Are Orthotics An Arch Support?

Often orthotics are recommended, but are they just an arch support?

As opposed to an arch support that can be purchased at many stores, an orthotic has some distinct advantages:

1. Orthotics are designed to last for years, instead of months from an arch support.

2. An arch support (and most shoes) are designed for the average foot, but an orthotic is custom made for your foot.

3. Although an arch support will provide support to the arch, the orthotic supports the entire foot and cradles the heel.

4. An arch support may flatten with running or increased pressure, where an orthotic will be firm and maintain the position of the foot.

5. An orthotic actually improves or optimizes walking or running patterns by rotating the foot into "neutral position". In this position, the foot functions at the highest level.

Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
http://www.utahfootdoc.com/

What Shoe Insert Do I Need?

On a regular basis, I see people looking for a more comfortable shoegear and possibly inserts to place in shoes to make them more comfortable.  Often this is the first step that many take to improve the pain of their feet.  I also see multiple patients come into my office with "orthotics" that they were given by a podiatrist, physical therapist, chiropractor, a specialty store or even a shoe store.  Some even order these "orthotics" over the internet or off the television.  My goal is to educate people on the different types of shoe inserts and help them see what they may need.

Shoe Insert -- Many stores (including grocery stores, sports stores, and pharmacies) carry shoe inserts that are designed by multiple manufacturers.  These are typically pads (especially the gel type inserts) and usually just increase the cushioning to the shoes.  The provide no arch support and usually wearout quickly.  Although they may be more comfortable than the original shoe insert, they provide little or no longterm benefits to the way your feet function.

Arch Support -- Although these inserts can also be found from similar stores as shoe inserts, they typically will provide some increased support to your feet and may even prevent pronation in some individuals.  These are typically designed for average foot types and have little or no benefit for the flat foot or high arched foot.  Some common brands include spenco and sofsole.

OTC Orthotic -- The next level will include arch supports that can be slightly modified for size and foot type.  Among others, these include SuperFeet orthotics, Lynco orthotics, and GoodFeet orthotics if they are fitted to your foot by someone with knowledge of the product.  Again, these are not specifically designed for your feet, but do provide some support and may even modify your walking or standing patterns sufficiently to improve some foot and ankle complaints.  These are a relatively inexpensive alternative for many people that just need some additional support.  These also may not truly function with a flat foot or high arched foot.

Heat Moldable Orthotics (Semi-Custom Orthotics) -- Although these are also off-the-shelf products, they can be modified by heating the product and adjusting them to your feet.  The start with a standard shell and can be modified to better fit your feet.  One type of product of this type is Sole Custom Footbeds, that have helped many people get the mild to moderate support to their feet without the cost of a custom product.  These still are limited in their functioning and will not last more than 6 - 12 months usually in an active individual.  I often use this product in my running shoes and must replace the insole at least every 6 months.

Custom Orthotics -- This is a product that is designed to modify the functioning of your foot, by either accomodation or modification of your gait pattern.  Although there are multiple variations on a custom orthotic, the goal is to produce a more ideal gait pattern and alleviate the stresses and abnormal motions that may produce pain.  I plan to discuss these products in more details, but they should be considered as a more longterm solution that can alleviate pain and help you minimize injury.  The key to remember is although these cost more, you are getting significant benefit for the price.  This is not just a shoe insert or an arch support, but should optimize what you were born with.

Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
http://www.utahfootdoc.com/

What Is An Arch Support

We have all seen the commercials about "back pain" or "tired feet" being relieved by an arch support. Companies offer new "supports" or gel pads or even shoe inserts that are promised to help alleviate thes problems. If you walk down an isle in a grocery store or a pharmacy, there are hundreds of choices that can be utilized to "improve the comfort of your feet". The question is what do they do and can they really help your feet.

From an early age, I have had "flat feet" but have never had foot pain or problems. I am very active and wear sensible shoes, but don't add these extra pads or shoe inserts to make me comfortable. What makes the difference why some feet are normally comfortable and others are not?

The foot functions primarily as a mode of gait (the act of walking or running). It is designed to work ideally in a position called neutral, where all the joints, muscles and ligaments align to produce the best motion with the least amount of stress on any part of the foot or leg. When you talk with someone about your walking or running, they will use terms like pronation or supination. Pronation is the act of flattening your arch or rolling the foot towards the arch (away from the neutral position). Supination is the act of increasing your arch or rolling the foot away from the arch (again, away from the neutral position). In both cases, the foot fails to function in the ideal conditions and can cause problems.

An "arch support" is a product from the shelf that is designed to support the foot with an arch. It doesn't account for the neutral position, because it is designed for the average foot, not your individual foot. In a high arched foot, these are usually insufficient to support the foot. In a low arched foot (like mine), the foot is forced into the supinated position and usually leads to arch pain.

Gel inserts or other softer pad products are usually just as helpful. They add only padding to the shoes, but fail to modify the way the foot functions. They are therefore usually only comfortable for days and then flatten and fail to provide benefit.

Orthotics, custom appliances for the shoes to replace arch supports or shoe inserts, produce much more benefit. They should be created custom for your foot by cast molds, foam press boxes, or digital scans. If produced correctly, they will modify the function of the foot to the neutral (or ideal) position allowing they muscles, tendons, joints and ligaments to work simultaneously to produce locomotion. So this could be described as the true arch suppport, but an orthotic is actually so much more.

Some products have taken the arch support theory to a new level by providing some of the customization of orthotics to an off-the-shelf item. The Sole Footbeds have been the best product I have found to provide this functionality in a semi-custom (heat moldable) product. Although these are not orthotics, they will provide a 6 month product that can support the foot, while helping it function closer to the neutral position.

So, what is an arch support? Usually it is a product that wants to be an orthotic but doesn't work for 90% of the population since each of our feet are different. Only a small precentage of the population has the average foot, all the rest of us are flatter or higher arched than the average and need something designed or customized for our foot. For additional information visit us at http://www.utahfootdoc.com/.

Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
www.UtahFootDoc.com

Are You Gellin?

A genius ploy by a marketer has allowed many to recognize "gellin" as a description of comfortable shoes. It has even been equated with a better functioning individual by many of the commercials created for these products. There are many companies (which I will not name here) that have profited on our need to be comfortable, our need to continue to walk, our need to exercise or just be active. Activity has continued to be based on our ability to be comforable in a shoe. We are all spending good money on these products hoping they will work, but do they?

Before we can differentiate the different products available or decide what will help my feet or even your feet stop hurting, it is important to ask some key questions with the understanding that pain is NEVER normal.

- Why do my feet hurt?
- Is there a problem that can be addressed?
- Is it a problem of padding? (Gel or foam insoles or pads will help)
- Do I have foot deformities that cause pain? (What will address the deformity?)
- Is the way I walk a reason for my pain?
- Is this problem similar to what my parents, siblings or children have?

As we think about these questions, we can start to determine what is the best option for alleviating your pain, while ensuring you pay only for products that will address the reasons for your pain. Over the next while I plan to address each of these individual issues.
Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
www.UtahFootDoc.com