Are Custom Orthotics Worth It?

If you are a frequent visitor to Foot and Ankle Associates of North Texas in Grapevine or Keller, TX, you probably already know about orthotics. Maybe you have even purchased orthotics.  

Custom Functional Foot Orthotics

A foot orthotic is an insole placed into the shoe that helps control foot position. There are two main types of orthotics: Functional and accommodative. These can be prefabricated; like Lyncos that are popular at Healthy Steps or custom; which the doctor fabricates unique for your feet. A functional orthotic controls foot movement and helps a person walk in a way that best supports joints and muscles. An accommodative orthotic helps distribute foot pressure evenly over the bottom of the foot.  Most patients use a functional orthotic and usually these are custom for long term usage.  A functional orthotic can be useful for many problems and are used to balance the biomechanics of your feet. Think of them as an in-shoe tire realignment for your feet. Accommodative orthotics are very useful to distribute stress in the elderly, diabetic and arthritic populations.

In the foot care aisle at your local drug store or grocery store, you may have seen readymade orthotics for sale.  Does it really matter whether you buy store bought orthotics or custom orthotics from your podiatrist?   Well, some people may be able to get away with wearing store bought orthotics for a period of time. We even start with these type of prefabricated devices so we can get you on the road to better foot health quickly, but most patients do need custom for long term control of their foot type.

When you think about the long term health of your feet, custom orthotics are the way to go!  Store bought orthotics are made to fit many foot problems for a large variety of people; one size fits all usually means one size doesn’t truly fit anyone!  To be truly effective, an orthotic must be fitted for YOUR particular needs.  Wearing an ill fitted orthotic is not only a waste of time, but it can also make your foot problems worse.  Over time these problems can lead to leg, knee, hip, and even back problems. Store bought orthotics tend to not offer long lasting comfort. 

If you find yourself buying store bought orthotics every few months because of foot pain, it may be time to schedule an appointment to see one of the doctors at FAANT. Your podiatrist will produce orthotics that fit only YOUR feet.  The materials used will be those that are best suited for your walking and running needs.

Everyone deserves special treatment! With a real custom orthotic that is exactly what you have. Yes, custom orthotics can be costly, but so can surgery from walking incorrectly over the years.  I’m always amazed that insurance companies will often not cover orthotics, but will pay for surgery! Doesn’t make any sense!! Think of the orthotics as an investment and an investment in your health is one of the best choices you can make for yourself.

Does Running Cause Arthritis?

Is it a foregone conclusion, that if you run for years, you will have arthritis? Many of my patients are concerned that the aches and pains that are inevitable from distance running are actually harbingers for the future aches and pains of arthritis. This fear is even strong enough to get older runners to quit and start a lower impact exercise regimen like swimming and cycling. Is this a reasonable fear? Yes and No! Running by itself does not cause arthritis; improper biomechanics coupled with the rigors of running can cause arthritis.

Consider the stress of running on the joints for a minute. The foot hits the ground and the bones and joints experience force up to six times the runner’s body weight at impact. The joints are being asked to move and glide efficiently and smoothly while enduring this stress. In the event of a misstep or stumble, the joints need to continue to be stable to maintain their perfect alignment.

Osteoarthritis, a.k.a. “wear and tear arthritis”, is what runner’s dread. This is degeneration of the articular cartilage which absorbs shock, distributes stress and allows the joints to glide smoothly. The ability to run pain free depends on the health and integrity of this cartilage as we age. In osteoarthritis, the surface of the cartilage becomes roughened, fissured and even starts to shred into small fragments. These fragments “float” around the joint and cause more damage. The bone tries to protect itself by producing small bony prominences called osteophytes which actually in the end make the joint damage and pain worse.

Any kind of sports participation can increase the incidence of osteoarthritis due to increased twisting forces, high impact, muscle weakness or over-development and joint instability which causes abnormal peak pressures and greater stress in certain areas of cartilage which can lead to osteoarthritis. Nevertheless, for normal joints , there is no scientific evidence that simply the action of running, even over a long period of time, causes permanent joint damage or even a predisposition for osteoarthritis.

What is the risk of osteoarthritis in runners? Many studies of long-term runners show no increased incidence of osteoarthritis in these competitive runners. Some studies did show more evidence of osteophytes, but no correlation with joint pain or instability. Confusing the issue for many runners are the numerous incidents of misdiagnosis of repetitive stress injuries like patella-femoral syndrome as arthritis. This is reversible and caused by abnormal tracking of the kneecap, which is treated with physical therapy and orthotics.

Joints are in fact strengthened by activity and damaged by inactivity. Studies have shown that the articular cartilage actually thins and becomes more fragile with inactivity, therefore increasing the risk of arthritis. Joints adapt to the stress of exercise and become stronger and more able to endure the long term stress of running. Remember the doctor saying to increase slowly? This is why. Ligaments and muscles, which support the joints, are strengthened and reinforced by the stresses of the running activity, improving joint mechanics, if the joints are properly aligned.

Here is the truth about foot biomechanics. Proper biomechanics during the strengthening process is essential for joint health. Improper biomechanics can increase the stress on the joints in an abnormal fashion and actually increase the incidence of osteoarthritis and hasten joint damage.

Bottom line? Running does not increase the incidence of osteoarthritis unless the lower extremity biomechanics are faulty. In fact, almost 75% of Americans over the age of 65 experience some symptoms of osteoarthritis. This is not increased in runners. In fact, running may actually help with the symptoms of osteoarthritis.

The benefits associated with long distance running profoundly overshadow the risk of osteoarthritis. In runners, orthotic devices to correct their biomechanics early in their training may actually decrease the stress associated with increased osteoarthritis. If you have joint symptoms, see a sports medicine podiatrist today and have your gait realigned. Your joints will thank you. Remember, your feet are meant to carry you for a lifetime. Don’t let the fear of osteoarthritis rob you of the joy of a lifetime of distance running!