So, I Got These Orthotics…Now What?

July 16th, 2020

If you’re a runner, have ever been fitted for athletic shoes, or have ever had any pain from your low back down to your feet, chances are that, in your personal investigation or in conversations with health care professionals, you have come across orthotics. There are tons of different choices for orthotics out there to address over-pronation or midfoot rigidity, made from this material or that material, and can range from $30/pair up to $400+/foot for custom-made options – it can definitely be overwhelming! Your best bet to not get lost in the sauce is to speak with your physical therapist to discuss the particular and specific reasons why an orthotic might be good for you and how to go about finding the right fit.

What I’d like to take the time to do now, though, is talk about “life after orthotics.” I have often found that my patients got orthotics “way back when because their high school running coach told them to” and are still using them several years later without any idea if they should still use it, if they’re still the right pair, or whether it’s actually helping them. Orthotics, like any training shoe, should be looked at intermittently depending on a number of factors: mileage, wear, and pain being the main ones that come to mind. And, orthotics, in and of themselves, are not going to necessarily address any underlying problems that could have led to the pain that prompted them to look at orthotics in the first place. This is where orthotics should go hand-in-hand with an assessment from a physical therapist to develop an individualized plan to address all the underlying factors that could be contributing to your pain.

I’m going to talk specifically about the ankle and foot region here. It’s a super complicated region, with tons of joints (33 joints comprised of 28 bones), tons of muscles (34 to be exact), and tons of ligaments that work in a complex and nuanced way to support everything that your ankle and foot does for you throughout the day: standing, walking, climbing stairs, running, etc. It would be ridiculous to think that just adding an orthotic without looking at any of these other factors would be sufficient to fully address any pain that you may be experiencing! Whether it’s mobility in the ankle joint or somewhere else in the lower extremity, muscle length or flexibility, or strength and coordination of your muscles, addressing any and all of these factors is crucial to maximize your potential and reduce any future injuries or pain.

Let’s get into some stuff. First up: check your ankle mobility.

You should be able to keep your heel on the ground and have your knee touch the wall with your toes at least 9cm away from the wall. Follow along with the video to see how to properly set yourself up.

Next, let’s stretch.

Make sure you get a good stretch in you calf with your knee straight AND your knee bent. Putting your toes on the towel roll helps to also stretch out your plantar fascia.

And finally, let’s do some toe yoga.

As you do this, keep the rest of your foot on the ground, and don’t let your whole foot just roll in or out. This is TOE yoga!

Toe yoga gets at a few different things, but namely control and coordination of those 34 muscles in your ankle and foot. If you have a difficulty with this, imagine how hard it is for your foot to do similar complex, nuanced changes at high speed every time you take a step as you run!

These are just some of the things that could be contributing to your initial need for orthotics that you should also be addressing. Orthotics are a great supplement to add to your training, but so is addressing mobility concerns, flexibility issues, strength deficits, and coordination impairments. Talk to your physical therapist or drop a comment below if you have any questions or would like more information!

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