5 things you MUST know about orthotics

Foot pain, biomechanics and orthotics:

The majority of the population have some form of biomechanical condition (the way they walk or run) that can cause the body to react adversely. These problems can lead to chronic foot pain, ankle pain, knee problems and even some back pain related issues.

We all take approximately 8,000 to 10,000 steps on an average day. Add to this the amount of time we spend exercising and you can see how much punishment that your body has to absorb just for you to go about your day-to-day life.

Our bodies are like cars. They come in different shapes and sizes. Also, like a car they need to be looked after and are prone to wear and tear. The more we look after them the kinder they will be to us with the passing of time. Sometimes our bodies are not designed well enough to cope with all that we ask them to accomplish.

On a regular basis we see young patients’ that have heel pain (Severs disease) and knee pain (Osgood Schlatters disease) which are caused by doing too much activity during the growing stages of life.

We also see adults that are not active with heel pain (Plantar Fasciitis) and knee pain (CMP / patellar tendonitis) because their bodies were not designed to do what the patients asked of them.

Sporty people are more prone to biomechanical injuries than most because of the pressure they put on their legs and backs during exercise or sport. A lot of the sporting population ask their bodies to do things that they are quite simply not designed for, and they push these limits to the extreme!

A lot of people with bad biomechanics get by with no manifestation of pain. However, some people are less fortunate and can end up in extreme situations of pain. For most it tends to be a niggle that if not dealt with often develops into something more severe.

This is where The Spine CLinic can help!!

Assessing for and treating biomechanical conditions is a complicated business – FACT.

If you are attending a “foot specialist”, ensure you have satisfactory answers to the following questions:

1: Training and Experience:
You should expect at least a degree level qualification in a relevant field, ideally postgraduate study as well. Ensure that their qualification is in the field of biomechanics and or musculoskeletal health, for example a person with a PHD (doctorate) in English Lit will probably not be of much use to you for an orthotic assessment!!

There are so many so-called health care professionals advertising their services that include orthotics. Of late there are many non-health care professionals advertising foot scans and orthotics as well.

This usually means that they have had some minor training provided by the supplier of their orthotics who obviously has a vested interest in getting as many health carers providing orthotics as possible.

!Buyer beware!

2: Assessment is Key:

Recently there has been an increase in ‘high tech’ solutions to foot orthotics. They are only useful as an adjunct to a complete clinical picture. NOTHING replaces a full and comprehensive assessment. At PhysioCare we are fortunate to be able to offer casting, foam boxing, pressure plate analysis, and 3D scanning of your foot. We decide based on YOUR clinical presentation and discussion with you, which method to go for.

There are manufacturers and certain health professionals that do not have a degree level qualification in orthotics or biomechanics who are pushing orthotic therapy on many unsuspecting clients by using ‘machines’ that are supposed to be an intelligent assessment. It is often alleged that these machines can prescribe your foot orthotics just by you walking across them.

This is why a comprehensive and ‘correct’ biomechanical assessment is the key to a successful outcome in the treatment of biomechanical conditions. Your foot professional NEEDS to know what is happening in the whole body during walking to be able to correctly prescribe the right orthotics for YOU!

A full assessment should include a comprehensive history, an assessment of your gait cycle, as well as your lower limb mechanics, including lumbar spine, hips, knees and feet.

3: Who needs orthotics?

One of the biggest selling points of orthotics by ‘marketing’ led professionals is that everyone needs orthotics.

There is no quality research to support this allegation, which in my opinion is totally untrue.

We often get referrals asking us to check a persons’ biomechanics and we find that there are often other treatment options available such as Physiotherapy, or our good old friend spontaneous recovery and stretches.

Ensure that your foot health professional tells you WHY you need orthotics AND what results you can expect from your orthotic treatment. Make sure they are specific.

4: Ok I do need orthotics, do I need fully customised devices:

By definition an orthotic is any device that corrects or improves your foot mechanics. Many good shoe and runner manufacturer have become aware of this and now offer inbuilt corrections in their footwear. This works out really well if you have that precise problem – less so if you have not.

A simple heel raise or wedge can often go a long way to correct a problem. These can cost as little as €10, fully customised devices are exactly that, fully customised for your foot. Depending on materials, manufacturer and coverings can cost as much as €500 (and higher in certain cases).

We are finding that there are suppliers who are offering “Custom foot orthotics” that are in fact semi-custom. These can often be very helpful, but again beware, and be sure you are getting what you pay for.

They certainly should not be moulded insoles made ‘while-you-wait’.

If you are paying for a custom orthotic then you should expect a custom orthotic. This means that the foot care professional is using some kind of method of taking a non-weight bearing ‘shape’ of your corrected foot position.

5: Orthotics are NOT a Cure All for every problem.

Orthotic therapy (using orthotics to treat a biomechanical problem) is becoming a more common treatment. It has become more and more popular because, when used correctly, the results are there to be seen.

One downside to this popularity is, as we mentioned before, the increase in health care professionals jumping on the bandwagon to try and increase their clinics profits.

Unfortunately, this means that too many patients are being prescribed orthotics when in fact they don’t need them.

We have heard of people being prescribed orthotics for conditions such as neck pain, and even frozen shoulder.

Think about it logically, certainly an adjustment to your foot mechanics can help you back, but the further away from the pain you are, the less likely an “adjustment” will resolve the problem.

From experience and the research, orthotics help significantly with foot and ankle problems, less so with knee, less with hip and low back and less again with neck.

Your foot health care professional should discuss with you what to expect from a successful outcome from orthotic therapy. This means that you both understand what you are trying to achieve by using orthotics.


Common sense is important in choosing a foot care professional.

Make sure that you are not only comfortable with your foot care professional’s manner but also their qualifications and knowledge.

You should not be afraid of asking about their qualifications in the fields of biomechanics and orthotics specifically.

If they tell you that they have ‘done a course’ make sure to ask how long it was and who ‘sanctioned’ it.

If it was a short course and if the sanctioning body wasn’t a University then be very wary.

Most of these ‘so-called’ professionals did a weekend course provided by the orthotic manufacturing company.

Ask yourself if this ‘education’ in your interests or theirs….

Ultimately, buyers beware.

Try and get a personal recommendation from a friend that has had a successful outcome before going to a foot clinic. If you don’t know anybody that has, then remember the advice in this report.