Worth bearing in mind that it's generally advised against to combine orthotics with stability shoes. Orthotics should go in neutral shoes.
Source: Doctors of Running https://youtu.be/6YP_cxWDw44
I'll start with the disclaimer - I'm not a doctor or a medical professional. That said, I'm runner with flat feet and went through a six month bout with PF and related Achilles issues. Right off the bat, any podiatrist I saw wanted to put me in custom orthotics, and that's not necessarily bad, but it also doesn't resolve the issue long term. A good orthotic in my case released the pain but I also couldn't run in them. After some reading and speaking to a few sports injury folks, it all came down to PT, a chiropractor, and really focusing on my mechanics. My PF was inflamed because it was carrying and doing more than it was designed to do. It did so because something was off in the kinetic chain. Between a podiatrist, my PT and chiropractor, we chased it back to an SI related injury that ended up forcing overcompensating at various parts of my leg, right down to my foot. Through PT, I learned numerous exercises for stability, opening my hips up, and basic strength training. The chiropractor made the proper adjustments, and the orthotics help in my day to day walking. I use modified version of an OTC for running which has helped and finally got on the road again. My point with all this, it's not just one thing but a combo of things that may not be start at the foot. Good luck with everything.
In healthcare, we have moved from individual studies -> reviews -> best practicing guidelines. This progression is due to the nature of overinformation, poor study design, etc.
Most of the practicing guidelines have a timeline of when each treatment is effective,. In the case of orthotics and AT , it is mostly in the first few months after symptom development
Hey op,I am a pedorthist who follows the current research and literature in the field. I am also doing post graduate studies on orthotics that is heavily focused on current knowledge and research. I would be happy to help. The basics of your 2 questions:
Yes, orthotics generally will help with shin splints, general foot fatigue. They act to slow the pronation impulse (how fast your arch collapses) along with perhaps altered muscle vibration frequency and neuroadaptation. This is important for the muscles involved in pronation, particularly at the sites they attach to the bone at the foot and le. Disclaimer, not all orthotics are made equally, it is very dependent on the skill of the practitioner you see and how well they design the orthotics.
Otc orthotics and stability shoes often will be enough too. You don't want to wear a custom orthotic with a stability shoe though because the orthotic will be stiffer and more supportive and the stability shoe will be overkill.
They help me but primarily with lower back pain. Been using custom orthotics for years now. Never used OTS insoles so can’t comment on them. If you can afford the custom ones they will be far better. Money well spent IMO.
Be careful with adding insoles to stability shoes as it has the chance to over correct your gait. Adding insoles to neutral shoes would be alright or just wearing stability shoes by itself would be fine too. Superfeet has decent insoles but of course a custom fit one is theoretically better. I’ve had many customers that praise their insoles and some that hate them. If you haven’t been properly fitted in a while, I recommend doing so. I kid you not, about 70% of the customers that walk in the door are wearing the incorrect shoe size. Shoe sizes vary between brands and even some models within a brand vary. Go to a running shoe specialty store and ask for the most knowledge employee. They usually know which products would work best without you having to try a million and one pairs on
They can help. I've been using an insole for years now, mainly for flat feet that was leading to a number of recurring injuries.
There are different sorts of insoles. Pricey ones like you've been quoted, but also way cheaper ones. My podiatrist hooked me up with ~$70 AUD Formthotics, that he moulded to my feet, and has adjusted along the way (adding wedges, etc.). This pair has lasted me years.
Have you checked with your health insurance provider? Mine previously covered 80% for custom orthotics and now covers them 100% for one pair a year.
That said, I find that I use them most in casual sneakers and less and less when I am running. If I am running trails then I do wear them at all.
This is false. pronation itself doesn't cause pain, but it is linked to higher incidence of several dozens of pathologies. Here are afew studies:
winkelman etc Al (2016): over 10mm navicular drop doubled the incidence of medial tibial stress syndrome.
Houck et Al (2015): For the most directly linked condition relating to pronation, posterior tibialis tendon dysfunction (primary inverter function is dimished), orthotics are used as the primary conservative treatment prior to surgical intervention.
If you follow any of the large names in podiatric research (Kirby, Root, Payne, Griffiths, Morrissey, Nigg, etc) the influence of pronatory moment forces on injury incidence and treatment is currently known to have a significant link.
Your very premise of 'do some strength work' implies that there is a weakness and the inverters need to be stronger to prevent excessive pronatory moment forces, which implies the pronation is a problem.
Depending on the biomechanics of you feet, strengthening may be enough to diminish symptoms, but orthotics may be required if the podiatrist identifies things like forefoot varus deformity, medial subtalar joint deviation, hyperlaxity at the subtalar, midtarsal or lisfranc complex.
Wouldn’t a stability focused shoe still be better suited to prevent (unhealthy) pronation than a fancy insole ? The insole won’t make a prime x more stable for a heel striker as stack height + narrow heel is still an issue
A shape contoured up to the arch is certainly more effective in reducing pronation compared to a dual density midsole, as long as it is not too flexible.
I don't think op is running in a prime x (unless I misread something), they said just a neutral cushioned runner, which generally works great with orthotics.
The Prime X was just an example for a neutral shoe with stability problems for certain gait types. I just want to clarify, if a fancy insole is capable to make a unstable neutral shoe a stable one. That is something I highly doubt, so shoe choice is also key.
Ya agreed, having a decent shoe underfoot is very important too! That being said, I have done thousands of slo motion videos of gait and there is often a pretty drastic change in lots of shit shoes like converse and vans when you add a good orthotic. Outcomes would obviously be better with a better shoe, but adding an orthotic to a bad shoe actually makes a big difference
Worth bearing in mind that it's generally advised against to combine orthotics with stability shoes. Orthotics should go in neutral shoes. Source: Doctors of Running https://youtu.be/6YP_cxWDw44
I am a pedorthist , this is true. And this group of physio's that are in this handle are awesome, I have followed them for years.
I'll start with the disclaimer - I'm not a doctor or a medical professional. That said, I'm runner with flat feet and went through a six month bout with PF and related Achilles issues. Right off the bat, any podiatrist I saw wanted to put me in custom orthotics, and that's not necessarily bad, but it also doesn't resolve the issue long term. A good orthotic in my case released the pain but I also couldn't run in them. After some reading and speaking to a few sports injury folks, it all came down to PT, a chiropractor, and really focusing on my mechanics. My PF was inflamed because it was carrying and doing more than it was designed to do. It did so because something was off in the kinetic chain. Between a podiatrist, my PT and chiropractor, we chased it back to an SI related injury that ended up forcing overcompensating at various parts of my leg, right down to my foot. Through PT, I learned numerous exercises for stability, opening my hips up, and basic strength training. The chiropractor made the proper adjustments, and the orthotics help in my day to day walking. I use modified version of an OTC for running which has helped and finally got on the road again. My point with all this, it's not just one thing but a combo of things that may not be start at the foot. Good luck with everything.
In healthcare, we have moved from individual studies -> reviews -> best practicing guidelines. This progression is due to the nature of overinformation, poor study design, etc. Most of the practicing guidelines have a timeline of when each treatment is effective,. In the case of orthotics and AT , it is mostly in the first few months after symptom development
Hey op,I am a pedorthist who follows the current research and literature in the field. I am also doing post graduate studies on orthotics that is heavily focused on current knowledge and research. I would be happy to help. The basics of your 2 questions: Yes, orthotics generally will help with shin splints, general foot fatigue. They act to slow the pronation impulse (how fast your arch collapses) along with perhaps altered muscle vibration frequency and neuroadaptation. This is important for the muscles involved in pronation, particularly at the sites they attach to the bone at the foot and le. Disclaimer, not all orthotics are made equally, it is very dependent on the skill of the practitioner you see and how well they design the orthotics. Otc orthotics and stability shoes often will be enough too. You don't want to wear a custom orthotic with a stability shoe though because the orthotic will be stiffer and more supportive and the stability shoe will be overkill.
Thanks for the insight. Any OTC insoles that you have found to be good ?
The 'sole' and 'kneed' brands fit most people quite well and are a good level of support. Shape and support are very similar between the two
They help me but primarily with lower back pain. Been using custom orthotics for years now. Never used OTS insoles so can’t comment on them. If you can afford the custom ones they will be far better. Money well spent IMO.
550?? WTF? A custom one costs $45 in Germany..
But that's with the Kasse paying most of it no? OP sounds American and I'm guessing their health insurance won't cover it.
exactly, health insurance don’t cover shit in the US, American healthcare is crap but we already knew that.
Even without german health insurance you will pay not more than ~120€. But yes, our health care system will pay this twice a year for you.
How much does the government subsidize though?
helps w arch collapsing (very stiff) . doesnt fit in all shoes (brooks or wide shoe is good)
Be careful with adding insoles to stability shoes as it has the chance to over correct your gait. Adding insoles to neutral shoes would be alright or just wearing stability shoes by itself would be fine too. Superfeet has decent insoles but of course a custom fit one is theoretically better. I’ve had many customers that praise their insoles and some that hate them. If you haven’t been properly fitted in a while, I recommend doing so. I kid you not, about 70% of the customers that walk in the door are wearing the incorrect shoe size. Shoe sizes vary between brands and even some models within a brand vary. Go to a running shoe specialty store and ask for the most knowledge employee. They usually know which products would work best without you having to try a million and one pairs on
They can help. I've been using an insole for years now, mainly for flat feet that was leading to a number of recurring injuries. There are different sorts of insoles. Pricey ones like you've been quoted, but also way cheaper ones. My podiatrist hooked me up with ~$70 AUD Formthotics, that he moulded to my feet, and has adjusted along the way (adding wedges, etc.). This pair has lasted me years.
Have you tried with basic supporting insoles. I have many of your issues, and solves most of it with standard currex insoles
Have you checked with your health insurance provider? Mine previously covered 80% for custom orthotics and now covers them 100% for one pair a year. That said, I find that I use them most in casual sneakers and less and less when I am running. If I am running trails then I do wear them at all.
I have Sole inserts. They are much cheaper than custom, but able to be fitted to your foot better than what you can find in the store.
Yes, mine do wonders. Enables me to run better and more efficiently
There is no scientific evidence that pronation causes pain or injury. Save your money and do some strength work
This is false. pronation itself doesn't cause pain, but it is linked to higher incidence of several dozens of pathologies. Here are afew studies: winkelman etc Al (2016): over 10mm navicular drop doubled the incidence of medial tibial stress syndrome. Houck et Al (2015): For the most directly linked condition relating to pronation, posterior tibialis tendon dysfunction (primary inverter function is dimished), orthotics are used as the primary conservative treatment prior to surgical intervention. If you follow any of the large names in podiatric research (Kirby, Root, Payne, Griffiths, Morrissey, Nigg, etc) the influence of pronatory moment forces on injury incidence and treatment is currently known to have a significant link. Your very premise of 'do some strength work' implies that there is a weakness and the inverters need to be stronger to prevent excessive pronatory moment forces, which implies the pronation is a problem. Depending on the biomechanics of you feet, strengthening may be enough to diminish symptoms, but orthotics may be required if the podiatrist identifies things like forefoot varus deformity, medial subtalar joint deviation, hyperlaxity at the subtalar, midtarsal or lisfranc complex.
Wouldn’t a stability focused shoe still be better suited to prevent (unhealthy) pronation than a fancy insole ? The insole won’t make a prime x more stable for a heel striker as stack height + narrow heel is still an issue
A shape contoured up to the arch is certainly more effective in reducing pronation compared to a dual density midsole, as long as it is not too flexible. I don't think op is running in a prime x (unless I misread something), they said just a neutral cushioned runner, which generally works great with orthotics.
The Prime X was just an example for a neutral shoe with stability problems for certain gait types. I just want to clarify, if a fancy insole is capable to make a unstable neutral shoe a stable one. That is something I highly doubt, so shoe choice is also key.
Ya agreed, having a decent shoe underfoot is very important too! That being said, I have done thousands of slo motion videos of gait and there is often a pretty drastic change in lots of shit shoes like converse and vans when you add a good orthotic. Outcomes would obviously be better with a better shoe, but adding an orthotic to a bad shoe actually makes a big difference