A foot orthotic is a custom fit insole that you put in your shoe and goes between your shoe and your foot. The goal of a foot orthotic is to restore normal biomechanical function to the foot.
The average person takes 10,000 to 15,000 steps/day, walking 115,000 miles in a lifetime. 3.5 -‐5x your body weight passes through your feet with each step. The foot is made up of 26 bones and 33 joints, and it takes 200 muscles working just to take one step! Is it any wonder that if your foot in not working the way it was designed that you are going to have problems?
The foot is designed to absorb shock when we land, adapt to uneven terrain, and become a rigid structure to help propel us forward when we take a step. We run into trouble when this doesn’t happen and the body has to compensate, using muscles to do jobs they weren’t designed for. A foot that is not operating normally is like driving around with the front end of your car out of alignment, shaking and rattling the rest of the car. Eventually this will cause fatigue and breakdown.
The most common areas of pain from improper foot function are the arch, heel (especially first thing in the morning when you step out of bed), shin, knee, hip, and back. How can one body part affect so much? Remember those 200 muscles involved in taking a step?
What an orthotic does is reposition the foot to allow it to operate like it was designed to operate. This prevents excessive joint motion and muscle activation that is happening in an attempt by the body to compensate and allow you to move forward.
Are all orthotics and orthotic practitioners the same? Definitely not! Unfortunately foot mechanics and orthotic control are poorly understood and anyone can stick your foot on a force plate, push it in some foam, or cast it and have the lab make something that matches your foot. The challenge comes in understanding specifically how your particular foot functions, how you do or don’t compensate, what your activity level is, and what other stressors there may be (leg length, physiological or surgical limitations in movement, etc.). The ideal orthotic restores your normal biomechanical function; it doesn’t just take “a bit” of the excess stress off. I have a lot of people who have come in with bags of orthotics that have not helped but, when provided the correct device, their pain goes away.
Can’t I just strengthen my muscles/foot? Don’t orthotics make me dependent on them? Wouldn’t I just be better off going barefoot? If your foot is able to operate like it was designed, you don’t need orthotics. If it has stretched out, has abnormal alignment, or doesn’t work like it was designed, you will overstress it or other tissues.
The body’s tissues are designed for a specific load. If you ask part of the body to do another parts job, it can only help out a little before breaking down. You will not be able to move and function like the body was designed, and something will give. It’s like asking that out of aligned car to just toughen up. Do you want to spend all your time tightening bolts, replacing worn out overworked parts, or just address the problem and allow it to run smooth and efficient.
Do your homework before you get orthotics and make sure your provider knows what they are doing. I am happy to give a free consult to anyone who wonders about their feet, orthotics, or would like a second opinion. Happy trails!
Rick Stockwell, PT/ATC Sunrise Physical Therapy (970) 749-‐5308