Insoles can be prescribed to treat a wide range of foot problems.
Their primary function is to alleviate pain associated with abnormal forces that disrupt the normal function of the foot and ankle.
They are commonly prescribed for people of all ages, and many different designs and materials can be used.
Insoles can help with the management of many problems such as:
- Plantar fasciitis / heel pain
- Metatarsalgia / pain under the ball of the foot
- Morton’s Neuroma
- Foot / ankle instability
- Foot deformities
- Knee / Hip / Back and neck pain
- Leg length discrepancy
- Excessive pronation (foot rolling inwards)
- Excessive supination (foot rolling outwards)
- Sever’s disease
- Achilles tendonitis
Sizing
Insoles can be ¾ length (to just behind the ball of the foot), Sulcus length (to the crease of the toes), and full length (the whole length of the foot).
We can also use prescribe heel cups to optimise the alignment of the heel bone (calcaneus).
Materials
There are a few commonly used materials in the manufacture of orthotic
insoles. These include:
- EVA
- Thermoplastic – Polypropylene
- Carbon Fiber
- 3D Printed – Using a combination of materials
The choice of material will depend upon both the desired function of the device and durability, depending on the type of use it is intended for such as walking, sport and foot correction.
The clinician will consider the amount of control and correction that will be needed to get the best clinical outcome.
Common misconceptions about orthotic insoles
Q/ Can insoles change the shape of the foot?
A/ Insoles will not re-model the anatomy of the foot. This is particularly true in the case of the developing foot of a child. In the case of a ‘flat foot’ the insoles will not re-form the arch profile but will rather re-distribute any abnormal forces.
Q/ How important is the footwear I use with the insoles?
A/ Choice of footwear is extremely important when using corrective insoles. The insoles will function far better when used with appropriate shoes.
The main characteristics when choosing the right type of shoe are:
- Firm heel counter – If the heel of the shoe can be easily squashed together between the thumb and first finger it will not provide enough support in conjunction with the insole.
- The type of fastening – The shoe needs to fasten securely onto the foot. Ideally laces as they secure the foot well, sometimes velcro, zips and we also like to use the boa lacing system which is a wipe and clip button design.
- Slip-on styles such or soft unsupportive boots are not recommended to be used with insoles.
- Sturdy sole unit – The sole of the shoe should have good torsional strength i.e. you shouldn’t be able to grab the shoe in both hands and twist it this means that the soles aren’t strong enough to control the foot.
Building up use of the insoles
It is always recommended that the initial wear time is built up gradually. This is usually advised as starting at one hour maximum on the first day of wear, building up by one extra hour on consecutive days, until the full days wear.
Although the insoles may feel strange to wear in the beginning, they should not cause any discomfort or persistent marking. It is important for the user to check their feet regularly during the initial phase of use and discontinue wear if any problems arise and contact their clinician.