
[/quote]

As I said, and like you quoted me saying - the over-pronation is only PART of the problem. You are missing a lot of information to come to a conclusion like disregarding them immediately.

You don’t know how long I’ve been wearing them. Neither of us know exactly, to what degree damage has been done to the tibialis and connective tissue or how long it will take to resolve.

They said its not a severe problem and the orthotics may or may not help, my choice if I want to try.

I live in Canada and at the moment we still have health care which paid for $350 of the $400 total cost. I got these for a little more than the cost of Dr. Scholl’s.

Also, living in Toronto - walking barefoot just isn’t going to happen. I don’t wear orthotics around the house at home, and I sure as hell and not going to walk barefoot around the city.

I’m sorry you had a bad experience with orthotics but until you have the experience and training of my doctor (http://www.athletescare.com/) I’ll stick with these guys.