“Do I Need to Wear My Orthotics Forever?”

 Custom OrthoticsWe hear this question fairly regularly at our Seattle foot and ankle clinic and the answer is an unequivocal “maybe, maybe not”.

Most orthotic wearers can be put into one of two categories:

  • Those with severe mechanical abnormalities of the feet who will always need orthotics to prevent injury
  • Those who need support to heal an injury but may not need orthotics long term.

Why are foot orthotics prescribed?

One of the most common causes of foot pain, especially of chronic foot pain, is biomechanical dysfunction. In simple terms, this means that your feet and ankles are not working together properly and are likely out of alignment when walking, running, and even standing. Just as eyeglasses help to realign your vision, so do orthotics realign your feet and ankles to allow them to work together in harmony, as designed.

Suppose that, for example, you came to us because you were experiencing ongoing heel and arch pain. After taking a complete history of your complaint, along with a thorough examination of your feet, we prescribed for you a pair of custom made and personally fitted orthotics

And then let’s assume you get better.

Does that mean that you will always need orthotics?   Sometimes, but by no means always.

Some people do have foot types that place so much stress on tissue that they will always need orthotics. So for those people the answer is yes.  Common foot types that may need orthotics long term are those with either very flat arches or very high arches.

Others, however, may only need orthotics to allow their tissue to heal.  Once these people are better, they have two choices:

  • Decrease the load on the tissue by:
    • Continuing to wear the orthotics.
    • Losing weight.
    • Decreasing activity that causes pain.
  • Improve the ability of the tissue to handle load.  There are a number of methods to improve the load handling ability of the tissue, including:
    • Improved training techniques
    • Strengthening of the feet
    • Weight loss (yes, again)

Who Needs Orthotics Long-Term?

Some people have feet with quite severe functional problems. For example, someone with a severe flat foot may always place so much stress on their plantar fascia or the tendons of their feet that they may always need foot orthotics in order to prevent injury to those structures.

For those people with severe functional issues of the feet you can think of orthotics like a pair of eyeglasses. Think of it this way. If you’re having headaches that you believe are related to vision problems and you visit your ophthalmologist who prescribes a new pair of glasses for you. You wear the glasses for a couple of weeks and begin to feel better. Are you now going to stop wearing your glasses just because the headaches are gone? Not likely.

The same principle is at work when a patient with severe biomechanical problems of the foot is prescribed custom orthotics to relieve a painful foot condition. Even though you’ve begun to feel better, the underlying condition remains; just as your vision still needs correction, so do your feet.

Who Needs Orthotics Short or Medium Term?

Some people have a foot injury that requires orthotics to reduce stress on a certain tissue to allow that tissue to heal, but do not need to wear orthotics forever.

For example, let’s say someone is training for a marathon and has an injury of a tendon of their foot. They may have pretty normal foot function but they want to keep training for their race.

We can use orthotics to reduce tension on the tendon so that it can heal and in some situations even allow the patient to continue training normally.

Once the tendon has healed we can then work on strengthening the foot and that specific tendon so that over time the patient can reduce or eliminate the use of the orthotics.

How Long is Short or Medium Term Use of Foot Orthotics?

Feet live a rough life and take on much more force than most other body parts. Because of that they tend to heal slower than other body parts.

How long you will be in orthotics depends on many factors, including:

  • The specific injury
  • How active you are
  • How dedicated you are to your prescribed strengthening program
  • The activities in which you participate
  • Your foot and body biomechanics

In general, most people with fairly normal foot biomechanics who are dedicated to following a prescribed strengthening program can expect to need orthotics for 3 – 12 months.

What if I would rather wear my orthotics rather than doing exercises to strengthen my feet?

Even if you have fairly normal foot mechanics, sometimes it is easier to simply wear your orthotics than to follow a strengthening program to prevent injury. Strengthening programs take time and dedication. There is no harm if you would rather just continue to wear your orthotics.

Will orthotics weaken my feet if I wear them long-term?

There is no evidence that orthotics weaken the feet, and in fact some studies indicate that the use of orthotics may help slightly with strengthening your feet by allowing your muscles to function in a more normal position.

Strengthening your feet takes time and dedication and many people prefer to continue to wear their orthotics rather than do that work. There is nothing wrong with that.

If you would rather not wear orthotics long-term, however, strengthening programs work well for most people who commit to them.

The doctors at the Foot & Ankle Center of Washington, Dr. Larry Huppin and Dr. Doug Hale, are more than just local podiatrists. In fact, both Dr. Huppin and Dr. Hale have been named Seattle’s top doctors multiple times, and possess national reputations as experts in foot biomechanics and custom foot orthotics.

If you live in the Puget Sound area, and are suffering from ongoing foot pain, make an appointment with your Seattle podiatrist today at the Foot & Ankle Center of Washington.

Dr. Larry Huppin
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