Ask us any question you have about orthotics or shoes by going to the bottom of this page and leaving a reply to this blog. We’ll try to answer within a couple of days.
We look forward to hearing from you,
Larry Huppin, DPM Doug Hale, DPM
Dr. Douglas S. Hale
Specialist in foot and ankle biomechanics/orthotics and reconstructive surgery at Foot and Ankle Center of Washington
Douglas S. Hale, DPM, is an advisor for the International Foot & Ankle Foundation for Education and Research. He graduated with honors from both Tulane University School of Engineering and the Dr. William M. Scholl College of Podiatric Medicine. His engineering background gives him a unique perspective treating your problem biomechanically or surgically and believes in doing what is best for your medical condition. If all options for treating your problem “biomechanically” are exhausted, he provides the same level of capability and experience with surgical solutions.
Latest posts by Dr. Douglas S. Hale (see all)
- How Do Ballet Dancers’ Feet Change? - October 4, 2013
- Cold Feet in Seattle – Learn how to warm your toes - May 15, 2013
- Seattle Child Soccer Players are At More Risk of Ingrown Toenails - May 10, 2013
I am currently wearing an AFO on my left foot and leg I HAVE A DROP FOOT DUE TO AN ANUERYSM WHEN I WAS 12,I AM NOW 63 I CANNOT FIND SHOES THAT FIT COMFORTABLY WITH THE AFO.also i’ve only just starting wearing the afo inthe last 3 yrs
I love this website! I do not live near these doctors, but take their advice along to my podiatrist.
I have my second AFO and have experienced the same problems with orthofeet, which did fit my old AFO.
With frustration, I was in like with some shoes by Apis. They make Mt. Emey’s. The come extra deep and wide, but do not let that scare you. They also come with orthotics that can bring a ( D ) to a size ((B) on the non AFO shoe. We ordered a size larger (the place who makes the brace will help you).
They can insert material in the toe too!
I ordered two pairs after wearing Orthofeet (still do around home or going out) and having them fit to me the sane time.
Worth checking out. Their customer service is great with free shipping both ways.
Hope this helps as AFO ‘S are a tough one when it comes to shoes. Good Luck!
Janet
What are your opinions on the new minimalist running philosophy touted in, for example, C.McDougall’s “Born to Run” book? The philosophy behind running barefoot or using “minimalist” running shoes (Nike Free, Vibram Five Fingers, etc.) seems logical, i.e., our body was designed for running…why introduce foam padding, orthotics, pronation correction, etc. to interfere with one’s natural running gait? What would you advise to someone who wants to experiment with such a minimalist running style? I assume that a very slow “break-in” period would be necessary given that one’s body has been conditioned over a lifetime by the significant shock absorption of traditional running shoes.
Thanks.
Hi Mike,
I’ve actually seen a number of patients lately who have developed injuries using minimalist shoes, but on the other hand I’ve seen a lot of patients with injuries who were wearing regular running shoes.
There is forum called Podiatry Arena that has some of the top foot biomechanists in the world participating. There was a recent discussion on barefoot running and minimalist shoes on Podiatry Arena. Craig Payne, an Australian podiatrist and a top biomechanist, provided an excellent summary of the issue and I would have to say I agree with him 100%. I could never say it as eloquently as Craig, so I’ll quote him here and then refer you the thread on Podiatry Arena.
From Craig Payne on Podiatry Arena:
“We were created to run barefoot to survive, so we can move camps, can hunt for our food, etc. But that was before concrete got invented and we started to run for fitness, recreation and competition rather than survival (but given the obesity epidemic we may need to run for survival in the near future!). Because of the invention of concrete, we needed another invention – the running shoe.
Running barefoot comes in two forms. Those that do it in moderation as part of a balanced running program and those that use it as a philosophy that underpins their running. It is this later group I have a problem with. They are like religious zealots that are fanatical about it. They use nonsensical non-scientific mumbo jumbo to support what they do. They use any piece of evidence that is negative about running shoes as “proof” that barefoot running is better. They grasp at straws to misrepresent other research and dismiss any anti-barefoot research. They claim there is research for it, but when you look at the research, it does not support it – they misrepresent what the research is showing (…and even when you point that out to them, they continue to claim it supports them).
At the end of the day, there is not one piece of evidence that shows barefoot is even ideal, let alone beneficial. Yet do an internet search for barefoot running and look at the extraordinary range of claims being made for the benefits of it. HOWEVER, there is no evidence that it is not beneficial either. Yet the fanatical supporters of barefoot running quote a wide range of research to support their cause. When I read the reference list for the claims, not one piece of the research says what they claim it says. Trying to discuss rationally with these people is like trying to argue a religion – you never going to win that argument.
They also like to be dismissive of claims by Podiatrists that running barefoot is not good as Podiatrists have a vested interest in foot orthotics. That is just silly nonsense. Podiatrists will, generally, always be motivated by what is best for the patient and if the evidence says that barefoot running is beneficial, then they will be recommending it. There are even Podiatrists who are barefoot runners! I love the way the fanatics claims that Podiatrists are anti-barefoot running because of the orthotic $. They need to come up with some better evidence and data than that silly argument.
There have been some very balanced discussions on Podiatry Arena on barefoot running; certainly more balanced that the fanatism and zealotry seen on some running forums to do with barefoot running.
I not opposed to barefoot running; it is just I want good evidence to guide me as to what runners should and should not be doing it; it probably should be done in moderation as part of a balanced running program; and the zealots need to get over it”
Click here to read the thread on Podiatry Arena:
My son is almost 8 and is wearing orthotic for the last year. We are having difficulty finding him a pair of shoes (athletic) that are comfortable and extra wide. Any suggestions?
I have had great luck with the New Balance and Saucony brands of kids shoes for my pediatric patients wearing orthotics. Most of the models have removable insoles which makes it much easier to use an orthotic.
I have sort of a silly question. I have been wearing orthotics for plantar faciatis since about the first of the year. I have a problem with my inserts squeeking in my shoes. It doesnt happen in all my shoes. I have tried powder and putting a cloth in between. Nothing has helped. Do you have any suggestions?
Great question. First, here is our page on squeaky orthotics. Some other solutions are to use more powder than you think you need, use a dryer sheet under the orthotic and if you are still having problems, have your podiatrist narrow the orthotic just a little bit in order to decrease friction between the orthotic and the shoe. Also, silicone spray on the bottom of the orthotic can help.
RESUBNISSION:
I have multiple feet problems making shoe selection frustrating after visiting 3 specialty shoe stores.
Issues:
-LT side drop foot(stroke related). Using a rigid AFO ON ONE FOOT.
– 2 DIFFERENT SIZE FEET PARTLY DUE TO POOR BUNION SURGURY RESULTS+AFO issue (10.5-3E ON RT FOOT, 9 4E+ ON LT FOOT WITH AFO.
-UBABLE TO TIE SHOE LACES DUE TO LEFT ARM AFFECTED BY STROKE.
Questions
-are ther any better solutions for one handed shoe lace tying other than velcro or “curly” laces?
-is the FREEDOM® Soft Footdrop Brace helpful for drop foot?(less problematic in fit than the rigid AFO)
– altenatives to “fill” shoe on smaller foot for better fit?
Any suggestions would be helpful. Thanks
If you have halux valgus (bunions) from overpronation and later ankle instability, besides exercises and orthotics, would negative heel shoes be beneficial?
There is no evidence that we can find that would indicate that negative heels would help hallux valgus (bunions). On the other hand, there is no evidence that they hurt a bunion either.
I have a Morton’s Neuroma that flares up now and again. I have store bought orthodics with a Spenco cushion positioned on it. I am going to Disney World and will be walking all day. What shoe would you recommend? Also, if I use a Spenco cushion in one shoe, do I need to use one in the other?
If a patient has forefoot valgus, and he/she also has painful metatarsal heads, what material would you most likely recommend for the lateral wedge?
Regardless of material, using a valgus wedge when a patient has metatarsal head pain will increase pressure under the metatarsal heads and likely lead to increased pain. Because of this I don’t use valgus wedges on patients with metatarsalgia.
Doctors
I have partial foot drop but walk good barefooted. With shoes on Lifting my shoe is to weak and I need a AFO. It seems to me if I bought a minimalist shoe that is easy for my partial foot drop to lift up easier like being barefooted this would solve much of my problem. I did use a AFO with a typical shoe which felt like being reliant on it and making my weakness more by not using my weakend foot drop muscles. Would a a NIKE Free 3 or Nike 5 be good to try? Thanks Doctor
Would suggest a light but stable shoe. People with foot drop have to be careful they do not trip and injure themselves. Suggest you consult your local foot and ankle physician regarding your foot drop, shoe and brace options.
I just purchased Dankso Soltice to try the rocker sole for ball of foot pain. It slips up and down on my heel. Is this okay or should I return them?
Dansko clogs often slip up and down a bit. Some people are fine with this and it bothers others. If it bothers you then return them. If not, and it’s just a little slipping, I wouldn’t worry about it.
I recently purchased custom orthotics at your office and am now wearing them full time. They feel pretty good, unfortunately they make my shoes squeak and it’s driving me crazy. They squeak a bit less if I lace my shoes really tightly, but then my feet hurt. Is there something I can do to stop the squeaking?
Usually baby or anti-fungal type powder in your shoes resolves the squeaking. You can find more detailed info on squeaky orthotics here.
What are your thoughts and opinions on these shoes?
http://www.merrell.com/us/en/barefoot
I normally wear orthotics.
Thanks,
Michael A.
You can read our opinion on minimalist shoes here.
I just bought a new pair of New Balance cross trainers, and the shoe store guy commented that my custom orthotics were outdated because they use a hard plastic in the arch, and a hard material on the heel section. He said I need to get the “newer” version orthotics, which are softer and allow the foot to flex properly. My orthotics don’t really bother me, but what do you think? (I have bunions & overpronate).
There is nothing in the medical literature that would support what this salesperson is saying. Almost all studies show that the most effective prescription for a particular orthosis is dependent on the condition being treated treated and the function of the particular foot. Given that, most studies are very clear in showing that orthotics that tend toward being more rigid are more effective at treating the majority of foot conditions for which orthotics are used. I don’t want to sound dismissive but this guy is simply a salesperson. He may be the best shoe salesman in the world, but regardless of what he thinks he has no medical background and should not be talking about what he doesn’t understand.
How do I know if my custom orthodics are the right ones for me? I am now at a new dr. and my new orthodics are so different than my old ones.
Can orthodics correct a supinated foot?
Thank you!
You would need to find a podiatrist with expertise in orthotic therapy to evaluate your orthotics. As far as correcting a supinated foot, it depends. Orthotics can certainly treat many of the problems caused by an over-supinated foot. No orthotic, however, can permanently change foot structure.
I’m a runner and recently had a lot of pain on the top of my foot. My podiatrist believed it was because I was overworking my foot muscles. He suggested that I get “custom” orthotics, so I got Dr. Scholl’s after standing on a fancy machine. I have a few problems though: I can’t fit both my shoe insert and my new orthotic into my shoe, but if I don’t have my shoe insert in my shoe, the sole of my shoe is too hard, and I end up hurting my toes. I can’t really get new shoes, but is there any way to tie my shoes differently so that my heel doesn’t move up and down with every step?
Thanks!!
Hi Elizabeth,
This is a very common problem in runners. The most common cause of pain on top of the foot in runners is a condition called “dorsal compression syndrome.” Use the link to read about it.
As we explained at the link, flattening of the arch causes compression between the bones on the top of the foot leading to the pain. Custom orthotics that conform closely to your arch provide the most relief because they do the best job at stopping the foot from collapsing.
Unfortunately, the Dr. Scholl arch supports are not likely going to help. They are not custom orthotics and are not even very good over the counter orthotics. You can read our review of Dr. Scholl arch supports here.
Your best bet is to get a custom orthotic from a podiatrist who knows how to make “total contact orthotics“. If you can’t do that, or can’t find someone in your area who is experienced in treating dorsal compression syndrome, then you should get a good over the counter arch support. We review our favorite OTC orthotics at different price points here.
Regardless of which one you use, you need to remove the sock liner from your shoe before putting in the OTC or custom orthotic.
Hope that helps!
Larry Huppin
I am an incomplete para and use nifty, light and small toe off AFO’s on both feet. My right leg is the weak side and the left foot is a drop foot. When I work custom fit heavier AFO’s, I was able to have it molded to correct the severe pronation on my my right side. Now, there is no such correction and I find walking much harder in some ways and my right foot ends up pointing even more at a right angle. Is there some way to add an orthotic to my get up? Or, do I just have to back to the old, heavier, harder to get shoes for arrangement? (Pre SCI, I had custom orthotics to correct that pronation.)
You will want to find a podiatrist in your area who is an expert in orthotic therapy and have a pair of foot orthotics constructed to correct the pronation. They will go on top of the foot plate of your AFO.
These orthotics will have to be prescribed so that they include features to control the severe pronation. A standard orthotic will fail.
Yes!Yes! Thank you so much. I was hoping the orthotic would be worth a try. Of course, insurance may have something to say! What a great place
Dear Dr. Huppin,
I have planters fasciitis of both feet and have had surgery on my right foot. My foot and ankle doctor here made orthotics for me but they are very hard and uncomfortable. I am a nurse and retired last year early partly because my feet were hurting all the time. I also have mild lower back scoliosis and wear a lift in my shoe on my right foot. So needles to say I have lower back pain alot also. I went to Walmart and did the test there to find out what kind of Dr. Scholls orthotics would be good for me. I have been wearing them now for awhile. They help but I still have heel pain if on my feet most of the day. My feet are very small and it is hard to find shoes that give me good support. My doctor told me I have fallen arches but the arch of my feet are high and my foot is narrow. I usually wear between a 2&1/2 to a 3. In sneakers I usually wear a 3 unless it is made real big.
So you see noone makes shoes in my size. I have gone to those walk stores and of course they do not have any shoes in my size. I would like to wear sandals but can’t find ones that I could put my orthotics inside. I also use memory foam heel inserts on top of my othotics to help with the pain. They help a little for awhile. Do you know who would be able to either make shoes for me or have children shoes that were specially made for orhtotics? I am frustrated because childrens shoes are not made well unless I go to Dillareds or sports shoe stores where I might find better tennis shoes. I would like to wear other kinds of shoes besides tennis shoes. When I find sandals in childrens size I wear them without my orthotics because they do not fit. I know that is bad but I try not to wear them for too long of a time. I hope you can help.
There are some really well made children’s shoes from companies like New Balance and Sacouny. Where do you live – I might know of a good children’s shoe store somewhere near you.
Thankyou for your reply. I live in Mesa, Az. I would appreciate it if you could give me names of places where I can find them.
The doctors at Desert Foot and Ankle are excellent.
Thankyou for your reply. I live in Mesa, Az.
I have recently been recovering from a stress fracture on the top of my left foot I wore a boot most of the summer and have been wearing chaco’s which my foot really likes. But I live in Utah and they will not do when it gets cold which is soon. I am looking for a shoe that would be good for a stress fracture to wear casually and a walking shoe for exercise, your list was great but I could not find any of them at our stores is there a more current list
The list is current, but there are often geographic differences. The list, however, should be a good guide to shoes, even if the exact model is not the same.
To prevent stress fractures, the most important thing is to have an orthotic in your shoe that will reduce pressure on the metatarsals. This requires an orthotic that conforms very close to your arch. Read here about these total contact orthotics.
Dr. Hale,
What type of orthotics does your lab in CA make? I have a pair of really rigid orthotics made out of a white material. They only go under the heel and arch. I have a high arch. They are very painful to wear. I have a severe case of plantar fasciitis since Oct. 2011. I’m wondering if your place makes orthotics that have more flex in them and are the full length type. My plantar fascia is partially torn. Right now I’m wearing the powerstep pro full length and they are very comfortable but my condition isn’t getting any better.
Thanks.
We have detailed information on what the current best research shows are the best orthotics for plantar fasciitis here
Can you get a custom orthotic that conforms very close to the arch(total contact) and has a little flexibility to it so it isn’t completely rigid against your foot?
Thanks
I have a multitude of foot problems, mainly stress fractures which haven’t really healed, high arches, and bunions. I’m also about 40 pounds overweight and suspect I have arthritis in my ankles (both broken years ago). Needless to say, my feet always hurt.
I recently found that my regular work shoes (low chunky heels and casual flats) weren’t providing enough suppport – my feet would swell and even show bruising. So I started wearing walking shoes and the support helped immensely. I got away with that for about a month and then my boss said I needed to find something more appropriate for work, which by the way is a small casual construction office in Florida. I am at the front desk so I understand a little, but they know I have feet problems.
So, I went shopping. Spent about $100 on 3 or 4 pairs of shoes, and none of them are wearable beyond 3 or 4 hours. I was literally limping, and so have gone back to wearing the same old loafer type shoe I’ve worn all year. They are falling apart and have no cushion at all anymore. A pair of Dr Scholl’s orthotics are helping a little, but I can’t afford to waste anymore money on shoes that hurt and am afraid of causing more damage to my feet. The shoes on your recommended list are not available locally or are too expensive for me.
What I want to know, is there any good literature I can show my boss to try to convince him to let me wear my comfortable shoes again? At least until I lose some weight? I don’t have the money right now to spend on going to a Dr. to get a note, because I don’t think my insurance would pay for it or certainly not all of it.
Thank you. You’re info so far has been awesome.
I think it is critical that you get in to see a good podiatrist who can diagnose your problem and provide you with a logical treatment plan. From your description, I don’t think this will be terribly difficult to treat.
Hi,
Just wondering if you got the email system working so that you could email me the new, updated shoe list. I talked to somebody last week and they wee going to try.
I’m hoping to make an appointment soon for my orthotics and hope to shoe shop before I come in.
Thanks much,
Terri
I just have a question about wearing articulated/ hinged afo, I have had mine since October last year and was nervous about wearing it t first. The reason for the afo is I have ankle instability issues, but anyways as I started to wear it more and more tilli stared wearing full time except when sleeping stuff like, I have noticed when I’m not wearing it my ankle seems to be weaken so I depend on the brace. Is this normal for my ankle to be weaker and will I also lose muscle in my calf as well? Also over time will I alway need the hinged afo or will I end up with a different type of afo?
Thanks
Without an examination I can’t tell you if or how long you will need the brace. I can tell you that any patient who I put in a brace also gets a strengthening and balance program in order to maintain their strength. I recommended seeing a sports medicine podiatrist or physical therapist in your area for a strengthening program.
I have been running with support shoes (ASCICS GT-2000 and Kayano), but I have chronic PTT of the right foot. I consulted a podiatrist who was been making orthotics for 55 years in the St. Petersburg, FL area and he cast me for hard plastic orthotics which he said I should wear on top of the sock liner. I found that a bit strange in that I had the pleasure with working with one of the pioneers in the field, Dr. Richard Schuster, of Schuster labs in the 1970’s and after almost 2 years working with me, I was able to run pain free and went on to win three national running titles. These were leather topped orthotics (which I still have) and they were used in place of the sock liner. Does it sound legitimate to wear the orthotics on top of the sock liner? Mine will be ready in a few days and I will be able to see how it feels.
Hey Sandy,
In general it is the shape of the orthotic rather than the material that determines how effective the orthotic will be for a particular condition. In a case of PTT the goal is to reduce tension on the PT tendon as much as possible. You can find information on how we approach that here.
Newer materials such as polyproylene allow me to achieve the shape I want in a device that will last much longer than the old cork and leather devices – which had a tendency to wear out very quickly. In addition Poly can be adjusted to more flexible when needed.
Given that, however, I always like to use a cushioned cover on orthotics for runners. There are some good studies showing that the cushioning can reduce shock during runnning. More info on running orthotics here. You can also find some recommended prefabricated orthotics there.
That’s wonderful, by the way, that you had an opportunity to work with him) and he was a brilliant guy. Let me know if you have other questions.
Hello,
I am interested in an orthotic that will help me develop my calf muscles. Is that possible? When I do calf raises, it seems my toes (especially big to) lift, too. I don’t want to build my told muscles. Is it possible to have an orthotic that (maybe prevents toes from moving and thereby) forces calf growth?
Sometimes, also, when I do calf raises, I get an intense burn under me feet (soles) before my calves fatigue. Any orthotic to prevent that?
Thank you,
Tony
An orthotic is not likely to help develop calf muscles with one exception. If you have very flat feet and you get a very good flat foot orthotic, then you will be in a more stable position when you do calf raises and will get more normal function of the muscles of the calf. But that orthotic is only putting you in a position so the calf muscles work the way they should. There is no orthotic that will develop calf muscles simply by wearing it.
The orthotic may help with the fatigue by supporting the arch so the muscles of the arch do not have to over work to support you. Read the flat foot page at the link above for recommendations on custom and prefabricated orthotics for flat feet.
I had a total knee replacement in August and have had to wear an AFO brace on my right foot ever since. I am a dancer and want to know if a jazz boot would be better to wear than a regular jazz shoe.
Not necessarily. The upper portion on jazz boots are not usually stable and it is often more difficult to fit an AFO into a boot than into a shoe.
Hello,
I have quite high arches and have been wearing custom orthotics for the last 24 years with varying degrees of success. Lately I have metatarsalgia in the balls of my feet and I can’t go for even a 1 mile walk without being in mild to mid-level pain for days afterward.
I am reluctant to go to a new podiatrist, because EVERY time I go they always tell me the same thing: “Oh, those orthotics you’re wearing now are lacking A, B, and C, but the orthotics i’m going to prescribe to you have A, B, and C (and sometimes X, Y and Z), and will work much better. Thank you for your $600 (insurance does not cover). Oh, and be sure to stretch your calves (I stretch my calves daily)”. Then I wear the new orthotic, and still have the pain, and I go back to the podiatrist and they make an adjustment or two to the orthotic. I walk out, pain stays. I go back, and the podiatrist starts to treat me with disdain, because my foot pain is obviously all in my head. And then it’s $600 down the drain along with about $120 in copays. I literally have 20 pairs of orthotics sitting in a bag in my garage, none of which give me relief.
Questions: Do you recommend any orthotics specialists in the LA area? One that prescribes/manufacures total contact orthotics? Maybe one that even specializes in high arch treatments? Will special socks help, metatarsal sleaves?
I also wear NewBalance Rocker bottom shoes. I’m 6ft4, 195lbs (lost 45lbs over the last 3 years) It hasn’t reduced my foot pain in the slightest.. I want to be physically active, but can’t. I’m 46 and it’s very depressing.
Thanks for any advice you can give me.
That sounds really frustrating. In the LA area I would recommend Dr. Doug Richie. The goal when treating metatarsalgia due to excessive forefoot pressure is to 1) Reduce pressure and 2) provide cushion. This page has a lot of suggestions (although I know you have probably tried most of these). Given your history, I would highly recommend you see Dr. Richie.
Hello Dr. Huppin. Thank you for your reply. I will check out Dr. Richie. Was there supposed to be a hyperlink in the phrase “This page has a lot of suggestions”? if so, it did not come through. Could you please repost the link? Thank you!
My mom has drop foot, she is 83. We have a very hard time finding shoes that work. She has 2 braces … The only thing that works is high top boot like shoes. We can’t find them anymore. Can you please help…?
You really should see a podiatrist near you who specializes in orthotic therapy. Without an exam there is little I can tell you.
can orthotics be worn inside a shoe with non removable memory foam insoles?
Depends on the depth of the shoe and the thickness of the orthotic. Sorry to be vague, but the answer is “sometimes”.
I was just about to ask the same question I bought two pairs of sketchers with memory foam in them the young lady said that their sewn into the shoe but I could see that if you work with them hard enough the memory foam will come out and you could put your orthotics in because that’s what I’m going to try to do
Are orthotics always worn in both shoes, even if you only have a problem with 1 foot?
Yes – you want to maintain symmetry
I would like to know if an Articulated AFO with plantar flexion stop will help with supination? I am asking because I have both a foot drop and supination. I also have another question concerning shoes the foot that has the supination and foot drop is 2 sizes smaller than the other and the ankle is weak pes cavus deformity tendon surgery. Would it be better to buy to different size shoes.
Some, but not all AFOs of that type will limit excessive supination. You’ll want to work with an orthotist or podiatrist who is experienced with that type of bracing.
Yes, theoretically it would be better to buy two different shoe sizes. There are some sites that help with finding mismatched shoe sizes. Just google “mismatched shoes”.