Insoles

[weekatiepea]

I have been struggling with foot pain and shin splints for some time now and seemingly it is because I have flat feet. My physio has given me loads of strengthening exercises but he thought I should get an insole which will be more supportive for my feet when I orienteer. I could get one custom made but he reckons some of the off the peg ones were pretty good.

I have had a look and found 3 that look good but I have no idea which one to go for ...

http://www.fitnessfootwear.com/onlinest ... UPERFEET02

http://www.foothealthcare.com/acatalog/interpod.html

http://insoles.sandpit.com/products/mor ... egular.htm

I have heard good things about super feet. Does anyone have any experience of using insoles for arch support and can recommend which ones I should get?

[frodo]

ive got some custom green superfeet insoles and they work well. only use them in my road shoes as if your in terrain your foot goes all over the place anyway rather than having the uniform gait pattern experienced in road running. not sure they'd fit in orienteering shoes anyway but you can also get custom black superfeet which are of lower volume and would probably be better suited for orienteering style running.

[Harley]

I agree with Frodo. My podiatrist sorted my lower legs out a treat and was keen to make sure I had the right support for my overpronating gait. However, he was insistent that although I needed support in my road shoes, and walking around town shoes, I should not have similar support in my O shoes. Because, as Frodo put it, yer feet go all over the place to deal with the terrain. My podiatrist made the point that putting support into my O shoes would increase the risk and severity of ankle sprains. I had earlier tried to deal with my gait problems myself by putting supporting insoles in my O shoes and guess what? I got repetative ankle sprains, and I havent had any since I took them out.

[Nails]

Though insoles aren't everybodys answer. Personally I think that most people with enough alignment excersises can combat pronation or supination (most people pronate if anything!)

Also be aware that adding arch support can overstress the arch ligaments, which in turn can lead to pain in the connections to the toes/heel. Be very careful by adding arch support slowly over many months!

In essense -insoles are not a cure but a disguise of the underlying problem which on the whole can be solved with alignment excersises. Basically most problems stem from one muscle in a group (eg quads or calves) being too large and having more effect than the other muscle(s) in the group. This pulls the skeleton out of alignment and can cause pain/problems etc. With exercises this inbalance can be reduced/completely removed resulting in a much better long term cure.

[stodge]

Insoles - be very very careful.
If you get any strange pains in your feet afterwards, get straight back to your podiatrist and if in doubt get a second opinion earlier rather than later.

I havnt run for close on 4 years now due to orthotics which were trying to cure plantafaciatis (well its spelt something like that)causing a stress fracture in my foot that never healed.

Proff Rolf from Sheffield ( who eventually operated on me) did a load of research into use of orthotics for orienteers in Sweden and came to the conclusion that in O shoes off track they dont do anything as your foot is always landing differently, though may be of benefit in everyday shoes or road running shoes.

From my experience of 4 podiatrists it seems a very black art rather than a science in many cases, so get a reccomendation from several people before embarking on the insole route.

[Tessa]

I'm kind of sponsored by Sportsfeet UK and have just been given a pair of insoles with quite a big arch support. They are experts in feet problems, but told me to wear them in my o-shoes so I have been. But after 3 weeks I have had problems with the arch on my left foot. Its a weird pain, its not a bruise which I thought at first, its not bad to stop me running usually. I'm not sure whether its better just to phase in using them rather than everything straight away.

I'm going back to Sportsfeet UK next week to sort out this problem, so can ask any relevant questions on insoles and orienteering if its useful.

[stodge]

Is the pain in the ball of you foot.
My problem came frome the end of the orthotic bangin against the ball of the foot causing sessamoiditis ( dodgy spelling) and eventually a stress fracture.

[Tessa]

No, its on the arch, it doesnt feel like a bone problem. I honestly don't think its anything serious, etiher a bruise or slightly stretched ligaments. I'm running my foot over a tennis ball to loosen it and i think it helps.

[weekatiepea]

Cheers for the advice everyone. I am now thinking of insoles for my everyday shoes and running trainers and nothing for o shoes. Hopefully that will sort out my feet enough to be ok during an o event.

The pains I have in my feet are like what you describe Tessa and apparantly I have plantar fasciitis. I was advised to roll my foot over a tennis ball or a cold can of coke.

[Toni]

I got orthotics when i was 16 and wore them until I was around 24 - they gave me horrendous blisters. I experimented with soft and hard versions. I rarely wore them in o shoes and eventually stopped wearing them in any shoes. I now keep them in my mr happy slippers!

Like Neil I'm not completely convinced - I think some physios can get 'insole' happy and not look at what weaknesses can be solved through exercises.

[Lil' God'rs]

Proceed with caution would be my advice. I got orthotics about 9 years as I had bad shin splints. Took a few months to really get used to them and I never use them in orienteering or fell shoes. Shin splints have still been a problem over the years and I don't think the orthotics really made a difference for me. Best preventative advice for shin splints I have had is stretching and strengthing of the calf muscles. Have often thought about stopping using the orthotics but never quite done it yet - maybe this year.

[John Morris]

I now use off-the-shelf AOL insoles at all times (well, when I'm wearing shoes...) and having been doing so for 7 years. I have a softer, short pair (heel and arch) that I use when not running. I have a denser, full length (heel, arch and toe) pair that I wear when running. Both pairs have lasted the full 7 years - they've worn rather better than I have...

I previously had hard resin insoles (heel and arch only) custom fitted and built by the Edinburgh University Sports Clinic. Beautifully crafted though they were, their inflexibility was a disadvantage.

The only disadvantage I've encountered with angled (orthotic) insoles is that I need to be a little cautious of ankle strains if I'm walking barefoot, certainly until I've warmed up. However, being an arthritic 60 year-old, that's a price I'm more than willing to pay if it keeps me mobile when shod.

[Nails]

John -no no no --Please everyone -replace things more often than 7 years!
You feet will definitely have molded the things and they won't be giving you the support you decided that you needed in the firstplace. If you are going down the orthotic/insole road (and i've already urged that you think seriously about the route) then replace them regularly (as your gait will change!).

If indeed you need insoles at all! Often orienteers think that a pair of road shoes will last as long as a pair of o shoes -get some road shoes from a decent running shop with support and cushioning and replace them regularly too!

Tessa> I'm concerned you don't actually need to have insoles at all. Have you had a problem in the past that the superfeet people said they could fix?
Really as a young athlete with access to the multitude of sports physios aropund these day you should be able to fix such a problem without insoles.

And as a end note:
Many physios jump straight for the insoles and orthotics. Its an easy way out and easy money for them -get a second or third opinion before you put some insoles into your shoes! Its like proping up a big wall which has poor foundations -what you really need to do is take down the wall, lay new foundations and start again!

[RachelM]

Well then, arriving late to this discussion, it's been oh so interesting reading about the good/bad experiences, warnings and suggestions about insoles and orthotics.

I work at the 'Centre for Rehabilitation and Human Performance Research' at the University of Salford. The 2 year project that I'm on at the moment is looking at orthotics and I began with a critical analysis of the insoles/orthotics/footbeds that are available on the market at the moment. I did 3D gait analyses on Superfeet, SofSole, Conform'able (Sidas), as well as some aimed at the medical market. The plan was to see if the insoles actually do what they say they do, biomechanically as well as collecting some subjective feedback as well. Results were not good! What became apparent very quickly when I struggled to find good points about each pair, was that their success was directly proportional to the size and resource of their marketing team (especially Superfeet!) ... Their research is a wee bit thin on the ground!

My background is biomechanics. I am not a clinician: not a physio, nor a podiatrist. I find it difficult to accept that the orthotics work unless I see the proof in the before and after graphs, but the more involvement I have with podiatrists, the more I see what a subjective area it is (anyone remember that article in Runner's World?) and I have respect for podiatrists with years of experience looking at peoples' feet who can alleviate pain with insoles when the graphs tell me it shouldn't work. How frustrating it is too! I've resigned to the fact that the area of orthotics is a mix of art and science but I believe the 'art' component is there because motion of the foot is so complex - the spine, pelvis, lower limbs can all be modelled very accurately - motion predicted perfectly, but researchers are still trying to find a reliable foot model (that's what my colleagues across the hall are working on by going to Sweden and sticking pins in the bones of the foot. Nice ).

In orienteering there are so many different issues. The fact that your foot falls differently every time is a stickler for me - there's no consistency to work with there. Interesting what was said about 'alignment exercises' - changing the skeleton??! Hm... Sadly, no matter how disciplined you are with those exercises, only surgery will change your bone structure. As was mentioned, a muscle imbalance anywhere in the leg can eventually manifest itself as foot/shin pain too. Indeed, addressing such imbalances with exercises can alter how your leg is positioned as it is accepting your body weight (those high forces in running) and encourage the forces to move through a safer line, which is great - as long as that's the problem. Any pain south of your hips could be caused by your feet; a bony abnormailty you're born with, 'Runner's Varus' which is the natural motion of the foot rolling in more when you run (there's a reason for it), hell, my sister's boyfriend had chest pain because his feet were so bad, it made him walk funny and stand funny which gave him postural problems which compromised his breathing! Hm. It also may have nothing to do with your feet. The problem may be further up! Oh how feet can be misleading! Podiatrists aren't great at looking above the knees.. That's where there's no real substitute for full 3D gait analyses to really see what's going on. With that information, coupled with physical examination of muscle strength/imbalance/flexibility from the physio, the problem will usually reveal itself.

Unfortunately, 3D gait analyses can cost up to £350, so it's lucky for you (Mr Man who wrote initial post) that my colleague and I are currently recruiting subjects! He is looking at what predisposes runners to Achilles Tendon injuries and I'm looking at the coupling at the ankle and subtalar joint (where pronation/supination occurs) and how runners respond biomechanically to orthotics.

I have not indulged in giving my personal opinion on here -we argue enough between us in the research centre (!) but anyone can feel free to question me if you'd like to get into discussion.

So, subjects please!! Anyone will do because I need injury-free and injured subjects. If the analysis indicates that the orthotic we are using (designed in-house) may be beneficial for you, participants are given a free pair (These will eventually retail at about £32... value for money depends on whether they work or not eh?!)

Please contact me on R.Majumdar@salford.ac.uk to register interest! I'm in Manchester.

I'd best get back to work...

[helen]

I find it difficult to accept that the orthotics work unless I see the proof in the before and after graphs, but the more involvement I have with podiatrists, the more I see what a subjective area it is (anyone remember that article in Runner's World?)

Yes, I remember that article. Goes to show really - it was something along the lines of he visited 9 podiatrists for gait analysis without any major foot problems, almost all recommended insoles, one said left leg was longer than right, another right leg was longer than left...

I too would advise extreme caution with insoles, especially regarding arch support. I got a standard pair from the local hospital podiatrist to try and solve the arch pain I've been having for years, and when I put them in my O shoes, they were fantastically comfortable. But after one run, they had put so much pressure on my outer forefoot (a friend described it as: the arch acts like a spring - absorbs all the pressure of running - put a solid block underneath it and it can't work, so the pressure is thrown elsewhere) Anyway, they only ended up causing a stress fracture to my metatarsal, like stodge. Luckily, I caught it early, didn't use the insoles again and so was only out for about 5-6 weeks in the end, but slightly longer from O cos I didn't want to risk terrain running.