Foot pain is never normal, and it can ruin your day. Shoe inserts and orthotics can help relieve pain, but they won’t cure your condition.
The need for an insert or an orthotic depends largely on the severity of your foot issue. But you may be wondering how to choose between the off-the-shelf brand and customized orthotics from a podiatrist. Your podiatrist should be your first stop for their recommendation.
“What we look at is how much functional control the foot actually needs,” says Dr. Matthew Robison, a podiatrist and the owner of Aboite Podiatry. “If someone has a flexible flat foot with no other symptoms, I may just recommend an off-the-shelf device, and that may be enough. If someone has a pathological condition or a deformity, then we need to control the foot’s compensation and that may require a customized orthotic.”
Dr. Robision explains that each patient is individually evaluated, screened, and diagnosed to determine their need. Off-the-shelf inserts and custom orthotics are both considered and offered at Aboite Podiatry.
Let’s take a look at some of the similarities and differences between off-the-shelf inserts and custom orthotics so you can start putting your best foot forward.
There are a few options when it comes to store-bought inserts.
You can simply grab one that matches your shoe size, visit a Dr. Scholl’s kiosk and have your foot scanned to find a match, or visit a store that will evaluate your foot and recommend an insert for you.
Off-the-shelf inserts will never be a 100% match to your foot and your needs because they are manufactured to fit a broad type of foot.
On the flip side, custom orthotics fit much closer to the contours of an individual’s foot and can be manufactured based on a person’s specific needs.
Custom orthotics are created using different methods, from using plaster of paris to laser scan of a foot that creates a 3-D image.
Dr. Robison explains, though, that despite advances in technology, traditional methods, like plaster of paris, remain the most accurate way to measure a foot and create an impression for a well-fitted custom orthotic. That’s why he prefers the tried-and-true methods.
“You don’t see the result from a laser scan the same way as traditional methods, the information goes straight into the computer,” he says. “It’s a little more difficult to interpret whether that impression is accurate when you have nothing physical to touch and inspect.”
COMFORT AND SUPPORT
Comfort is a bit of a tricky subject when it comes to orthotics and inserts.
“Comfort can be as simple as providing cushion to the bottom of the foot,” Dr. Robison says. “If someone comes in and wants comfortable arch support, I can pad it up and it may be comfortable but it’s so soft that it’s not supportive. We want a supportive device that is also comfortable.”
Custom orthotics can be made with a variety of materials, like hard plastic or carbon fiber. They come with a top cover made of ethylene-vinyl acetate (EVA), neoprene, or another material, which cushions the tactile sensation of the plastic against the foot.
“We take a rigid orthotic and make it more comfortable for a patient depending on how we pad it,” he says. “You can take a really hard, supportive orthotic and make it much easier to tolerate as long as you’re providing contact to the entire foot.”
If he’s building a custom orthotic and makes a cast of a person’s foot, it’s much easier to provide contact to the entire surface of the foot evenly, he says.
A store-bought insert may not provide that same level of contact as a custom orthotic because it may not line up exactly with an individual’s foot. But that’s not to say they’re uncomfortable.
“With off-the-shelf inserts, the support you get can be somewhat random,” Dr. Robison says. “That’s because the manufacturer knows it won’t be an exact match for every person’s arch, they have to allow some flex in the device so it’s tolerable to use.”
For foot pain that’s not a pathological condition or deformity, an off-the-shelf insert may provide all the support and comfort a person needs.
Dr. Robison says that the majority of times that he sees someone having a difficult adjustment to life with orthotics is because it’s a poor fit between the orthotic and a person’s shoe, not the insert itself.
“Custom orthotics can be fantastic,” Dr. Robison says. “But there’s an art to doing them, it’s about knowing the patient and their condition and knowing what they’ll do well in. I think that’s an important conversation to have with everyone who comes in for orthotics.”
LIFESPAN AND COST
The life of an insert or an orthotic depends heavily on the activity level of the wearer.
Because off-the-shelf inserts tend to be made from silicone gel rubber, neoprene and foam and aren’t form fitted, they tend to wear out sooner. Dr. Robison recommends changing out an off-the-shelf insert at least once a year.
With a custom orthotic, Dr. Robison says that the internal plastic device can last from 5 to 10 years. What wears out is the top cover, the cushion, which can wear out anywhere from 1 to 3 years. Fortunately, the top cover can simply be replaced — by sending it to a cobbler or your podiatrist — which prolongs the life of the insert.
“I probably use more over-the-counter inserts than I do custom orthotics,” he says. “I can give an off-the-shelf product to a patient on the first day I see them. If their symptoms calm down and they start feeling better, then I let them know all they need to do is replace that insert once a year and they’re good to go.”
Dr. Robison says that if someone wants a custom orthotic, it’s something they can look into, but it’s not necessary for everyone.
Off-the-shelf inserts can run from $20 to $50, while custom orthotics can run from $350 to $500. Orthotics aren’t always covered by insurance, either, though Dr. Robison is noticing it becoming more commonplace.
VISIT ABOITE PODIATRY FOR YOUR FOOT EVALUATION
If you’re experiencing pain in your feet, it’s important to remember that it’s not normal!
Our team of doctors at Aboite Podiatry is trained to identify and treat foot conditions and can help you decide if inserts or orthotics can make a difference in your life. Make an appointment to meet with one of our skilled podiatrists today by calling 260-436-3579.