By Brian Toolan, MD
As the outdoor running reason winds down, you might be thinking about ways to prevent some of those nagging aches and pains next spring. My patients who are dedicated runners often ask whether they should be ordering custom-made foot orthoses (also known as orthotics or inserts) for their shoes. Some may be recovering from an overuse injury, while others believe custom orthotics will protect from the heavy pounding that occurs from running miles and miles each week.
Recent medical literature, however, reports that custom-made inserts may not work any better than over-the-counter insoles. In addition, customized orthotics can be pricey, ranging from a few to several hundred dollars, and most often are not covered by insurance plans.
Before you shell out a lot of money, try less expensive alternatives. You can purchase orthotics from your neighborhood drug, department or shoe store in a variety of styles and brands. I suggest runners go to a running shoe store because they have over-the-counter inserts that are designed for runners and the employees can assist with choosing an insert.
Most inserts are three-quarter length which means they extend only to the balls of your feet, not to the end of your toes. Because they are semi-rigid, these orthotics hold their shape well, but bend and twist slightly when you apply your body weight to them.
Look for inserts that have a comfortable, soft top layer that feels good against the sole of your foot, and a bottom layer that's firm rubber or plastic so it won't crack or tear. Try them on and take a run around the store to see how well they fit your foot, especially your arch. The contour of the orthotic's arch should match the shape of your arch. If it's too high, the increased pressure may feel uncomfortable. If it's too low, your foot may ache because of the lack of support.
Try these less expensive alternatives for a few weeks. If you like how they feel when you run, you're all set. Otherwise, visit your orthopaedic foot and ankle doctor to discuss whether the extra expense of custom-made orthotics would be helpful to the health and function of your feet.
One last thought: sometimes a runner's overuse injury has more to do with his or her running form than the shoe or orthotic. If you think that could be the case, ask an expert to examine your form and recommend changes that would eliminate the need for orthotics custom or otherwise. Also, be sure to work on strengthening and balancing, which can also help some runners avoid the need for inserts. A physical therapist can help.***
Brian Toolan, MD is an orthopaedic surgeon who is an expert in the care of foot and ankle disorders for adults and adolescents. He specializes in post-traumatic, arthritic and inflammatory conditions.
For more information about the Orthopaedics Center at the University of Chicago Medicine, visit us online at uchospitals.edu/ortho. With locations in Chicago's Hyde Park, Matteson and River Forest, the Orthopaedics Center at the University of Chicago Medicine makes access to an orthopaedic specialist easy. To make an appointment to be evaluated at any of the above locations, simply call 888-824-0200 (toll-free.)