Orthotics

[Lybi]

Okay people, help me out here.  What is your opinion of orthotics?  I just had my aches evaluated, and it turns out that my right arch is significantly lower than my right, meaning I pronate more on my right foot.  I am excited about this revelation, since every running injury I have had has been in my right leg--never my left.  So unless I want to have to wear a stability shoe on my left and a motion control on my right, I need to get orthotics.  What is the best kind of orthotic?  They are expensive--I'd like to get something that will last forever.  I don't even know what kind of doctor would be best to see to get an orthotic made.  Any ideas?

[Dale]

See a (sports/running) podiatrist.  They specialize in the foot and mine diagnosed my foot problems and ordered custom orthotics to correct my many foot problems. Visits are often covered by insurance, including prescription orthotics if needed, and will provide a professional medical evaulation of your individual biomechanics.  Before going to a podiatrist, I had two injuries (both on my left side) and when I put shoes with about 100 or so miles on them on a table, they both tilted to the outside.  After going to a podiatrist, I haven't had an injury that's stopped training for more than a day or two, my shoes wear evenly, I've been able to increase mileage from 30 to 80 MPW, and my feet *feel* better.  Actually, I just went back the other day because of some new foot pain that developed a few months ago (I put off going to him thinking it'd go away....it didn't), and wound up coming away with new prescription orthoes that correct my new issue.  I guess most folks wind up getting one prescription, thinking that'll last you for life, but just like your vision, your biomechanics change over time, especially when you go from couch-potato to runner (i.e. me).  Anyway, the new orthotics have made an immediate difference for me.

Oh, and I did try non-prescription orthotics for a while (Superfeet green).  They worked better than nothing (i.e. normal shoe inserts) but my prescription orthotics are much better and solved problems the over-the-counter orthotics did not.

[Josse]

I have had several differant orthotics made for me.  They usally help for while and then over correct the problem and something else gets injured.  I have found that they are good for some people and not for others, you just have to make sure you don't get to strong of a persription.  I also found that I like the superfeet better than the orthodics. 
Also if you do get some work them in very slowly.

[Adam R Wende]

I need them. I had some foot and knee problems about 8 yrs ago. I got orthotics and both went away. The problem is that now I have to run with them. I've tried a few times to wean myself off but each time my knee would start to hurt so for now I just wear them...

[Paul Petersen]

My experiences with orthotics:
I did pressure testing with a podiatrist and got some custom orthotics with a hard plastic mold and a heel-lift when I was dealing with PF back in 2006. I wore them for running every day from September - March 07. My PF had completely gone away, and I was injury-free. However, then I started having pain at the ball of my foot, which I eventually blamed on the heel-lift. I stopped wearing the custom orthotics and went over to over-the-counter PowerSteps. Didn't have any problems afterward, and even started racing with no orthotic at all during the summer.

My philosophy on orthotics, is that they are like a cast. When you injure your arm what do you do? You wear a cast for a relatively short amount of time in order to force correction and promote healing. After the problem is corrected and healed, you remove the cast and begin physical therapy to re-strengthen the arm. What would happen if you wore the cast for the rest of your life? Easy: your muscles would atrophy, and if you ever took the cast off, it would immediately get re-injured. Conversely, if you refuse to ever wear the cast in the first place, your arm will never heal, and you'll never get full functionality back. Thus, the middle ground is to wear the cast long enough to ensure return to full health, and to ensure correct alignment, but then take the cast off and and s-l-o-w-l-y restrengthen the muscles so that they can return to normal activity.

That is how I feel about orthotics. They can serve as a crutch while your body heals and while you pursue finding and solving roots of the problem (usually addressed through a physical therapy program). Yes, I do think in some cases an orthotic is the ONLY solution and some people need to wear them for life, but I think a greater number of people can use them as temporary steps within a more holistic treatment strategy.

Another thing to remember is that custom orthotics are essentially a "prescription" from a podiatrist. If/when your body changes, the "prescription" is no longer as effective.

Of course, I am no doctor; I'm just some guy who knows how to type!

[Jon Allen]

Of course, I am no doctor; I'm just some guy who knows how to type!

A lot, apparently 

[Fredrick Teichert]

Excellent observation, Paul. Having just been diagnosed with Morton's Neuroma, I'm convinced I got here by training my feet to be lazy. Traditional treatment for my condition evolves into something like, "If your foot hurts, take out the nerve." You wouldn't do that for a headache!

Over the years i've spent more and more money on more cushiony, correcty shoes. i think those barefoot guys might have something. They don't complain about problems with their feet. They do look like hippies, though.

[Lulu]

Consider that your arch problem may be coming from having weak glutes (and usually abs). Hear me out here. You are a woman who has had three kids and this often translates into weak abdominal and glute muscles. To see if it is your glutes, have someone who can properly evaluate your arch look at your feet when you are standing relaxed with feet approximately shoulder width apart and then evaluate again when you squeeze your butt so tight you could hold a quarter between your cheeks (TMI, I know). If your arches raise, strengthen your glutes and abs. I agree with Paul about orthodics being a temporary fix. This might make podiatrists mad, but sometimes, they often spend too much time look at feet and not looking at the mechanics further up the line.
Lulu

[Michael]

I went to a orthotic specialist and was surprized, instead of taking my money and having me pay for some custom orthos, he recommended that I try a store brand. I got power steps for my plantar fascitus problem. At first they felt like my foot was on top of a rock, but They now seem to be helping. My plantar problem seems to be improving because of them, so if that works I saved a bunch of money

[Adam R Wende]

Because of this thread, I've decided to give it a try again. I ran without my orthotics for the first time in about seven years today. So far so good. I'd pounded them so flat over the last decade maybe it was like I wasn't wearing anything anymore anyway. We'll see it is only day one.