Benefits of My Custom Orthotics

I recently received my first pair of custom made orthotics. I have to admit I felt as though this purchase decision was a bit of a leap of faith on my part. Other than my structured-cushioning running shoes designed for over-pronators I have previously taken no further consideration for my tendency to walk and run with flat feet which liked to roll inwards.

I share a few photo's of my new orthotics below as well as a comparison photo of my inward ankle roll with and without the orthotic in place. 

Why I opted for a pair of custom orthotics

There were a few reasons - the first; an ache and frequent twinge in both of my knees that was hanging around long enough to cause some concern. In the absence of any recent trauma I considered what might be causing the discomfort. I had recently switched to a new brand of trail running shoe which could have been a contributing factor.

I also have never forgotten the video-recorded running gait assessment I completed at the Asics store in London last year which revealed my relatively severe ankle misalignment on foot strike. Hence my choice to wear structured-cushion running shoes.

I also own a couple pairs of 'barefoot' shoes - the closed toe not 'five-finger' type. I know - why the heck would I wear barefoots after explaining my need for structured-cushioning shoes!?

Well, I don't run in them regardless of all the hype around how we should all be running barefoot, naturally. I do enjoy walking barefoot so figured that a pair of 'barefoot' shoes which provided minimalistic cover, grip and toe protection would be a great choice for regular outdoor walking.

I really like my barefoots but the lack of arch support is very noticeable. The front of my foot tends to kick outwards slightly before landing each step which accentuates the inward roll of my ankle.

I have read extensively on the preachings of the barefoot advocates, many of whom are very well educated biomechanics specialists. I understand their approach to a more mid-foot strike walking and running style and much of it makes sense to me. For a good read on the subject Mark Sisson offers a non-technical insight for - Preparing for Barefooting.

My running style has adapted slightly towards the front mid-foot strike but we are not all created equally and the degree of pronation can vary considerably from one person to the next. There are those too of course who suffer different degrees of pronation between each foot.

My point here is this:

I'm an over-pronator and despite a concerted effort to adjust my foot strike, in keeping with the advice given by the barefoot running community, I cannot avoid an inward ankle roll. Seeing it recorded on video and even noticing it by looking down at my feet during a run I can't help but be aware of the potential strain I could be causing on my lower limb structures. As such, I strongly doubt that given my biomechanical profile, I am the the sort of person who would make the transition to barefoot running successfully and without injury.

Is my knee pain directly associated to this misalignment?

I researched information about orthotics and of course sought professional advice from the team at Mount Merrion Chartered Physiotherapy. After another gait and orthotic assessment it was made clear to me that orthotics would be beneficial in terms of improving lower limb alignment while running which would reduce the mechanical load on my knees. This would assist in reducing current niggles as well as reduce the risk of more serious biomechanically related overuse injuries down the line.

I surely intend to remain very active on my feet for the rest of my hopefully long and happy life. So I have taken the view that if there is something I can do now for the benefit of my longer term fitness and stability then why wait until more significant problems arise?

Justifying the cost of custom orthotics

When researching information about custom made orthotics I came across a few comments people had made about how expensive they are. Price point value is surely a subjective concept.

My reasoning for going the custom route was fairly simple. I felt it would be better long term value to invest in a device that was designed to provide me the best alignment possible for my precise degree of pronation. Buying them would not take food off my table so I believe this means I could afford it. They would last me a couple years and be flexible to place in almost any shoe.

If I spread the cost across the lifetime of the orthotic and compared this to some of the other luxury items I may very well purchase - to me a custom made device with such flexible, everyday use, is not expensive. Buying an Apple iPhone to make phone calls, send texts and receive emails - is expensive! A subjective view of course.

My results using a custom orthotic (never knew I had such a 'pointy' ankle bone) 

You can see the inward role I suffer from without the orthotic. 

As you can see in the image above my alignment is of course better with the orthotic in place. But more than simply the appearance I must emphasise what a difference I have noticed physically.

I followed the given advice to wear them in gradually to allow myself time to adjust. I must admit however that my first few walks were my usual off-road routes over some rough and uneven terrain including patches of loose rock.

I was very surprised by the added stability I could feel. I truly did not expect to notice such a difference. My inward ankle roll is no more - I guess that was to be expected and what I paid for.

The first time using them it certainly felt strange having these 'foreign objects' inside my shoes. Initially I could feel every millimetre of the inner and outer edges of the orthotic and it wasn't the most pleasant walking experience. But, within my first 30 minute warmup walk this unpleasant sensation had disappeared.

My knee pain that I was experiencing - gone!

I can't say when the pain stopped because I simply forgot about it from not feeling it anymore. Can I claim with 100% certainty that my custom orthotics is what cured me? No I can't. It might be one big coincidence but I'm not trying to convince anyone either way. I'm happy with my product and can feel the positive difference when wearing them.

How often do I wear my orthotics

It is great that I can swap them between so many different styles of shoe type but I don't wear them everyday in every shoe I put on. I'm not sure if I should but I feel better not forming a complete reliance on them. I tend to wear them when I know I may put myself under a bit more strain during longer walks and runs.

No, I don't wear them in my barefoot shoes! But I will restrict my barefoot use somewhat. I'll listen to my body and adjust accordingly.

The orthotic assessment process

I'm going to offer my non-technical description of the process I went through for ordering my custom made orthotics.

Following the gait assessment where Paula, a Chartered Physiotherapist at Mount Merrion, observed me walking, she continued to determine my degree of pronation by gradually adjusting my alignment with small pieces of purposefully shaped foam inserts placed in set positions under the sole of each foot.

Then the fun started. I had plaster casts moulded around each foot which provided the exact footprint for my orthotics - hence 'custom'.

I had a form to complete detailing my choice between full length or three-quarter length, colour and foam density depending on my intended use and expected shoe type to be used with the orthotic.

I chose three-quarter length because I believed this would take up less space in my shoe allowing me to place the orthotic on top of the already present insoles. This has worked out nicely for me and so far my orthotics fit well in my runners, boots and even my more fancy going-out shoes.

Lastly Paula completed a foot sketch and marked various points on heel and ball of foot.

For more information about the assessment process and costs see here - Orthotics Assessment

International delivery of my orthotics

I don't live in Ireland so I required that my orthotics be sent to me through the post. As expected they arrived promptly in well secured packaging.

If you are considering going the custom orthotic route I would recommend highly that you get assessed only by someone qualified in orthotic assessment and who provides a high quality product. Don't be shy to ask for specifics when making an enquiry and follow up on the responses.

If you happen to live in Dublin I would of course highly recommend the team at Mount Merrion Chartered Physiotherapy for your orthotic needs.

Happy walking.