DO I NEED ORTHOTICS? Article by Stewart Hayes, Sports Podiatrist - [ Ссылка ]
One of the most common questions I get asked by people is "Do I need orthotics?". Not everyone needs orthotics as sometimes choosing the correct shoe does the job, it all depends on the following factors (but is not limited to) -
1. Foot Mechanics
People often use the term "flat feet" to describe the motion that is actually "pronation" or when the feet roll inwards, but this is a misleading phrase as high arch feet can be pronated. Pronation is a necessary and normal part of gait required for shock absorption. Problems tend to arise when people excessively pronate.
Supination is the opposite of pronation, when the feet roll outwards. Supination is also a necessary and normal part of gait required so that the feet can become rigid levers to propel the body forward. Excessively supinated feet tend to be quite poor at absorbing shock which means they are not ideally suited to prolonged high impact activity.
The following photos show various foot mechanics. When viewing these compare them to a wheel alignment on a car or a foundation on a building, ie; they should be aligned vertically and be a stable foundation for the structure above.
Click to view the ideal foot mechanics video (the left foot only) - [ Ссылка ]
Click to view the pronated foot mechanics video -- [ Ссылка ]
Click to view the supinated foot mechanics video -- [ Ссылка ]
2. Body Types
The height, shape, mass, alignment, flexibility, etc. of each person's body all play a part in the suitability for high impact weight bearing activity such as running. Further to this, some people have hyper-flexible ligaments which means their joints often move past an ideal range, which in the feet means an unstable foundation (think of wobbly front wheels on your car....). Typically, hyper-flexible people take to orthotics like a duck to water as the excessive motion of their feet is then minimised. An interesting fact is that bodies are rarely symmetrical, which can mean that legs are different lengths. Treatment via a heel lift or orthotics all depends on the level of the difference.
3. Age
You may not like to read it, but it's true that we all wear out at some point and for a lot of people it starts to occur in their 30s to 40s. How many professional athletes continue past their early to mid 30s? Not many, because the older we get, the less supple our muscles and tendons become and our joints can potentially have signs of the dreaded osteoarthritis. So, the older we get, the less our body copes with misalignments or wear & tear. Again, back to the car -- if you ignore a poor wheel alignment in an older model car and keep driving that car, worn tyres will be the least of your problems given enough time.
4. Aches & Pains
Quite simply, if you have aches & pains every time you stand, walk or run, something must be wrong with the way you stand, walk or run. It may be that the injuries from times gone by are coming back to haunt you, but they don't necessarily have to cause so much discomfort.
5. Level of Activity
The more high impact weight bearing activity (such as running) that you do, the more you magnify all of the factors mentioned above, especially in the modern, concrete world.
ORTHOTICS
I have stated that pronation is a normal and necessary part of gait required for shock absorption, which is a big factor in a concrete world, yet people are often fitted with a hard plastic or carbon fibre orthotic that they find uncomfortable and impossible to run with. I do not believe that people should be wearing rigid orthotics that block all pronation, thus blocking the shock absorbing benefits of it. People should be in devices that bend & flex somewhat to allow the initial pronation, whilst then limiting the excessive pronation and finally allowing the foot to re-supinate and become a rigid lever for propulsion.
As such, 'sports orthotics' are ideal for runners as they are made from a flexible plastic shell, which is reinforced underneath with EVA that can be adjusted to increase or decrease the level of pronation control on a case by case basis. The orthotics are then covered to the full length of the foot with 3mm of neoprene (wetsuit) as it has great vertical and lateral (friction) properties to minimise blisters.
SHOES
Shoes are another topic themselves, but I will say that if you wear orthotics, you have to be very careful when selecting shoes. Putting a pair of orthotics into the wrong shoes can result in too much supination or still allow excessive pronation to still occur. Yes, even with orthotics, your feet can pronate through shoes -- the feet pronate into the orthotic and then the orthotic pronates into the shoe's midsole (see below). This is where expert shoe fitting is imperative.
