19 replies to this topic

[Davo]

Has anyone ever successfully weaned themselves off orthotics?
I developed plantar fasciitis in the left foot about 18 months ago and was prescribed orthotics for both feet. Seemed fair enough, an orthotic in just one foot would have made me unbalanced. But they were never comfortable, although I wore them all the time except when sleeping.
Anyway, they seem to have done the job, the p.f. has gone and I'm wondering if I should start to wean myself off them. Theoretically now there's no need for me to be wearing them, and as I said, they've never been comfortable.
My podiatrist, of course, says that I'll have to wear them for the rest of my life, but I wonder if she is just generating business?
Has anyone had similar experiences?

[Ultraphil]

No,
But am thinking about getting myself weaned off the orthotics. They never seem to go all the way to the toes and consequently I seem to develop a blister or two right on the balls of my feet! (between the orthotic and the rest of the shoe!)

Phil

[JC]

If the orthotics fixed the pf problem, wouldn't it just come back if you stopped wearing them?

[Jogger]

I've had/got pf and am using orthotics. Mine are very comfy, so much so that I will not wear shoes if I can't wear orthotics.

Maybe you need to be changing orthotics, or podiatrist .... Can recommend mine at Gladesville ...

[PurplePete]

I've also had pf and using orthotics. Mine are also comfy, as they have a soft covering on top (and below) the hard orthotic that goes to the end of the shoe.

I know a guy in Marrickville (not a podiatrist) who makes orthotics, who could possibly put a cover on your current orthotics.

He also makes new orthotics using a new system called FAS (foot alignment system), which takes alot of the guess work out of orthotic design.

see here

[RLS]

I haven't worn my orthotics for the last 3 years and have not had a major reocurrence of the dreaded PF. I found some running shoes that best suited me and I also switched to wearing supportive everyday shoes, namely Birkenstok.

[Chris B.]

Davo,

I have been wearing orthitics for over 15years now. High arches that sag and caused my to collapse the side out of runners in about 3 -4 months. Orthotics have stopped that and when ever I don't wear them I get sore feet and legs.
I considered weaning my self of them also but the physio did not think it was a good idea.
I am considering seeing a sports podiatrist and see what they think.

I would love not to have to wear them but it is a small price to pay for being able to run and not destroy my feet and runners.

[daveb]

I've also had pf (nightmare) and have been wearing orthotics for 6 years. Pod said to wear them all the time. If I'm running on soft surfaces I sometimes uses shoes without the orthotics but I don't really find them too much of a drama and I'm that scared of getting plantar again I'm not prepared to risk not wearing them.
Guess it would make sense to get an opinion from a second Pod.
Good luck
Daveb

[Chris B.]

It sounds like most orthotic wearers here are using the half solid fibreglass/resin type with a half or full top cover.
I found these to stiff for running and managed to track down a company that make a more flexable version made from a rubber/foam material.
These are cast to your feet and are made full length, so no rub spots or sole destroying bases.

They may be an alternative and a way to wean yourself of solid orthotics.

[Ultraphil]

Chris,

thanks for the info about flexible orthotics (rubber foam) on the message board. I will ask my podiatrist when i get in to see him.

Thanks

Phil

[PodRunner]

Hi Davo,

I've worn orthotics since 1984, to correct patella tracking problems and the agony of 6 months left me in 7 days. I was so impressed I studied podiatry.
Since then, the technology in shoes has improved considerably, but very few people have symmetric feet . I try to encourage patients to see their orthotics as "customizing their running shoes" as opposed to a pair of Forrest Gump calipers!

As for soft orthotics, I wear them in spikes and racing flats where weight matters, but the average runner can put up to 4 times their body weight through each foot at heel strike with fast running. Imagine how much a soft orthotic will deform under the 300kg heel strike of a 75kg runner.

The bottom line is over-use. The more exercise you do, the more a small biomechanical misalignment can become a major injury.

One important thing to remember is that orthotics do not heal you, but can help to reduce the forces which initially caused the problem. Think of it as preventative medicine...better to not get injured in the first place.

Certainly some acute problems treated with orthotics will heal in time and the orthotics can be retired, but if your problem is of the gradual onset, chronic, worse with increased exercise type, you should get re-assessed before you give them up.

Personally, I love mine because I couldn't run without them!

Cheers, Andy

[Chris B.]

I have been using the soft orthotics for many years now. The last couple of pairs have lasted about 2 years before wearing through and flattening a little. My present pair are starting to wear and I'm looking at another pair soon. I have stepped up the running/training in this last year and guess that is why they are wearing out in jst over 12 months. Mine I put in all my shoes and runners, even hike up Bogong to go ski touring with a 25kg pack in them <_<
That puts a fair load on the orthotics !
Actually the only shoes they don't go in are sports sandles and my rock climbing shoes.
Yes I do notice my legs when they start to flatten, hence time for a new pair. Even a year a pair I figure is good value considering I get a fair bit of that back. I save that on runners. ;)
I would not go back to solid orthotics now in runners. Two pairs could be an idea if not too expensive.

[PodRunner]

Davo,
Forgot to add that fibreglass/polypropylene orthotics come in four different thicknesses ranging through flex,semi-flex,semi-rigid and rigid.
What we use depends on the weight of the patient and the type of problem. Plantar fasciitis usually responds best to a moderately high arched , semi-flexible orthotic, as this reduces the workload of the p.fascia itself.
Big advantage over soft orthotics is that they retain their shape/don't compress, unlike soft orthotics. All orthotics should have a thick soft topcover for running however.
Andy

[Chris B.]

Andy

your postings have been most informative.
Any suggestions for a Melbourne Northern Eastern Suburbs podiatrist who understands runners feet ?
May be now worth a second opinion ;)

[PodRunner]

Hi Chris,
One with a good reputation in Melbourne is Matthew Mollica. 03 9326 2220
Cheers,
Andy

[Steve 'The Footman']

Davo with regards to the original question about weaning off orthotics I think the answer depends on how much your biomechanics was related to the original problem.

You can have OK biomechanics and just hurt your plantar fascia in a minor incident. It gradually gets worse over a few weeks and you have an injury. Orthotics will speed up the healing process but it would probably get better by itself within 3 months anyway. This also means that you are not at any more risk of getting the problem again if you go without orthotics. If they were never comfortable then you need to decide if they were suitable anyway. There are certainly other people who have structural issues that require orthotics forever. Going years without injury does not mean that you are protected either because your feet can change.

When it comes to the issue of whether to use the hard plastic/fibreglass orthotics or to use a softer EVA orthotic I differ from what Andy/Podrunner believes. In my podiatry practice I find I get better results with the fulllength softer EVA orthotics and patients find them much much more comfortable.

I am not convinced that harder materials give more control. Firmness is what is important and you can achieve that just as well by having a softer material that can work with the shoe and has no gap between the underside of the orthotic and the inside of the shoe (so no bowing). You should also remember that orthotics do not hold your foot in a neutral position but rather they redirect your feet as the foot rolls over and deforms upon it's surface.

The other major advantage of a full length orthotic is they do not try to control your forefoot from the rearfoot. Instead of having to finish where your foot bends they have a smooth transition zone and the correction can be extended to the forefoot. A rearfoot device is close to useless for midfoot/forefoot runners as well during propulsion when your heel is off the ground.

So if you have been unhappy with your rigid rearfoot device then it is worth trying a more comfortable full length EVA orthotic if you feel you still need the support.

[Davo]

Steve, I live on the north side of Brisbane and one of these days I'm going to come and see you in your professional capacity.
My p.f. started with my training for the Melbourne marathon of 2002. It was only my second marathon although I'd run about 14 half-marathons over a period of eight years before that. I think it was just plain and simply increased mileage. I'd never had trouble with my feet before.
But I take very seriously the observation that if I give up the orthotics the original problem will come back.
At the moment it's not as bad as it was when I first posted, so I'm plodding on.
Maybe I'll even catch up with you at the Doomben half on Sunday eh?
Davo.

[PodRunner]

Hi Steve,

"Davo,
Forgot to add that fibreglass/polypropylene orthotics come in four different thicknesses ranging through flex,semi-flex,semi-rigid and rigid.
What we use depends on the weight of the patient and the type of problem. Plantar fasciitis usually responds best to a moderately high arched , semi-flexible orthotic, as this reduces the workload of the p.fascia itself.
Big advantage over soft orthotics is that they retain their shape/don't compress, unlike soft orthotics. All orthotics should have a thick soft topcover for running however.
Andy "

"When it comes to the issue of whether to use the hard plastic/fibreglass orthotics or to use a softer EVA orthotic I differ from what Andy/Podrunner believes."

"I am not convinced that harder materials give more control. Firmness is what is important and you can achieve that just as well by having a softer material....."

Aren't hardness and firmness the same thing in this context? The dictionary thinks so. Surely a 400 density EVA orthotic is "harder" and "firmer" than a semi-flex carbon-fibre orthotic.

Don't get me wrong- I also prescribe EVA orthotics for spikes and racing flats where weight is essential, but their tendency to warp and compress gives a very limited lifespan. All the areas under load will compress, effectively making the arch higher, and potentially causing blisters. All the sports orthotics I prescribe have a full length, thick,soft topcover also, so they don't feel any harder than a dense EVA orthotic.


You should read my posts more carefully.
Cheers, Andy

[Judster]

While on the issue of orthotics.
How quickly should they break down? I need to replace mine every 12 months. Granted I run in the National Parks & sand gets in my runners which causes a lot of the damage.
Can anyone recommend a good podiatrist in Sydney, specialising in running?

[PodRunner]

Hi Judster,
It's important to pull your orthotics out of your shoes after each off-road/sand session. Then rub your hand around inside your shoes to loosen particles which may have become stuck in the fabric of the shoe. This will reduce the wear factor.
On the subject of renewal, your podiatrist may still have your casts on hand, as the lab I use keeps the casts for 2 years. It is unlikely your presciption will change in this time.
Cheers, Andy