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/