Orthotic Insoles: 20 Most Asked Questions Answered

Orthotic insoles are designed to support the foot and influence how pressure and forces are distributed beneath it while standing and walking.

Depending on their design, orthotics may support particular areas of the foot, redistribute pressure and influence the way the foot functions inside the shoe.

At Custom Made Insoles, we believe the starting point should be understanding the individual rather than simply choosing a generic arch support.

We assess the feet, footwear and the way a person stands and walks before deciding what support may be appropriate.

Orthotic insoles can help certain people and certain conditions, but they are not a universal cure for foot or musculoskeletal pain.

How useful an orthotic is depends on why the person is experiencing symptoms, their individual foot structure and movement, the design and fit of the orthotic and the footwear being worn. This is why assessment is important.

The objective is not simply to put an insole inside somebody's shoe. It is to understand what is happening when that person stands and walks and determine whether changing support beneath the foot may be useful.

For the right person, custom-made orthotics can be a worthwhile investment.

However, not everybody experiencing foot pain automatically needs custom orthotics.

Some people may benefit from footwear changes, exercises, temporary cushioning or a good-quality prefabricated insole.

The value of a genuinely custom orthotic lies in the individual assessment, design, fit and follow-up, rather than simply having the word “custom” attached to the product.

Shop-bought insoles are manufactured to standard shapes and sizes. They may provide cushioning or general arch support and can be perfectly adequate for some people.

Custom-made orthotics take the individual into account.

An assessment can consider:

• Foot shape and arch structure
• Areas of increased pressure
• How the person stands
• How the person walks
• Footwear
• Differences between the left and right sides
• Movement through the feet and lower limbs

The important difference is therefore individualisation.

You may benefit from an assessment if you experience persistent or recurring discomfort in your feet, ankles, knees or hips, or back pain where foot and lower-limb mechanics may be relevant.

The feet provide the base of support for the body. At Custom Made Insoles, we look beyond the feet alone to assess how you stand and walk, and how movement through the feet and lower limbs may relate to symptoms elsewhere.

However, mechanical pain in the body, legs or joints does not automatically mean you need orthotics.

The first question should be: Why is the problem occurring?

Once we understand the factors contributing to your symptoms, we can determine whether individualised foot support may be appropriate.

Yes, orthotic insoles can help with plantar fasciitis and heel pain as part of an individually assessed treatment plan.

At Custom Made Insoles, our three-arch orthotic insoles are designed to redistribute load beneath the foot. Appropriate support may help reduce excessive strain on the plantar fascia—the strong band of connective tissue running beneath the foot from the heel towards the toes—and make standing and walking more comfortable.

Our assessment approach considers the wider body framework, including posture and movement through the pelvis, torso, neck and shoulders. Where relevant, we also consider reported pelvic-floor tension and whether assessment by an appropriate practitioner may be helpful. We look at these areas alongside the feet to understand the individual's overall movement and how they bear weight.

The feet bear load under gravity and encounter forces from the ground during standing and walking. We therefore consider both the support beneath the feet and how the person moves above them.

Depending on the individual findings, we may recommend additional care alongside orthotics, such as sports massage, postural alignment therapy, physiotherapy or osteopathic assessment. The treatment and number of sessions depend on the person's needs; additional treatment is not necessary for everyone.

Pain along the inside, or medial arch, also needs assessment. In some people, increased inward rolling of the foot may contribute to strain through the arch and plantar fascia, although arch pain can have other causes.

Persistent heel or arch pain should therefore be properly assessed rather than simply covered with additional cushioning. Our aim is to understand the contributing factors and combine appropriate foot support with any additional care needed to reduce symptoms and improve comfort.

Orthotics can provide support and influence loading for some people with symptomatic flat feet.

However, having flat feet does not automatically mean something is wrong.

Many people naturally have relatively low arches without experiencing pain.

The important question is whether the person's foot structure and movement appear to be contributing to discomfort or difficulty with movement.

People with high arches may concentrate pressure beneath particular areas of their feet because load is distributed differently.

Appropriately designed orthotics may help redistribute pressure and provide support where required.

A high-arched foot should not automatically be given exactly the same type of arch support as a flat foot.

This is another reason individual assessment matters.

Pronation is a normal part of human walking.

The question is not simply whether somebody pronates. We need to consider the amount and timing of that movement and whether it appears to be contributing to the person's symptoms.

Where appropriate, an orthotic may influence foot movement and redistribute forces during walking.

They can in some cases.

Pain beneath the ball of the foot — sometimes described as metatarsalgia — may be associated with excessive pressure through the forefoot.

Appropriately positioned cushioning, metatarsal support or an orthotic designed to redistribute pressure can sometimes help.

However, forefoot pain has several possible causes. Persistent, severe or unexplained pain should be properly assessed.

The feet, ankles and knees work together during standing and walking.

Changing support beneath the foot can influence forces and movement further up the lower limb.

For some people, foot mechanics may therefore be relevant when investigating knee symptoms.

However, knee pain has many possible causes and orthotics should not be presented as a treatment for every knee problem.

Assessment is important.

The feet form part of the body's movement chain, and changes in foot mechanics can influence movement elsewhere.

However, this does not mean that every hip or back problem originates in the feet.

Orthotics should not be promoted as a cure for back pain or sciatica.

Instead, we assess how the individual stands and walks and whether foot or lower-limb mechanics appear relevant to their overall movement.

Changing what happens beneath the feet can sometimes change aspects of how somebody stands or moves.

However, posture is influenced by many things, including joint mobility, muscular strength, previous injuries, habits, neurological control and individual anatomy.

We therefore prefer to assess how the feet and lower limbs function within the person's overall movement rather than promising that an orthotic will simply “correct posture”.

Yes. An orthotic can influence how pressure is distributed through the foot and may influence aspects of walking.

That is precisely why the orthotic should be appropriate for the individual.

At Custom Made Insoles, we are interested not only in what somebody's feet look like while stationary but also in what happens when they stand and walk.

New orthotics normally require an adjustment period.

Some people become comfortable with them quickly, while others may need a couple of weeks or longer.

New orthotics are generally introduced gradually rather than immediately being worn all day.

The aim is comfortable adaptation — not forcing your body through significant pain.

New orthotics may initially feel unusual because pressure is being distributed differently beneath the foot.

Being aware of new pressure is different from experiencing significant pain.

Sharp pain, persistent rubbing, numbness, blistering or worsening symptoms should not simply be ignored.

If an orthotic is causing significant problems, it should be reviewed.

Many people can wear their orthotics throughout their normal daily activities once they have gradually become accustomed to them. However, how many hours you should wear them—and whether you need them longer term—depends on your individual condition, symptoms and response to treatment.

For example, someone using orthotics for plantar fasciitis may not need to continue wearing them long term once their symptoms have resolved. Others may benefit from ongoing support because of their particular needs.

At Custom Made Insoles, we base our advice on the individual. A reassessment can help determine whether continued use is appropriate or whether wear can gradually be reduced.

Wearing an orthotic does not make foot strength and movement irrelevant.

An orthotic provides or changes support and loading. It does not replace the muscles of the feet and legs.

Where appropriate, strengthening, mobility work, general activity and suitable footwear may be used alongside orthotics.

Orthotics and exercise do not have to be opposing approaches.

Our orthotic insoles can be worn in a wide range of everyday footwear, including shoes, Wellington boots, boots, steel-toe-cap footwear and work boots. The important thing is that the foot and orthotic fit comfortably together inside the footwear.

At Custom Made Insoles, we generally recommend a simple shoe design with a firm, relatively rigid, flat sole and a comfortable fit.

The toe box does not need to be unusually wide. It should suit the natural shape of your foot, allowing your toes to sit comfortably without being cramped or compressed. There should be enough room for your foot to settle comfortably onto the orthotic.

We recommend avoiding memory-foam footbeds when wearing our orthotics. Memory foam compresses under load, and our preference is for a firm, stable base beneath the orthotic.

Whenever you buy new footwear, take your orthotic insoles with you and try them inside the shoes before purchasing. This applies equally to everyday shoes, Wellington boots and work footwear.

The lifespan of an orthotic depends on its materials, construction, frequency of use, activity levels and the individual. A durable orthotic shell may last for years, while top covers, cushioning and other components can wear more quickly.

At Custom Made Insoles, our orthotic insoles have an expected lifespan of approximately 10 years, depending on use and individual circumstances.

There are three key circumstances in which we ask you to contact us to discuss reassessment:

• Significant weight gain, for example around 22 lb (10 kg).
• Surgery that may affect your movement or how you bear weight.
• An injury to your body that may affect your movement or how you bear weight.

Please reach out to Custom Made Insoles and talk us through any changes, problems or concerns. We can advise whether your orthotics need to be reviewed or whether reassessment would be appropriate.