Sports Injuries and Foot Orthotics: Prevention and Recovery
This is a guest post from Pedorthotic Association of Canada looking to increase awareness of foot orthotics among athletes.
Foot orthotics, commonly referred to as shoe inserts, are used for a number of purposes including:
- Arch support
- Correction of overpronation and oversupination
- Treatment of lower limb injuries like plantar fasciitis
- Improving athletic performance
Image 1. Example of semi-custom insole with various inserts in the background.
Research can be challenging due to the complexity of the foot, with dozens of joints, bones, and muscles that all work in concert during exercise and sport. Each person’s ‘normal’ and thus pathology is different in subtle but important ways. For this reason, there is no one-size-fits-all orthotic. Studies show that different podiatrists, orthotic specialists and pedorthists will prescribe completely different orthotics for the same patient. Additionally, the effect of the same orthotic on different patients with the same condition (such as overpronation) can vary widely.
The Placebo Effect
Image 2 and 3. Examples of over the counter orthotics
Oversupination & Overpronation
Custom and Semi-Custom Orthoses
The study did find that CFOs and SCFOs both reduced eversion velocity in a statistically significant way. Comfort was also studied, and while CFOs were considered significantly more comfortable than SCFOs in the foot arch, differences in comfort elsewhere were statistically insignificant. This suggests the main advantage of CFOs over SCFOs in helping pronation issues lies in foot arch comfort.
Hume et al found that semi-rigid custom orthotics have “a moderate to large effect on treating and preventing plantar fasciitis and posterior tibial stress fractures, and small to moderate effects in treating patellofemoral pain syndrome” (Hume 208). This same review found that “further research with randomized controlled trials is needed to establish the clinical utility of a variety of FOs for the treatment and prevention of various lower limb injuries.” For this reason, we postulate that foot orthotics likely help with injury recovery, but the degree of benefit and which disease states respond to this treatment requires further clarification.
- Munteanu SE, Scott LA, Bonanno DR, et alEffectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trialBritish Journal of Sports Medicine 2015;49:989-994.
- MacLean C, Davis IM, Hamill J. Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners. Clin Biomech (Bristol, Avon). 2006 Jul;21(6):623-30.
- Davis IS, Zifchock RA, Deleo AT. A comparison of rearfoot motion control and comfort between custom and semicustom foot orthotic devices. J Am Podiatr Med Assoc. 2008 Sep-Oct;98(5):394-403. doi: 10.7547/0980394. PMID: 18820043.
- Hume P, Hopkins W, Rome K, Maulder P, Coyle G, Nigg B. Effectiveness of foot orthoses for treatment and prevention of lower limb injuries : a review. Sports Med. 2008;38(9):759-79.