Q: When I wear certain kinds of shoes, I feel pain in my knees and hips. Someone suggested I need orthotics in my shoes. How can that help?
A: Some shoes, but not all of them, don’t offer the support you need to keep your body properly aligned when your feet hit the ground. You may feel pain any number of places in your lower extremities, such as your heels, your ankles, your knees, or your hips, and sometimes the pain can be delayed for a few hours so you can’t immediately see the cause and effect between the shoes and your discomfort. You may simply think you’ve been standing on your feet too long, or you’ve been exercising too hard. In any case, maybe it’s time to see a podiatrist. Orthotics — which are molded devices that slip into your shoes to correct foot function — might be just what you need.
Underlying the issue of whether your shoes are properly supporting your feet is the likelihood that something is simply “off” in the biomechanics of your stride. Biomechanics is the study of how the movements and forces of the foot affect the movements and forces in the lower body—and vice versa. Podiatrists are uniquely trained to understand how these forces work together, and how to diagnose and correct the problems that occur when all the muscles, bones, and tendons of the lower body don’t work in harmony.
Abnormal foot and lower body function give rise to a wide range of painful conditions that might include: bunions, arch and instep pain, shin splints, ankle and heel pain (plantar fasciitis), as well as painful tendinitis and bursitis in the knees and hips. If your goal is to relieve pain, heal your body, and get back to living an active life, then you may need a custom-made orthotic device to address your specific foot problem.
What are Orthotics?
If you came into my office and complained of hip, knee, ankle, or foot pain, my first suggestion might be to try a store-bought insert for your shoes (also called insoles) to provide some shock absorption for your feet when you walk or run. Or perhaps a heel cup if your heel is sore. But keep in mind that these provide little, if any, biomechanical control or support. If you can bend an insert in half, it is nothing more than a comfort aid.
After that, I’d suggest that what you really need is something that can reduce the strain on injured parts of your body so they can heal and free you from pain. I’d do a complete workup to evaluate the biomechanics of your gait and posture and body structure, and help isolate the cause of your pain. If we determine you need a foot orthotic, I’ll take a plaster impression of each foot and send it to a lab that makes custom-fitted devices just for you. (I usually prescribe orthotics as a pair so both feet are aligned and work together.) Orthotics slip into your shoes to relieve stressed tendons, correct fallen arches, provide shock absorption, help align and support the foot or ankle, and generally correct your specific foot problem.
I always say that orthotics are like eye glasses for the feet. You can’t really change the mechanics of the foot, just as you can’t really change your eyes. But you can compensate for the functional inadequacies with a device that is prescribed just for you.
While many people benefit from orthotics in shoes worn every day to work or play, I’m also well aware that athletes have a particular need to make sure that feet, ankles, and legs function efficiently and painlessly. I’ve prescribed orthotics for runners, soccer players, basketball players, golfers, tennis players, football players, and everyday gym rats to ensure great performance and great enjoyment when doing the things they love to do.
– Dr. Shier