Part 1: Orthotics! Can They Improve Your Running Performance?

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?