Orthotics and Footwear: Finding Your Fit
There may come a time when your feet need special attention in the form of an orthotic. Perhaps things are changing with your biomechanics as a result of an injury or aging. Or sometimes genetics play a part with inherited conditions like bunions or osteoarthritis. Once you have your orthotic, the next step is to find footwear that will accommodate it, which can be a bit of a journey of discovery. Many foot specialists rely on fit experts in specialty shoe stores such as New Balance to continue the cycle of care.
Orthotics are a prescribed, personalized medical device made by a specialist such as a podiatrist, pedorathist, or chiropractor to correct biomechanics issues and/or alleviate pain. The process of creation starts with analysis of the feet, stationary and throughout the gait cycle, with the aid of a 3D scanner. In some situations, the specialist
will make castings of your feet and design the orthotic from that information. Often the term “medical device” is interchanged with “insole,” but the over-the-counter variety offers general cushioning and support, not specific correction for foot problems.
The rigidity and density of an orthotic varies, as does the possibilities of footwear designed to accommodate it. There are four features to look for in shoes: depth, width, shape, and stability. Typically an orthotic is thicker than the liner that comes inside a shoe so there needs to be enough room to include your foot. The shoe liner itself should be removable.
The depth of a shoe is the distance from the top of the upper to the foot bed. Your instep is the measurement from the top of your foot to the bottom of the arch – some people have a high instep, either because of foot thickness or high arches. An orthotic further lifts the foot higher; hence, the need for greater depth. When shoes are laced up, ideally there is a moderate, parallel gap between the laces, and no uncomfortable pressure on the top of your feet. If the shoe is too shallow, heel slippage is common.
Most New Balance shoes come in different widths, and there are many that cater to orthotics, which is why many specialists suggest this brand to their patients. The 928v3 or 840v5 for example, have generous room in the toe box, come in multiple widths, and have a straight last. If you look at the shape of the shoe from the bottom outsole you will see that the shoes do not taper much in the arch. The wider, straighter
last allows orthotics to sit flat upon the foot bed, providing the proper support as they were designed to do.
A shoe’s stability is defined by the amount of motion control, torsional rigidity, and heel support. The most stable shoes will feature some sort of shank that reduces the flexibility. In New Balance shoes it is called the Roll-Bar, and its main purpose is to prevent excessive pronation or supination. People suffering from plantar fasciitis or diseases like osteoarthritis benefit from shoes that reduce stress on the fascia, ligaments, or bones of the feet. If you can easily twist the shoe, it does not have great torsional rigidity. A strong heel counter also contributes to stability and copes better with orthotics that are made of rigid materials like plastic or carbon fiber.
Orthotics do change how shoes fit and may nudge you into a bigger shoe size. If you find that no matter how many shoes you try, the orthotic does not fit or actually causes discomfort, communicate with the foot specialist and the fit expert to make adjustments. Discover your options and forge the best pathway forward!