Can orthotics improve your running performance? The simple answer is yes! This article will reveal some of the myths, misconceptions and benefits of orthotics, and inevitably how the correct orthotic may improve your performance on the track, trail or road. Many years of research and studies have shown how correct foot and ankle biomechanics can significantly cause an increase in power output and prevent the rate of injuries in competitive and recreational athletes by increasing muscle efficiency and decreasing excessive joint forces.
However, what the research doesn’t highlight is when orthotics have a negative effect on biomechanics and what style of orthotics generally cause a positive result, negative result or no effect at all. Those with experience with orthotics may already have their mind made up about the pros and/or cons based on their own personal experiences. For the rest of us, here is some background information:
First things first – what is an orthotic? My simple definition is that an orthotic is a device that is meant to create a positive biomechanical change or provide accommodation for the prevention or treatment of injury.
However, what you may not know is how many different styles and adjustments of orthotics there are. Orthotics are generally branded into two main categories; “off the shelf ” or “custom made”. Generally made from EVA foam, an off-the-shelf orthotic can be given by anyone and may be beneficial for some patients, though it is often over prescribed for others. Although there are many brands of off-the-shelf orthotic and it is possible to make tweaks to certain models here and there, the shape and density generally come pre- determined.
A custom orthotic is more specific, where a mould of the foot is generated and then scanned or pressed onto the material to create the insole. It is not when a cheap EVA or plastic orthotic is grabbed off the shelf and then modified to the foot as the patient sits in the room. This is because the shape of the shell is pre-determined and can therefore never be truly customised to the foot.
For patients who require a custom- made orthotic, a podiatrist will take into consideration the necessary variances to ensure the orthotic accommodates the foot without blocking out normal motions, and what arch height, control point and thickness the orthotic requires to work with the running shoe. A sports podiatrist will know how the laboratory they use (there are many different laboratories, but that’s a whole different story) creates the orthotic.
They should know how to decrease the bulk of an orthotic without compromising correction or comfort, the exact degree of change required to affect joint torques, and how ground forces created by the patient during walking and running may affect the surrounding joints and muscles – an important consideration in the prevention of injury.
Although some clinicians may argue there is research literature that has shown little difference in results between an off- the-shelf and custom orthotic, the right custom orthotic appropriately fitted to the athlete who requires it is a difficult thing to standardise, and I would contest that many of these studies were not well controlled. So how important is it to correct biomechanics at the feet? And once corrected, how can this affect power output or, at the very least, decrease the risk of injury?
Part 2: Orthotics! Can They Improve Your Running Performance?
So how important is it to correct biomechanics at the feet? And once corrected, how can this affect power output or, at the very least, decrease the risk of injury? To answer these questions, I put myself in the patient’s shoes and under the microscope.
The BioMotion Lab at Visy Park in Carlton is used by a number of elite athletes and sports teams, most notably the Carlton Football Club in the Australian Football League, and is surrounded by expert analysts and health professionals. It detects ranges in joint mnotion, forces in those joints, sequencing of force production, asymmetries and power output – all in 3D and without putting a single marker on the body. “If we know we can change these performance measures simply by adding the correct orthotic, imagine the possibilities for not only improving running times in an athletic population, but also decreasing injury by placing the body in a position of balance”.
In short, the results were incredible. The detailed report below demonstrates just how well modern-day technology is able to measure the ability of orthotics to create a change in performance and improve efficiency of movement. For example, without orthotics I generated a 50cm vertical jump, with hip and knee joint torques on take-off exceeding 45 per cent higher than the normal expected value in newtons. The ground reaction forces (GRF) were asymmetrical, with my peak GRF being 912.80 newtons (N – unit of force) versus 1614.44 N from left to right. With a custom-fitted pair of orthotics slipped into the shoe, the results were nothing short of remarkable, and the change was far more dramatic than I had expected.
My vertical jump increased by 5cm, with the GRF equalising to 1062.15N versus 1028.49N left to right, creating a balanced power distribution and force generation. Furthermore, the torques at the hip joint dropped by more than half on the left side and almost half on the right, with the left knee joint also showing a 35 per cent decrease in torque – a big deal considering excessive torque at the joint is a major cause of overuse injuries and increased degenerative changes of the joint, which can potentially lead to conditions such as arthritis. Many other positive results were found in a variety of movements tested. If we know we can change these performance measures simply by adding the correct orthotic, imagine the possibilities for not only improving running times in an athletic population, but also decreasing injury by placing the body in a position of balance.
The final critique for the pros and cons of orthotics is how they relate to footwear. Modern-day footwear is now designed to take into consideration all the latest trends, fads and, occasionally, some research. People have forever been debating the merits of Nike Air, adidas boost, ASICS Gel or the Brooks Mojo cushioning in relation to each other without taking into consideration factors such as heel-ramp height, density of foam/EVA in the midsole, and width of the forefoot – and how these affect the foot’s biomechanics. When comparing sprinters and long- distance runners, different ankle, sub-talar (rearfoot) and mid tarsal joint (midfoot) biomechanics will result in different torques and ranges of motion in the joints during gait. It is very difficult to self-analyse in assessing footwear, so how are you meant to know what “normal” feels like?
For those seeking to take it to the next level, establishing correct running technique is more important than anything else, as correct motor patterning means your nervous system fires the right muscles during running, which is important for rate of recruitment of muscle fibres to create power and speed production. However, sometimes to increase performance, biomechanical alterations are required. In these instances, added control via the shoe or an orthotic is a viable option. The shoe is limited in the amount of control it can provide because wear tends to disperses unevenly based on the way you run.
However, if you can generate a safe and regular wear pattern consistently in your shoe with an insole/orthotic, you increase the longevity of both the shoe and your body. If you need to be put in a big, bulky shoe then there’s more than half a chance it’s because you have poor biomechanics, whether they are stemming from your hips or your feet. Although understanding the body is important, an assessment by a podiatrist may be the best method for those wanting to improve their efficiency during running or movement to ensure their body achieves its best for an extended period of time.