7 myths about foot orthotics (Orthoses)
How do foot orthoses actually work?
Sam Chidwick Podiatrist Cheltenham
10/7/20264 min read
7 Common Myths About Foot Orthotics (orthoses)... What’s Actually True?
Foot orthotics are often surrounded by strong opinions. Some people believe they are essential for correcting the way we walk, while others worry that wearing them will make the feet weak or create a lifelong dependence.
The reality is much more nuanced.
Orthotics (Orthoses/Orthosis) are tools. They can change how forces are distributed through the foot and lower limb, but they aren't a magic fix and they certainly aren't something that everyone needs.
Here are some of the most common myths about foot orthotics.
Myth 1: “Orthotics correct your feet”
Not quite.
Orthotics don't necessarily “correct” the structure of your feet. Instead, they can influence how your foot interacts with the ground.
An orthotic can alter things such as:
Pressure distribution under the foot
How loads are transferred through the foot and leg
Joint movement and mechanics
Muscle and tendon loading
The stresses experienced by bones and soft tissues
Think of an orthotic less as a device that changes your feet and more as a tool that changes the environment your feet are working in.
This can be particularly useful when certain tissues are being overloaded or when changing the way forces are distributed helps someone move more comfortably.
Myth 2: “Orthotics weaken your feet”
This is one of the biggest concerns people have.
The idea is that if an orthotic supports your foot, your muscles will become lazy and stop working.
But that's not necessarily how it works.
Your feet don't simply switch off because you're wearing an orthotic.
In many cases, an orthotic can help redistribute load so that tissues are exposed to a more manageable level of stress. That may make it easier for someone to walk, run or exercise comfortably and the tissues can heal and end up much happier and actually stronger!
Importantly, an orthotic shouldn't automatically replace exercise or rehabilitation.
Myth 3: “If I have orthotics, I'll need them for the rest of my life”
Not necessarily.
Some people may benefit from orthotics for a long time, particularly where there are ongoing structural or mechanical factors that make them useful.
But other people may only need them temporarily.
For example, an orthotic might be used while someone:
Recovers from an injury
Builds strength
Gradually returns to running or sport
Allows an irritated tissue to settle
Adapts to a change in activity
The body is remarkably adaptable. Rather than asking, “Will I need these forever?”, a better question can be:
“What role are these orthotics playing right now, and what can I do to eventually need them less?”
For some people, the answer will be that continued use is helpful. For others, the need may change over time.
Myth 4: “If I wear orthotics, I don't need to exercise”
Definitely not.
Orthotics aren't a substitute for movement, strength or rehabilitation.
If someone has a foot, ankle, knee or lower limb problem, there may be a role for things such as:
Strength training
Calf and foot exercises
Balance work
Gradual exposure to activity
Running or movement retraining
Appropriate footwear
Load management
An orthotic can be one part of the solution, rather than the whole solution.
In fact, reducing discomfort with an orthotic may allow someone to participate more comfortably in the exercise they need to become stronger.
Myth 5: “Overpronation is bad”
This is a particularly important one.
Pronation isn't automatically a problem.
Pronation is a normal movement of the foot. Feet are designed to move.
The mistake is assuming that there is one “perfect” foot position and that anything outside it needs correcting.
Some people pronate more. Some pronate less. And people can have very different foot shapes and movement patterns without experiencing problems.
What matters much more is the individual person.
If someone has no pain and is functioning well, the fact that their feet pronate doesn't automatically mean something needs fixing.
On the other hand, if a particular movement pattern is contributing to symptoms or excessive tissue loading, changing how forces are distributed may be useful.
The aim shouldn't be to eliminate movement. It should be to find a level of movement and loading that your body can comfortably tolerate.
Myth 6: “Fallen arches mean there's something wrong with your feet”
Having a low arch or what is commonly called a “fallen arch” doesn't automatically mean your feet are damaged or abnormal.
Foot shape varies enormously between people.
Some people have "high arches". Some have "low arches". Some feet look different from left to right. And many people with "flat" or "low arched" feet have no pain or functional problems at all.
The appearance of an arch is therefore only one piece of information. To make it more complicated, we don't actually have arches in our feet... but that's for another day... or email me sam@theleglab.co.uk if you want to find out more.
Instead of looking at the foot and immediately saying, “That needs correcting,” it's more useful to consider:
Does the person have symptoms? How is the foot functioning? What activities are they struggling with? How are they responding to load?
A foot doesn't have to look a certain way to be a healthy, capable foot.
Myth 7: “Custom orthotics are always better than off the shelf orthotics”
More expensive doesn't automatically mean more effective.
Custom orthotics can be very useful in certain circumstances. They allow a clinician to create a device around an individual's foot, footwear and requirements.
But that doesn't mean a custom device is automatically superior for everyone.
For some people, an off the shelf orthotic may provide enough of the desired change at a lower cost.
The right question isn't:
“Are custom orthotics better?”
It's:
“What does this person actually need?”
If a relatively simple, affordable device provides the desired outcome, there may be little reason to spend considerably more.
Customisation becomes more valuable when there is a specific reason for it, such as unusual foot shape, footwear requirements, mechanics, difficulty tolerating standard devices, or a need for a particular mechanical effect which cannot be achieved reliably with a prefabricated device.
So, do you actually need orthotics?
The answer is: it depends.
Orthotics can be incredibly useful for some people and completely unnecessary for others.
The important thing is to move away from the idea that every foot needs to be corrected into a particular shape or position.
A good assessment should consider the whole person:
What symptoms are you experiencing?
What activities are important to you?
What loads are your feet currently dealing with?
How strong and adaptable are your tissues?
What footwear are you using?
Could exercise or rehabilitation help?
Would an orthotic make a meaningful difference?
And sometimes the best orthotic is no orthotic at all.
The goal isn't to create a “perfect” foot.
The goal is to help you have feet that are strong, adaptable and capable of doing the things you want to do.
An orthotic can sometimes be part of that process, but it shouldn't be the entire process.
Sam
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