Orthotics provide a stable platform in a neutral position, so almost everyone will benefit from wearing them! Some cases that will certainly perform better in an orthotic include:
Pronation is necessary to our gait, but over pronation will put pressure on the medial knee and lower back. To check for excessive pronation, try to insert three fingers under the instep of the person who is standing in stocking feet. Insertion to the first joint of your finger is healthy. Inability to slide your finger under the persons instep to your first joint in an indication of flat feet, or excessive pronation. Ideally we want a 90 degree angle between the back of the leg and the floor. A strong pronator will have a reduced angle at the medial ankle bone.
Medial Knee Pain
Repeated medial knee pain may indicate excessive pronation.
Hip pain may indicate excessive pronation or a leg length difference. It may also indicate faulty function in the hip. An orthotic will provide stable and neutral ground forces for less stress on the hip.
Back pain after running
As above, an orthotic will help to support all joints including the back.
Uneven leg length
What is important is how much difference there is! If it is more than one centimetre our body must compensate. Suspect an even leg length if you see single foot pronation, an uneven belt line, uneven shoulders, or back of the head that is not level. Walking or running on a long leg is equivalent to running on one high heel! Ouch!
Dropped metatarsal heads
Check for calluses anywhere under the ball of the foot. This may mean the met head is getting repeated pressure on it. Pressure can be evened out with an orthotic.
Heel spurs or sore spots on foot
Sometimes the bony structure of the foot has a sensitive spot due to a heel spur or bony malformation. A cut out in the orthotic will allow space for the spot so it’s not stressed.
Bunyans, or an enlarged first toe joint
This may be caused when there is repeated stress on the first metatarsal phalangeal joint (MTP), and is often due toe excessive pronation. For some people the first toe is very rigid and doesn’t bend well with the toe off. Osteoarthritis may form in this joint, causing a sensitive and enlarged knuckle. An orthotic can help by distributing the weight evenly among all the toes or by allowing a cut out for the first MTP, reducing the pressure.
Repeated Shin Splints
Shin splints are micro stress fractures in the tibia (shin) bone. An orthotic can help cushion the landing part of the gait and soften the ground forces shearing into the leg.