Orthotics Aren’t Just About Changing the Way You Walk
When people think about orthotics, they often associate them with running, gait analysis or changing the way somebody moves.
But that’s only part of the picture.
Orthotics are a clinical tool, and there are many different reasons why we might recommend one. Sometimes we’re interested in movement and how forces are travelling through the foot and lower limb. At other times, the aim can be much more specific, perhaps reducing pressure beneath one particular part of the foot, accommodating a painful area or protecting vulnerable skin.
The important question isn’t simply “Do I need orthotics?” It’s what are we trying to achieve with them?
Taking Pressure Off a Painful Area
Sometimes a very small area of the foot can cause a disproportionate amount of discomfort.
For example, a prominent joint or bony area beneath the foot can be exposed to repeated pressure when you stand and walk. Over time, this may contribute to a persistent area of callus or a painful corn that keeps returning despite regular treatment.
In these situations, an orthotic can sometimes be designed specifically to offload that area.
Rather than simply adding cushioning beneath the whole foot, we can incorporate specific features into the orthotic to reduce the pressure going directly through the problem area. This might include an area of accommodation or a carefully positioned recess within the device.
This can be particularly useful when treating the corn or callus provides temporary relief, but doesn’t address the repeated pressure contributing to its return.
Protecting Vulnerable Feet
For some people, reducing pressure isn’t simply about comfort.
Certain medical conditions can make the feet more vulnerable to damage. Peripheral neuropathy, for example, can reduce sensation, meaning someone may not feel excessive pressure or friction in the way they normally would.
This can be particularly important for people with diabetes who have been identified as being at increased risk of foot complications.
In these circumstances, an orthotic may be used to redistribute pressure and help protect vulnerable areas of the foot. The aim isn’t necessarily to change the way the person walks. Instead, we may be trying to reduce repeated pressure, friction and shear on the skin and help reduce the risk of tissue breakdown and ulceration.
Managing Load and Movement
Orthotics can, of course, also be used as part of the management of musculoskeletal pain and injury.
Depending on the individual problem, an orthotic may be used to alter how load is distributed through the foot and lower limb or reduce demand on a painful or irritated structure.
For an athlete, that might form part of returning to running or sport. But you don’t need to be an athlete to benefit from an orthotic.
The goal might be getting through a working day more comfortably, walking the dog, enjoying a weekend walk or simply remaining active without being continually limited by pain.
The principle is the same: the orthotic should be designed around the problem we’re trying to solve.
Why a Proper Orthotic Prescription Matters
An orthotic isn’t simply a shaped piece of material that fits inside your shoe.
It is a deliberately designed clinical device, which is why a proper prescription matters.
When prescribing an orthotic, we need to consider what we’re actually asking the device to do. Where do we want to reduce pressure? Where might we want to redistribute it? Do we need greater support or more cushioning? Are we trying to accommodate a particular part of the foot? Is friction or shear against vulnerable skin something we need to consider?
The answers to those questions influence the design of the orthotic.
They also influence the materials we choose.
Different materials have different properties. Some provide greater structure, while others may be selected for cushioning or shock absorption. Where protecting vulnerable skin is particularly important, materials and coverings can also be selected to help manage pressure, friction and shear.
Specific features can then be incorporated into the device to accommodate or offload individual areas of the foot.
This is why two orthotics can look and feel completely different. They may have been prescribed to do completely different jobs.
Does That Mean I Need Custom-Made Orthotics?
Not necessarily.
A proper prescription doesn’t automatically mean a custom-made device.
For some people, a prefabricated insole may provide exactly what is required. These can sometimes be adapted or customised to address an individual’s needs. For others, the level of prescription required may mean a fully bespoke orthotic is more appropriate.
Sometimes an orthotic isn’t the right treatment at all.
At Feet & Motion, the starting point is always assessment. We consider your symptoms, your feet, your movement where relevant, your footwear, your medical history and the activities that matter to you before deciding whether an orthotic could help and, importantly, what we actually need it to do.
Orthotics With a Purpose
Orthotics aren’t simply about correcting feet or changing the way somebody walks.
They can be used to manage load, relieve pressure, accommodate a painful area, support movement or help protect vulnerable tissue.
And that’s why there isn’t one orthotic that’s right for everybody.
What matters isn’t simply whether an insole is labelled custom, supportive or orthotic. What matters is whether the device has been selected and designed with a clear clinical purpose.
Because ultimately, an orthotic is a tool, and like any clinical tool, its value depends on using the right one, for the right person, for the right reason.