The subject of who needs to wear orthotics for performance or injury prevention has been extensively researched and debated amongst runners and health care professionals. Currently, there are 3 main schools of thought or “camps” about runners using orthotics. Outlined below are the arguments held by these camps:
1. Camp Extreme Barefoot: You should hardly even be wearing shoes. The argument is that our feet (and rest of our body) evolved without shoes and therefore, any footwear should be absolutely minimal, perhaps only to prevent cutting the foot on the ground.
2. Camp Extreme Orthotics: Everybody, runners included, need orthotics. The argument here is that poor feet support results in poor alignment and imbalance and subsequent injury, degeneration or poor performance.
3. Camp Somewhere-in-Between: Some people need orthotics and some people do not. Even though you have flat feet or high arches, this does not mean that you are destined for orthotics.
When I am asked if injuries can be prevented with orthotics, my answer varies between yes or no, depending on many variables including arch height and other structural variations, muscle balance, strength and endurance, age, training age (experience), previous/current injuries, daily activities, and performance. As you can see, I belong to Camp Somewhere-in-Between. The reason is that runners may have overuse adhesions (scar tissue), weaknesses, and/or imbalances around the hips, knees and ankles or training/lifestyle factors that cause aches and pains or poor performance. If these factors are not modified, a pair of orthotics may only temporarily mask a condition or injury.
Therefore, if you already have a persistent ache or a pain from running, I recommend that you first try a new/different pair of shoes. If the ache or pain persists, I suggest that you seek professional advice to learn how and if it can be treated without orthotics; such as with specific exercise, stretches and/or drills or treatments including, but not limited to, Active Release Technique (ART)™, Graston Technique™, Massage, Acupuncture, IMS etc. Finally, if none of the above solutions work for you, I suggest orthotics because as a member of Camp Somewhere-in-between, I believe some people really do need to wear them. Many people wonder why they haven’t pursued custom orthotics sooner after they start using them.
Aaron Case, BSc, DC, CSCS
Chiropractor and Marathoner