Melbourne Podiatry Clinic

Top 4 Orthotics Problems and Solutions

If you’re considering that you may need foot orthotics and you have spoken to other people who have had them, you’ve probably encountered some discussion of the problems associated with orthotics.

The purpose of this article is to address, with full disclosure, four of the most common problems that may occur with foot orthotics. We will also discuss the cause of these problems, and how you may be able to avoid them. These problems occasionally occur, although they can be avoided, and often amended if first, we understand them.

At Melbourne Podiatry Clinic we are passionate about the benefits of custom-made foot orthotics. We have made it our goal to deliver world-class foot orthotics as part of our rehabilitation programs for people who they are suitable for. We have been through extensive training in orthotic prescription as part of our podiatry university degrees and have prescribed over 4000 pairs ourselves.

We will admit though, that not every orthotic prescription goes perfectly. Due to the large volume of orthotics, we’ve prescribed for a wide range of foot and lower limb issues, and for everyone from weekend warriors to elite athletes, we have an intimate knowledge of the good, the bad, and the ugly of foot orthotics.

The Most Common Foot Orthotic Problems And Solutions:

  1. They’re too hard
  2. They don’t fit into shoes
  3. They hurt
  4. They don’t work


1. They’re too hard



Are orthotics hard? The answer to this question is that it depends. The feeling of “hardness” underneath

the foot is subjective. If twin brothers with the same body and foot wore the same set of orthotics, one may perceive the orthotics as feeling hard and uncomfortable while the other may find them to feel quite normal.

It is important to point out that some people even prefer to have their orthotics feeling quite hard under their feet. Regardless, orthotics that are designed for you should always be useable, and not uncomfortable or painful– otherwise, there is no point in having them! There are a few variables that may contribute to orthotics feeling harder, and therefore less comfortable than they should be. Let’s break them down…

THE THICKNESS / DENSITY OF THE MATERIAL USED

Modern-day orthotics can be made from a few different types of materials. The most common are polypropylene, EVA, or 3D-printed nylon. When an orthotic is designed, the podiatrist decides how thick or dense the material is going to be based on factors such as the person’s weight, foot shape, the way their foot moves, their injury, and the desired effect of the orthotic.

The thickness of the material can also be altered in different parts of the orthotic. For example, it may be 3mm thick in the heel area of the foot, but only 2.5mm thick through the arch. If the orthotic material is designed to be too thick or dense in certain areas of the foot, it can feel like it is too hard.

WHAT’S THE SOLUTION?

If it is an issue with the material, then the orthotics can be modified on-site. The orthotics can be heated or ground down, to reduce the thickness/density of the material at the points where it feels most uncomfortable.

At your review appointment, your podiatrist can work with you to find a happy medium between reducing the thickness enough that it becomes more comfortable but still having the desired effect on your foot that it was originally designed for.

THE SHOE THAT THE ORTHOTIC IS FITTED INTO

How orthotics feel under the foot is also influenced by the shoes that they are fitted into. If you wear your orthotics in a pair of Nike running shoes, for example, they will feel slightly different to if you wore them in a pair of steel cap work boots, which will feel different again to a pair of leather business shoes.

If the shoe you wear is harder, then the orthotic will also feel harder under your foot. What you are feeling under your foot is ultimately the net effect of the interaction between your foot, the orthotic, the shoe and the ground.

WHAT’S THE SOLUTION?

Ensure that you bring all of your shoes that you may wish to wear your orthotics to your appointment with your podiatrist. They will be able to discuss which shoes are going to be the best to fit the orthotics into and will be able to recommend some alternatives if they foresee any issues.

Another solution is that you could have multiple pairs of orthotics made which are designed differently, to suit each of the different shoes that you want to wear them in.

THE ORTHOTIC TOP COVER

The orthotic itself is often covered with one or two layers of padding and cushioned material to make it feel more comfortable. Common materials used include EVA, poron, neoprene, leather, and vinyl. These paddings also come in varying thicknesses and densities. The wrong combination of top-cover material can make the orthotic feel like it is too hard.

WHAT’S THE SOLUTION?

If the orthotic top cover is the issue, then it can easily be removed and replaced with an alternative top cover that makes the orthotic feel “softer” under your foot.

THE ACTIVITY YOU ARE USING THEM FOR

The same pair of orthotics may feel comfortable whilst walking, but then too hard when running. As a general rule (although not always the case), higher-impact activities such as running or lifting heavy loads can make an orthotic feel harder. Orthotics may also begin to feel harder if you are wearing them for longer durations of time such as extended shifts on your feet at work.

WHAT’S THE SOLUTION?

Any of the before-mentioned solutions may be helpful in this scenario, such as reducing the thickness of the material, ensuring the orthotic/shoe combination is appropriate, and checking that the top cover is suitable.

Communication with your podiatrist about exactly what you are going to be using the orthotics for and with specific details will also be helpful before they are designed.


2. They Don’t Fit into Shoes


Will your orthotics fit into any shoe that you want to put them in? Nobody wishes this to be true more than podiatrists! Unfortunately, the answer is no. Orthotics are designed with the shoes that they are going to be fitted to in mind.

If you require orthotics, you must bring all your shoes into your podiatry appointment so that the podiatrist can see which ones that they are working with before they design the orthotics.

Often, they can design “happy medium” orthotics that will fit into a wide selection of your shoes, but there still may be some limitations. Let’s dissect some of the reasons why orthotics may not fit into some shoes.

THE LENGTH AND WIDTH OF THE SHOE

This is best explained with a specific example. A pair of orthotics made for steel cap work boots are often too wide to fit into a pair of football boots. Football boots are often narrower, so the orthotic needs to be designed accordingly, but then if you place it in a steel cap work boot, it may be too narrow and move around inside the boot. This same scenario could apply to several other shoe examples such as dress shoes, running shoes, hiking boots etc.

WHAT’S THE SOLUTION?

In this scenario, if no happy medium design is possible and you wish to wear orthotics in both shoes then the best way is to have two separate pairs of orthotics made, one to fit each shoe type.

Another solution is to find an alternate pair of football boots that are wider, or work boots that are narrower, so that a “happy medium” may be easier to reach. This can sometimes cause more problems, and if you were happy with the shoes, to begin with, it may be best to just leave them as they are and instead have two pairs of orthotics made.

If the orthotic itself fits into both shoes, but the orthotic top cover is too long or wide at the front end of the shoe (it creases up in the toe area), then this can easily be trimmed and tapered by your podiatrist to fit better.

THE DEPTH AND FIXATION OF THE SHOE

The length and width of the shoe may be the same between two different shoes, but one shoe could be shallower or “lower cut” than the other. This means that the same orthotic design in this shoe is more likely to make your foot feel like it is “coming up out of the back of the shoe”, or too tight on the middle of the foot.

The fixation of the shoe has a similar effect. What we mean here is the shoelaces, zippers, Velcro straps or any other alternative that you use to tighten the shoe to the foot. The design (or lack of) fixation can alter the way that the foot/orthotic/shoe relationship functions.

WHAT’S THE SOLUTION?

The fixation can be adjusted. For example, you can do up the laces of the shoe differently to make them “tighter” or “looser” in particular areas of the foot. A shoemaker may also be able to alter the fixation, such as by changing the Velcro into laces.

Ensuring that the shoes have a removable insole before buying them, and removing this insole of the shoe before you put the orthotics in will allow for extra depth.

THE ORTHOTIC ITSELF

First and foremost, the orthotic is always designed to achieve the desired effect on your foot. This might mean that once this is accounted for, the design may not work for any of the shoes that you currently have.

If this is the case, your podiatrist will recommend more suitable shoes to go with the orthotics. If however the shoes are suitable and would be expected to fit an orthotic into, but the orthotic simply doesn’t fit, then it may be an issue with the orthotic itself!

WHAT’S THE SOLUTION?

Orthotics can often be modified by heating and grinding them down. This can be done by your podiatrist to make them narrower and to taper them to fit into different shoes.

All of these shoe-fitting problems can potentially be avoided if you take your orthotics with you to the store when you are purchasing new shoes so that you can test them inside the shoes themselves before you buy them (and remember to remove the insole that is already in the shoe before you do!). It is not uncommon for people to go up half a shoe size when they have orthotics, which is rarely an issue.


3. They hurt


Should orthotics hurt? The answer to this is no. Orthotics should not cause any severe pain or injury and are always intended to be comfortable and useable. This is not to say that it does not sometimes happen, but it would be very rare.

When you first wear a new pair of orthotics, often they can feel foreign and unusual. We liken this to when you first wear a new piece of jewellery such as a watch. To begin with, the new watch will feel foreign and noticeable. Then as time goes on, it just becomes a normal part of how you feel your arm. The same thing happens when you get new orthotics, with some people getting “used to them” quicker than others.

Unlike the watch, however, throughout the wearing-in phase of new orthotics, some people experience mild aches and pains in their muscles and joints. These certainly should not be severe and should ease within a short period of time (days/weeks).

WHAT’S THE SOLUTION?

To minimise the likelihood of having these mild aches and pains in the first couple of weeks of wearing your orthotics, we often recommend wearing the orthotics in progressively. A typical protocol may look like wearing them for 3 hours the first day, 4 hours the second day, 5 hours the third day, and so on.

When you can wear them all day without issues, then you can start to run and play sport in them. If these temporary aches and pains still occur for you, simple strategies such as heat packs, massage and stretching, as well as keeping active and moving about can be helpful until they subside.

If your orthotics are causing severe pain or injury, then they must be reviewed by your podiatrist to find out what the culprit is so that it can be addressed for you as soon as possible.


4. They don’t work


What could be more frustrating than investing in something, only to be disappointed by its results? You would feel like you have wasted your money and time. This is an objection to orthotics that we sometimes come across. Let’s break it down!

When discussing orthotics with your podiatrist, it’s important to understand how they are intended to help you. In other words, we need to know how they “work”. When we understand how they are intended to function for your foot, we can make better judgements of their effectiveness.

When you have pain or an injury, there are multiple ways in which you or your podiatrist can help to alleviate the issue, of which orthotics are just one possible solution.

Orthotics are often used in combination with other solutions, and therefore make up a percentage of the expected recovery. For some people, orthotics may be the 100% answer to their problem. Most of the time, however, orthotics are used as a tool to help with our overall recovery process, which can increase the effectiveness of other solutions.

Let’s say that you have been struggling with plantar fasciitis, and you know you need to improve the strength of your foot and ankle to help with this. What if you have been struggling to do the exercises or make any progress in strength because of the pain?

An orthotic may then be useful for you to reduce some of the pressure and pain underneath the foot. This could allow you to then continue with your exercises more comfortably and complete your rehab. In this example, we may loosely attribute 50% of the success of the rehab to the orthotics, and 50% to the strengthening exercises.

Hopefully, from this example, you can understand that the problem with orthotics “not working” is quite often when the expectation of the orthotics to be the 100% cure for your pain is not quite accurate.

WHAT’S THE SOLUTION?

Ensure that you discuss with your podiatrist the role of your orthotics in the recovery of your specific issue, and what realistic improvement you can expect to see once you start using orthotics (which will be different for everyone!)

Find a podiatrist who understands this, can effectively and honestly communicate this to you and formulates a comprehensive rehab plan addressing all aspects of your recovery.

If despite all of this, the orthotics still do not have the desired effect, then they can be re-evaluated or modified by your podiatrist.

In Conclusion…

It is not a mere coincidence that we have legitimate solutions to the top 4 problems associated with foot orthotics. At Melbourne Podiatry Clinic, we constantly scrutinise our services and processes to eliminate potential problems and make life easier for everyone.

You want effective, long-term solutions to your problems so that you can get back to doing the things you love with confidence. Our goal is to make that a reality.

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