Shoe orthotics are custom made shoe inserts that doctors (podiatrists, chiropractors and orthopedic MDs) use to help patients suffering from foot, ankle, knee, hip, or back pain.  The concept is that, since the feet are literally the foundation of a standing human body, any problems in the foundation will translate to problems further up the body.

If you stop to consider this, it makes a lot of sense.  You don’t have to have any special training to realize the connection.  For example, if the foot rolls inwards when walking (called prontation)  it can place twisting forces in the knee and hip.  This will require more effort from the locomotor muscles, which are not only your leg muscles, but also your gluteus (buttock) muscles and psoas muscle (major hip flexor) which attaches itself to the lumbar (lower back) spine.   This happens subconsciously behind the scenes, but you will definitely notice the effects: pain in the weight bearing joints, back stiffness, reduced mobility/agilitiy, and fatigue.

Take a moment to look at the soles of your shoes (find an old, heavy-used pair in your closet).  Are they worn out a lot more on the inner edges?  If so, chances are you are over-pronating.  This is common with people who have flat feet, or “fallen arches.”  If this is the case, a pair of shoe orthotics shaped in a way to counter the rolling-in action can be prescribed.  They may be rigid or semi-rigid, depending on what the doctor thinks is more appropriate.  If the rolling in can be minimized by the shoe orthotic, then there will be less twisting forces to the knee and hip, resulting in a more efficient gait (walking motion) and less strain to the lower back.

A May 2011 study in the Journal of Manipulative Physiological Therapeutics studied the effects of custom shoe orthotics on a test group of 50 people experiencing lower  back pain.  Some were treated for 12 weeks with the orthotics, some had no treatment, and some were treated for 6 weeks.  It found that from 0-6 weeks of treatment, there was improvement in subjective scores for pain.  From weeks 6-12, improvement was maintained, but did not continue to improve.  The people who did not use orthotics continued to experience the same level of pain.

These findings suggest that there is a relationship between foot biomechanics and lower back pain, and that improvements can be effected by correcting imbalances in the foot.  However, it also suggests that more studies are needed.  What I take from it is that orthotics prescription is appropriate when indicated for treating lower back pain, but must be complemented with other types of interventions, depending on the case.  This may include exercise rehabilitation, somatic exercises, nutrition, and spinal manipulation.

If you desire to get custom made foot orthotics, you can seek out the services of a podiatrist.  Some chiropractors can prescribe orthotics as well.  Two of the main brands chiropractors use are Amfit and FootLevelers.  An off the shelf brand that I have found success with is the WalkFit orthotics.  These come with a gel cushion for the heel and acupressure massage surfaces to help with blood circulation.  If you wear sandals, which can pose a problem for traditional, doctor-prescribed orthotics, the WalkFits come with sandal attachments.  Plus, they are a lot less expensive; less than $20.

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