By Kylie Pearce, B.Sc (Podiatry), C.Ped
There’s an old maxim in the Podiatry
and Pedorthic world that, an orthotic is only as good as the shoe you put it
in. This has proven to be very true and it is worth discussing this in detail
when going over orthotic therapy as an option. This is commonly referred to as
having the ‘shoe talk’. It doesn’t matter how expensive and customized your
foot orthotics may be, they could end up having little functionality and benefit
if you decide to wear them in shoes that are worn, fit incorrectly or aren’t well
designed to accommodate foot orthotics.
It’s important to educate anyone who is
considering foot orthotics that they need to look at what shoes they will wear
with them and make sure that the shoes aren’t too small to accommodate the
orthotic devices because orthotics do take up some room in your shoes and there
needs to be adequate, length, width and depth to ensure that your feet will fit
correctly in your shoes with foot orthotics.
It’s really important that the
orthotics sit correctly at the back of the shoe, the heel cup should cup around
your heel and there shouldn’t be any gap between the orthotic and the back of
your shoe (heel counter). If you have shoes that a long enough, wide enough and
deep enough, there are a few other factors to consider. Many shoes have a build
in foot bed, if you remove this and replace it with your orthotics then usually
fit problems are lessened. But in certain shoe styles, like elastic sided boots,
the orthotics have a tendency to slip forward, especially if the heel height is
greater than an inch. If you are wanting to wear your orthotics in shoes that
have heels higher than an inch, you should discuss this with the practitioner
who is issuing your orthotics because the orthotics may need to be customized
for this.
Unfortunately these days, many athletic
shoe models aren’t orthotic friendly. Shoe brands that are notoriously bad for
accommodating orthotics are Nike, Adidas and Reebok. Please refer to our shoe
recommendations by foot type list that you can download here.
Here’s some tips on troubleshooting
these problems:
The orthotic isn’t seating itself
back far enough in the shoe, or it has a tendency to slide forward when
you put your foot in the shoe. This is commonly because of shoe fit or shoe
style problems as discussed above but if you have shoes that fit correctly and
are a suitable style then a simple way to prevent this is to use a little bit
of double-sided tape or Velcro to ensure that the orthotic doesn’t slip
forward. If the orthotics do slide forward when you are putting on your shoes,
usually if you tap the back of your heels the orthotics will slide back into
place and often your weight is enough to keep them there. If not, try the
Velcro or tape trick. Just place double-sided tape under the heel of the
orthotic and in the center of the heel area in your shoe if you are using
Velcro.
The other possible problem is that the orthotic
is too wide. To test this, stand on the orthotic outside your shoes and
look down at your feet. If the orthotic is not wider than the circumference of
your foot i.e., you can’t see any of the orthotic when you are looking down then
the orthotic is not too wide! If the orthotic is wider than your foot, your
practitioner can have this adjusted for you.
So it basically comes down to:
The orthotic is too wide - this is rare because your orthotics should
have been fitted correctly when issued to you.
Or, the shoe is too small (not wide enough, deep
enough or long enough).
Or the shoe style isn’t really suitable
for orthotics.
If your orthotics feel good and look like they
fit correctly when you are standing on the orthotics when they’re not in the
shoe, then it’s most likely a poor fit between the orthotic and the
shoe. Have a look to see if the orthotic sits all the way back into the
shoe. Some shoe styles, like dress shoes or even Nikes and Adidas –
really cut out the midfoot and the orthotic doesn’t sit properly in the heel
counter. This can be an issue. The answer is to look for a better shoe
style, or cut the orthotic down, which reduces correction, so this is only
indicated when the orthotic is too wide or if there are restrictions on what
styles of shoes can be worn. Sometimes there is a balance between getting the
right amount of correction and getting orthotics that fit well in your shoes.
But in my experience starting off with the right shoe style that accommodates
foot orthotics well and fits your feet correctly will get you off on the right
foot in regard to getting you the maximum benefit from wearing foot orthotics.
Twitter: @LSteps @QuadraSTEPS
