Arch Supports vs. Foot Orthotics
There has been a lot of talk and advertisement about foot arch supports lately. I would like to answer some question that I have been asked about arch supports and foot orthotics. Right up front, there is a big difference between arch supports and foot orthotics even though they are often used synonymously.
Arch supports are just that - an arch support. They do nothing else accept support the arch.
Foot orthotics have several subgroups.
1) Generic or over the counter orthotics
2) Custom made orthotics - custom made to the patient's foot
Both generic and custom orthotics will have an arch support. What arch supports and generic orthotics usually do not correct is forefoot varus angle deformity. This is the biggest and most often overlooked foot condition. A forefoot varus angle deformity is where the front of the foot, called the forefoot, is angling in the inverted position with regards to the bones in the front of the foot in relation to the heel. (See figure 1)
The forefoot varus angle is the most damaging condition to the body. This will cause the arch of the foot to drop.
What causes the arch to drop in the first place is the question we should be asking. The forefoot varus angle is the main cause of most foot problems. It is the most common cause of shin splints. It will cause internal rotation of the leg leading to more stress on the knees. It is also a major cause of IT band problems, hip pain and low back pain. (See figure 2)
Our bodies can handle very little forefoot varus angle before problems arise. Our bodies can only handle 0-4 degrees without problems. Once the angle gets above 5 degrees the forces on the body are too great and will cause break down.
I routinely see forefoot angles that are 20 - 30 degrees. Any forefoot angle that is greater than 10 degrees defiantly requires a custom made orthotic to ensure the best correction and fit.
Arch supports and generic orthotics don't correct for the forefoot varus angle, thus, leaving you susceptible to those damaging forces. Over time your body will continue to break down. There are a lot of custom made orthotics that also don't correct for the forefoot varus angle. You need to be aware of who is making the orthotics for you and if they are adding in all the appropriate correction necessary.
Another concern, does anyone ever adjust your foot or ankle before fitting or recommending arch supports or orthotics? It defiantly should be done before putting anything in your shoes.
Just think about it. If the bones of your foot that make up the arch have dropped, don't you think it would be a good Idea to put them back in place first? By doing that will change the size of arch support you will deed. I have also seen the forefoot varus angle change up to 5 degrees just by adjusting the ankle. If you take a mold or impression of a dysfunctional foot, and then make an orthotic from the dysfunctional model. What are you going to get? A dysfunctional orthotic!
A better way is to adjust the feet and ankles first, restoring the function of the foot. Then and only then make an orthotic to support the foot.
If your feet, legs or low back bother you, you may want to get your feet checked to see if they are causing you problem. It is a simple check. You either have a problem with forefoot varus angles or you don’t. If you have any questions feel free to call and talk with me about your health condition. I am here to help. Please share this with someone who may be suffering with a foot related problem.
Yours in Health,
Wayne Johnson D.C., C.C.E.P.