By Michele S Jang, PT
When the feet are fitted for orthotics, the goal is for the foot to be positioned more ideally. So if the orthotics help the foot to be in a better position, why do they often feel so darn uncomfortable to wear? There are many factors that contribute to comfort while utilizing an orthotic or shoe insert. Here are some common reasons for discomfort.
Your foot has to adjust to being forced into a different position. The joints and ligaments themselves, even how the muscles function, may be altered over long- term abnormal positioning. Joints may be stiff and more rigid making adaptations demanded by the orthotics quite uncomfortable. Before being fitted for orthotics especially custom made ones, I recommend having the joints of your foot and ankle mobilized. Muscles may also be tighter which can contribute to abnormal tensions in your foot. These also should be stretched out adequately.
Another important factor is that shoes come in a variety of shapes and can serve different purposes. Furthermore, orthotics, whether over-the-counter or custom, don’t work in shoes lacking back of heel support as orthotics will simply slide backwards out of the shoe.
Heel height plays a factor as well. Our foot mechanics change from being in a flat position to rising up more onto our toes such as wearing heels. Most orthotics, however, do not account for and adapt to changes in shoe heel height.
Some shoes are made for special purposes. “Stability” type shoes generally have additional support built into the shoe, which provides posting to the heel to address excessive pronation, i.e flat feet. Placing an orthotic in a “stability” shoe may provide more support than your foot needs leading to discomfort. The same is true for shoes built to rock your weight forward.
I personally have 3 different pairs of orthotics I wear with a variety of shoes. One pair of orthotics is made for my dance shoes, another pair for my work shoes and a third pair to go in my running and hiking shoes. The shaping of the shoe may fit one orthotic and not another. Many aspects of a shoe allow an orthotic to work ideally. These include having a wide enough toe box, the ability to tighten the midfoot portion of the shoe and material firm enough to control your heel.
Figuring out the right orthotic for the right shoe can be challenging but is well worth the effort to get it right. Your feet will thank you. As with most things, you must build up your tolerance to wearing them. If you need guidance, we’re happy to help!
Michele S Jang, PT is a physical therapist who likes to look outside the box. She has been a physical therapist for over 22 years and has extensive training in manual therapy or the use of hands to help rehabilitate the body. Michele has taught both in the United States and abroad. Her clinic, Spirit Winds, offers Free Consults on Tuesday afternoons. Spirit Winds is staffed by a team of therapists who offer an array of expertise on exercise, fall prevention, foot and shoe assessments, body mechanics and proper breathing technique to increase awareness and healing. For information, call 805 543-5100 or go to [email protected].
