When Custom Orthotics Do More Harm Than Good

A couple of years ago, an ultra runner came in with pain in his foot.  Pain that he had been dealing with for quite some time.

Even though he had enough knowledge to know that it didn’t make a lot of sense to artificially support his painful feet with a pair of custom orthotics, like so many other people that find themselves in pain – he was still searching.  

Searching for why he wasn’t capable of running or even training for the 50-miler in a couple of months.

While I was working with him, he told me a great story I like to share with my Kinesiology students. He said, “When my daughter was little, I remember a time when my whole family was playing a game in the yard.  At one point in the game, her ball rolled onto our gravel driveway.  Without giving it a second thought or even changing her stride my daughter ran across the yard and right onto all of that gravel in her bare feet.”

Right after I finish telling that story, students will often talk about how they rarely wore shoes when they were growing up.

And how they loved that feeling of being barefoot.

No matter how much I try not to talk about their base of support, in every class, we end up talking about how their feet are supposed to interact with the ground.  

(Principles)

When you combine the way your feet are supposed to interact with the ground with the reality that gravity is constant, it’s easy to see that rather than your feet adapting the ground they’re being forced to adapt to those pebbles in your shoes. 

Since that’s how your chain moves, it’s difficult to imagine how the cultural code for everything from plantar fasciitis to lower back pain has led to the experts blocking motion throughout your feet.

If we’re being honest orthotics are just one more attempt at chasing the pain.

Or believe it or not, relying on the next best guess.  🙄 

There’s no legitimate research to show that custom orthotics are correcting or aligning anything.

And who was it that said you need correcting or aligning anyway?

Rather than stand stationery like a building, we’re talking about an amazing array of movement that’s available to you.  

Dynamic-movement that allows you the freedom to navigate planet Earth in more ways than most people can imagine.

When experts mention orthotics correcting or aligning something, besides the fact that they stand to profit from their recommendation, suggesting that either are possible shows they don’t have a complete knowledge of human movement.  

Sure they have a title, but that hasn’t stopped them from working from a position of first-layer knowledge.

Referring to custom orthotics in a 2011 New York Times article entitled, Close Look at Orthotics Raises a Welter of Doubts, “The vast majority of our patients are happier having them than not”.

What does a statement like that even mean?

When I improve a muscle’s ability to contract in a client’s suspension system (read: core), without touching their feet clients consistently walk away much happier. 

And that’s without anything blocking motion of their feet.

And if they still have any lingering pain in their base of support, I’ll address muscles throughout their thighs, legs, and feet.

So not only do they walk away from my treatment table with muscles that are capable of holding up their feet without any artificial support they’re actually running in a shoe with less cushion and little-to-no support.

(Preparation)

When our feet are functioning without any outside support even the slightest amount of arch support has the potential to cause pain. Pain that resembles that of plantar fasciitis.  

If we just focus in on our feet without even considering the role that our suspension system plays in all of this; when our base of support reaches a certain level of strength anything that pushes up from below is a stressor to the muscles that are capable of playing their role.

Rather than moving in the direction of being more fragile as we grow older (which is what custom orthotics do!), we should be working on moving in the opposite direction. 

(Curiosity)

If you think back to the interactive image of a golfer in my most recent post on plantar fasciitis, once explained, it’s pretty easy to see how custom orthotics do more harm than just weakening your feet.

When you have the audacity to look beyond cultural norms, it’s easy to see that there’s no legitimate science behind orthotics.

In fact, all they do is drive your foot away from the pain.

And here’s the kicker, you can’t drive a foot that includes 28 bones and 33 joints in one direction, which just so happens to be the opposite way in which your foot is supposed to move at that time and not expect another body part to also be driven in an abnormal way.

Orthotics are what they are. 

Imagine confining any other joints, ligaments, muscles, and the surrounding area to a cast for years.  

Only to address the symptoms.

As my students start to see the synergistic relationship that their feet have with everything else, they not only start to wear zero-drop shoes, they also throw out their custom orthotics.

To give you an idea of how much of an influence understanding human motion can have, a former student from a class that just graduated used to ride bulls as a professional.  Rather than wear cowboy boots on a regular basis, he wears LEMS Shoes for casual wear and for his work as a massage therapist.

In the class before that, students started wearing Inov-8 shoes, and the first zero-drop running shoes (affiliate) that actually resemble the shape of your foot.

A student in my current class just picked up a pair of Vivobarefoot shoes for massage (affiliate).  I’ve also had students look into Xero Shoes.

To reinforce how misunderstood your foot is, in class, I make a point to mention that if they’re capable of grasping all of the things that we’ve talked about over a few days, I should be able to walk right across the street and share the same message with the chiropractic students.

Since the chiropractic students are paying somewhere in the range of $200,000 to eventually put the letters DC after their name, they should be capable of understanding the science of biomechanics.

If it turns out that the chiropractic students are capable of seeing what my kinesiology students have a working knowledge of, and they still go out and sell custom orthotics in their own practice, well, that doesn’t sound like the right thing for anybody.

I don’t know how you would frame that, but I’m going to go right ahead and say that with all of the different ways in which custom orthotics can wreak havoc on your chain, that is unethical.

(Priorities)

Or to paraphrase professor Cal Newport, it’s the opposite of deep work.  Which means that if your arches are pressed right up against those pebbles in your shoes, whether you know it or not you received nothing in the way of value.

Last week, one of my students told me that she bought custom orthotics one time, and when she turned them over, there was a sticker that read, “may cause fatigue”. She also said that for the short time that she wore them they felt very awkward.

In any other circumstance, if something didn’t feel right or was downright uncomfortable to walk in, rather than chalk it up as another lesson learned I’m thinking you would ask for a refund.

But that option is not a part of the game that is being played.

Said another way, if you went to a specialty running shoe store, and after wearing the shoes for short periods of time throughout the first week of having them they still felt very uncomfortable, I’m thinking you would return them.

Sidebar: anytime you see the word, “custom” before orthotics, know that they’re not as custom as you have been led to believe.  

If you don’t believe that right now, by the time you finish reading what I have to say about custom orthotics –  I’m thinking that you will.  

 
Custom orthotics are #NotForHumansClick to Tweet!

If after reading this you can’t see how badly custom orthotics mess with the human chain, it’s more than likely due to the fact that you see yourself as an expert on foot function.

Rather than look at custom orthotics for what they are, it’s much easier to continue to sell molded casts for feet that are supposed to be capable of absorbing shock and adapting to the ground.

Both of which custom orthotics don’t allow for.

Rather than acknowledge the role that the muscles play in all of this, it’s much easier for an expert to ignore them altogether.  Not only muscles throughout your feet but muscles throughout your entire chain.

“A man much smarter than I am once described a “racket” as something that “is not what it seems to the majority of the people,” where only a small group of insiders know what’s really going on and they operate for the benefit of a few and at the expense of basically everyone else.”

— Ryan Holiday, from TRUST ME I’M LYING

How many people have pain in their feet and are looking for answers?

Whether you know it or not, due to the first-layer knowledge that comes straight out of the mouths of the experts you’re only given options that have been repeated over and over again only to provide lackluster results.

I’ve seen many runners that had the level of pain that the ultra runner came in with that day, and they’ve gone in the direction of a cortisone shot.  A shot that more often than not comes up short.

And not only that, besides masking the BIGGER issue with a super potent anti-inflammatory, a cortisone shot has also been shown to have a negative impact on cartilage.

And when they’ve chosen not to take that path, they’ll choose a less expensive Band-Aid (i.e., Kinesiology Tape).

When those weak attempts at clearing the pain while still addressing the symptoms don’t go according to plan, working from a place of desperation, an individual will end up resorting to placing their base of support in an environment that forces their feet to adapt to the rigidity that comes right along with custom orthotics.

<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/05/Custom_Orthotics.jpg" alt="A pair of custom orthotics lying on a table" width="500" Height="334" /></figure>

For more information, hover over this image. photo credit: My orthotic shoe inserts via photopin (license)

Given enough time spent interacting with the ground in such an awkward way can be unpleasant in more ways than one.  (For more information, hover over the image above.)  

If you’re thinking short-term custom orthotics can be very difficult to walk away from. 

And before you know it, the damage is already done.

(Prevention)  

If we know one thing about the human chain, it’s that it is very good at adapting (i.e., compensating).

So even though the expert didn’t point this out before they went in the direction of recommending custom orthotics, the truth is, you were compensating before that.

<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/05/Foot_Function.jpg" alt="Feet of four athletes running" width="500" Height="333" /></figure>

For more information, hover over this image. Photo Credit: Emanuele Vercesi via Compfight cc

Since custom orthotics aren’t capable of getting to the root cause your brain will figure out a different movement strategy.  

A workaround that allows for a whole different compensatory pattern.

A new workaround in which you will be capable of advancing forward.  But with less efficiency. Meaning, it takes more effort to cover the same ground.  (For more information, hover over the above image.)

This is where hearing the story, aND Being Able to Look beyond the expert’s First-Layer knowledge Comes In Handy.  

(Leverage)

Having worked with the human chain for over two decades now, I can tell you that I’ve never seen a base of support that needed custom orthotics.  

What I have seen is a lot of experts that don’t understand how your foot actually functions (in any environment!).

I have also seen a lot of people that find the “quick fix” very enticing. Usually out of desperation.

If the custom orthotics are pitched in just the right way, that molded device will drive your foot away from the pain.  But now your foot is being forced to move in a way that is far from what could be considered efficient movement.

What the expert forgot to tell you is, the pain was the symptom.

So even though you don’t have the same pain in your feet, there are much BIGGER problems at play here.

Bigger problems that have only just begun.

The bottom line is, rather than those 33 joints serving as a mobile adapter to whatever is underfoot, instead, your feet and the entire chain are forced to adapt to that prefabricated device that is in your shoes.

And I do mean forced! 

[ ➡ Note: The following conversations with the experts took place on Twitter after publication. ]

[ Note: @KevinaKirby never answered the question.  🙄  ]  

I wrote this because I wanted to shine some light on something that is very difficult to deny, but yet is not acknowledged nearly enough, and that is: Custom orthotics have failed people for many years.

And being that that is the case, it’s not only time to ask different questions, it’s also time for the experts to put their egos aside.

Rather than continue to hide behind a title, it’s time for the expert to serve up information and results that go way beyond the half-truths that first layer knowledge allows for.

To take this story a step further, when it comes to pain and/or an injury, as long as it doesn’t require surgery, it’s much easier to get people out of pain than the experts profess to. 

 

<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/05/overpronation_foot.jpg" alt="A foot that is over-pronating" width="500" Height="375" /></figure>

photo credit: ankles via photopin (license)

 

I have seen a lot of feet that had muscles that weren’t capable of contacting at the right time, in the right direction, or at the right joint.  In order to see the human chain from that vantage point, questions have to be asked. 

Questions that require deeper thought, and produce (much!) more value in return.

“Test-and-learn doesn’t sound all that painful. However, baked into this approach of acting on questions via constant experimentation is the near certainty of failure–and not just one failure, but quite possibly many, each bringing some level of disappointment if not actual pain.”

— Warren Berger, from A More Beautiful Question

Rather than look at the role that the muscles play in all of this, it’s much easier to ignore your entire muscular system completely.  If for no other reason than, it takes clock hours to address muscles.  And there are only so many hours that can be spent at work in a day.

Rather than go right to the *source*, it’s much easier to reach for the band-aid.

What happens to muscles that you’ve been told are too weak to hold up your arches?

They don’t get stronger.  (emphasis added)

And since there are a lot of muscles in your feet, what happens to the muscles that were strong prior to using those custom orthotics?

All of those muscles also get weaker.

Besides the story that the expert is telling you, there is a whole other story that often goes unnoticed.  

It’s so sneaky that it regularly flies under the radar. Rather than continue to ignore it, consider the story that the expert has been telling themselves for all of these years.

Stories that make the predicaments that we find ourselves in seem much bigger than they really are.  

When you combine those stories with the pain that you’ve been experiencing that sensation has a way of driving you to do things that aren’t contributing to your overall health.

If you were to hold the expert’s feet to the flame, their decision to put your feet in a cast stems from fear (i.e., false evidence appearing real).

Not facts. Or even logic.  But rather – FEAR.

So don’t let the expert’s false evidence impact your reality!

SHIP.

(Art)

If you found this post on custom orthotics to be educational, and you feel like somebody that you know could benefit from the information that I have provided here, I would greatly appreciate you sharing this post.  You can do this by emailing it to a friend, family member, colleague or feel free to share it on Facebook. 

A BIG thanks in advance.  (:D

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Photo Credit:  My orthotic shoe inserts via photopin (license)

Photo Credit:  Emanuele Vercesi via Compfight cc

Photo Credit: photo credit: ankles via photopin (license)

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I have held a license to practice massage therapy for over 20 years. For the first 18 years of my career, I was a nationally certified personal trainer. During that time, I completed thousands of one-on-one personal training sessions. I went on to teach biomechanics to personal trainers, group exercise instructors, and physical therapists throughout New England. I worked as a sports massage therapist at ESPN. Over the last few years, I have been quoted in Runner’s World UK, Massage Therapy & Bodywork, Massage Magazine, IDEA Fitness Journal, Massage & Fitness Magazine, and The Guardian Liberty Voice. I have also served as an applied biomechanics consultant for the fitness staff at Canyon Ranch, The Greenbrier, and ESPN. For the last 7 years, I've been teaching applied anatomy & kinesiology at Parker University. I have a private sports massage therapy practice in Dallas, Texas.