Are Orthotics Good for Runners? NO!

In running, orthotics are used to correct abnormal foot motions (also known as foot over-pronation) and reducing foot pain, however a concerning amount of research has found that orthotics are actually a losing strategy for helping you run well and safe. In fact, orthotics were found to be especially ineffective and a risk factor for injury in runners who heel strike!

Benefits of Orthotics — Orthotics are essentially casts for your feet, and they’re intended to keep the foot steadied during running. Orthotics are also thought to improve foot pain, but on the clinical research side, orthotics have been consistently found to be less capable of maintaining postural stability of the foot during running, while contributing to factors that lead to progressive degeneration of the foot’s arch and plantar fascia!

Case in point, an eye-opening study by Sinclair et al. in the Journal of Applied Biomechanics found that orthotics DID NOT reduce plantar fascia strain and significantly reduced midfoot range of motion, proving that orthotics not only failed to deflect impact stress away from the plantar fascia, but restricted the foot’s NORMAL motions too much, which may encourage abnormal foot/ankle mechanics during running. Simply put, the rigidity or inflexibility of orthotics over-restrains foot motions, which causes the foot to undergo compensatory actions that results in more uneven stress along the plantar fascia.

Most notably, the runners in the study were heel strikers, not forefoot strikers. The problem with heel striking when running is the plantar fascia experiences significant traction when the body weight transfers over the arch onto the front of the foot during the later half of the single limb support phase [2].

The foot rollover mechanism after touchdown in heel strike running (shown below) ‘squashes’ the arch which challenges the arch muscles to manage greater loading –this is how the plantar fascia suffers in heel strike running. To fix this, heel strike runners turn to orthotics for plantar fascia strain relief but experience little resolve since orthotics fail to be effective as they actually make the problem worse by causing over-pronation!

Heel Strike Running Causes Overpronation of the Foot — In heel strike running, the movement path of the foot after heel strike involves the foot rolling from heel-to-toe which was associated with more unsteady motions at the heel that are made worse with orthotics.

Is Forefoot Running Best? YES! — In forefoot running, there’s no rollover phase which results in a discrete loading mechanism on the arch and big reductions in hindfoot loading. This allows forefoot runners to by-pass the risk of plantar fasciitis [3], suggesting that adopting a forefoot strike is a better, more sustainable intervention for plantar fasciitis and arch pain as compared with orthotic therapy.

One thing we do know is studies (references below article) consistently point to the importance changing your foot strike pattern from heel strike to forefoot strike ( see here what a proper forefoot strike looks like) because the loading phase in forefoot running is less extreme on the arch, while foot pronation is more controlled, which is why orthotics are not needed in forefoot running. Even better, the feet spend less time interacting with the ground, which leaves less time for abnormal foot motion and postures to occur in forefoot running.

The loading mechanism in forefoot running is not only safer on the arch and plantar fascia since the over-loading roll-over phase is eliminated, forefoot running makes the most functional use of these foot structure as well! This is because the arch loads differently in forefoot running; it loads in ways that compliments the function of the arch and plantar fascia, whereas heel striking hinders the efficient and functional use of both the arch and plantar fascia, while loading more impact stress through these areas as well.

The good news is, since forefoot running compliments, not hinders, the functional properties of the arch and plantar fascia, this also strengthens these areas, thus orthotics can be avoided altogether just by switching to forefoot running and avoiding heel striking.

Better yet, forefoot running in a barefoot-like minimalist shoe gives the feet more power to engage and interact independently, acquiring the feet the means to become stronger on their own, thereby slashing the risk of developing plantar fasciitis even more!

Ultimately, the feet are highly adaptable and are perfectly capable of developing their own strength to control pronation, and this strength development is something that cannot be done with orthotics or in thick cushioned, stiff running shoes. In that light, read more here about why minimalist shoes are a great asset to your running performance, and also, read more here about why forefoot running is always better than heel strike running by every measure!

If you’ve enjoyed my blog post, you’ll love my content at my YouTube channel, here, where I show why forefoot running is the safest, most efficient way to run!

References:

[1]. Sinclair, J., Isherwood, J and Taylor, PJ. The Effects of Orthotic Intervention on Multi-Segment Foot Kinematics and PlantarFascia Strain in Recreational Runners. J Appl Biomech, 2014; [Epub ahead of print]

[2]. Perry, J. Anatomy and biomechanics of the hindfoot. Clin Orthop Relat Res, 1983:9-15.

[3]. Pearl, DP., Daoud, AL., Lieberman, DE. Effects of footwear and strike type on running economy. Med Sci Sports Exerc, 2012; 44:1335-43.

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