Shoe Insoles vs Barefoot Shoes - Which Are Best For Me?

In many cases, long term muscle imbalance exists already, an injury then occurs and an orthotic is prescribed to temporarily offload the injured structures to promote healing and recovery. 

In this situation, some biomechanics experts would argue that the orthotics, by placing the foot and ankle in a more ‘aligned' position, can actually help overcome and correct long term muscle imbalance, often with the help of corrective exercises and manual joint and soft tissue mobilisation techniques. This situation often occurs from the late teens onwards.

The younger, more pliable foot

On the other hand, there is the the younger, more pliable and malleable foot seen in childhood and adolescence. Current thinking is that this type of foot should be interfered with as little as possible and allowed to develop and strengthen naturally through exposure to different surfaces eg uneven ground, walking barefoot at times and using shoes that have good flexibility in the various planes of movement. Specific exercises can be prescribed by a Chartered Physiotherapist to help this development process. If this is allowed to occur, the end result should be a strong, stable and flexible foot and ankle which is less injury prone. If this does not happen - muscle imbalance and weakness occurs leading to the situation described in the first paragraph.

Barefoot - fad?

As for barefoot or ‘minimalist’ running, this is a controversial area which has its supporters and detractors and is a topic we have written about previously.

There has been a lot of hype around this concept, with many arguing that it is more natural for the human body to run barefoot. Various groups have been very effective in promoting a 'natural' running lifestyle. Like many other richly debated topics such as the low-carb diet the problem starts when advocates take opinions to the extremes - like a 'barefoot or nothing' approach. For most of us the real solutions exist somewhere in the middle after we have taken our personal adaptations into consideration.

If you are interested in some more detail and insight as to whether the barefoot movement is fading away and why, with some intelligent scientific discussion, I encourage you to read this interesting article over at sportsscientists.com - Minimalism as a fad and inconsequential footstrikes?

Basically, no one size fits all

Orthotics may be appropriate for some and not others, it may assist with recovery and strengthening or increase the risk of injury depending on your biomechanical profile and injury history. If you are thinking of barefoot running I would urge you to get professional advice from a biomechanics specialised Chartered Physiotherapist and not be lead astray by those who want to sell you barefoot running shoes.

Client example

I have a client who owns two pairs of a popular brand of barefoot walking shoes. He described to me how he had come to realise the discomfort being caused in his knees and ankles after a day wearing them.

In this specific case we advised the client, being a strong over-pronator, to use a more structured shoe to offset the inward role of his ankle, which many good sport shoe manufacturers produce. He started using such a shoe and found them immediately more comfortable

We went one step further and recently ordered him a pair of custom made orthotics prescribed by our clinic for additional support in his non-sporting and generally flatter, less structured shoes which has made walking in these shoes more comfortable as well.

We both found it amusing that, although not intended, he has experimented in wearing his new three-quarter length orthotics in his barefoot/minimalist shoes, also to good effect.

My client may, with much effort, have made the transition to barefoot/ minimalist running over time had he persisted. However given his biomechanical profile we decided the risk of injury did not outweigh the potential benefits. As such we decided to change tack and offer his foot the stability and support it needed, using good footwear and an orthotic device. He hasn’t looked back.

Conclusion

The message here is that shoe insoles or orthotics have their place and should aid to correct muscles imbalances not cause them. Knowing the state of your own individual biomechanic alignment and degree of pronation is an important preliminary step before making a decision for the use of orthotics or barefoot/minimalist footwear.