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If you have access, a really good sports Physio is likely the best place to start. Then depending on your diagnosis orthotics may be required short-term (some conditions) or long term for others or not at all. There is a growing movement that says orthotics are “for Christmas and not for ever” compared to previously where often people had them for life. Please don’t rely on a shoe shop’s comments.
If you are in the East Midlands, you could self refer to the University School of Podiatry at Northampton. This is a cheap, but really thorough service in my experience, although the students may scare you into thinking your legs are going to fall off, before they get their combined thoughts together.
There are a few podiatrists that posts on shoewawa that have given some great answers and is worth searching for.
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Such places do exist – google ‘walking gait assessment’ or ‘sport orthotics’ and you’ll find so much choice you’re liable to end up more confused than you were when you started.
However, a bit of basic self-assessment never hurts. Check that you walk with your feet pointing in a straight line rather than splayed outwards or pointing inwards. This (called pronation) puts all manner of unhelpful torsional stress on your legs, knees, hips and lower back and is easy to correct; just keep it in mind when you walk that feet should point straight ahead.
Insoles can help (I use footreviver ones) but nothing helps quite so much as making sure yourself that you’re walking right.
Beyond that basic self-assessment, if you still have issues then you may need to get checked over. That may cost, which is another benefit of doing the self-assessment first.
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However, a bit of basic self-assessment never hurts. Check that you walk with your feet pointing in a straight line rather than splayed outwards or pointing inwards. This (called pronation).
@alan Pronation is the turning of the foot outwards. A degree of pronation is normal in the standard gait. Over-pronation is not so good and someone whose feet do this would probably benefit from having it looked at.Turning of the foot inwards is called supination. Again, there is an element of that motion in the normal gait, during the push off phase, but if it’s present throughout the gait cycle then it’s best dealt with.
IMO there’s a risk that someone self-diagnosing and attempting to consciously alter their gait without understanding the possible underlying cause may end up creating more problems for themselves as bits of their body which aren’t actually meant to be taking the stresses and strains of walking or running end up being over-exerted or otherwise taking too much of a pounding.
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For most people off the shelf insoles will do. I think some “podiatrists” like to over sell custom insoles even though there is little evidence to suggest that they are any better than off the shelf ones for the average person. If you don’t have something fundamentally wrong with the way you walk you dont need to use custom insoles in my opinion. Hope someone can back me up with this statement with more inside knowledge, as Im just saying this as someone who has used both off the shelf and custom insoles and felt little differences between them apart from the effect it had on my wallet.
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For most people off the shelf insoles will do. I think some “podiatrists” like to over sell custom insoles even though there is a little evidence to suggest that they are any better than off the shelf ones.
I am one of those people who has hand made insoles from a Podiatrist, and yes recently they set me back £150 a pair. I initially got a pair on the NHS back in 1993 and they cost me a princely sum of £0-00.
I can only go off the little evidence, as in my own personal experience, and say that for me the insoles are worth every penny.
Before I had the insoles made in 1993, I used to have severe knee pain in both knees. Even walking up stairs was painful. However with a biomechanical assessment of the way I walk, by a physio and podiatrist, it was agreed by both medical professionals that I would benefit from bespoke prosthetics, made for free on the NHS. The only reason I bought a further pair 24 years later was that the NHS was rammed busy and my old podiatrist had gone private and I liked what he did for me all those years ago.
For anybody who is referred by a physio and a podiatrist then I believe that bespoke prosthetics in their shoes will greatly enhance their quality of life by reducing knee pain fairly quickly.
As for people with no medical reason for hand made prosthetic insoles, I highly recommend footreviver insoles. I have a pair in all my shoes and boots.
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If you have persistent pain in your knees and hips, and waddle round like a duck, you need to do something about it. An NHS physio might be able to give you some exercises to do that will sort the problem by strengthening your arches, if your local trust employs any and you manage to get to see one of them. Otherwise try a private sports physio.
Only if you’re suffering very badly, or have neglected the problem for a long time, will you need custom orthotics. You can get very good ones through the NHS, if you live in the right area, but you might well need to go private. Off the shelf insoles are the next best thing if you cannot get custom orthotics and there are lots of good brands out there such as Footreviver, Nuovahealth etc..
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Depends where you’re based, but highly recommend Footreviver in Marsden (Huddersfield area). They know what they are talking about regarding your feet, abuse they have taken oven the years and what you may need as supports within the footwear.
Have a look at their website footreviver.com Book an hour slot and they won’t give you any bad advice or sell you something you don’t need.
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I was horrified at the price the GP mentioned (about £70 then, a little more now) but he told me they would be an instant cure, which I did not believe, and would certainly help me months before I got anything from the NHS, whose standard insoles would be far poorer. Apparently fell runners use their services to.
I went thinking I would just lose my money as I could not imagine that they would help that much and even if they did how could they work in ordinary shoes and still stand up in running shoes.
There was instant relief, despite my misgivings, as well as long term improvement – when I went to the GP I had pain even getting out of bed in the morning and this is not the case now. I wear the insoles in most footwear apart from climbing soles and the estimated life is about 18 months but I have had fitted extra pairs every year or two and I’ve only just thrown the first pair out. The NHS insoles took a long time to get and were not in any way comparable in effect, robustness or comfort compared with the commercial ones.
They also alleviated a long term problem I had with stubbing my toes on descent – I think because of falling arches the feel elongate and hit the front of the boot.
I was in my 50s when I began to have these problems but was diagnosed with “flat feet” at Catterick in tha 1970s so I’ve not had great feet all my life, though strong boots always helped, AND I had a diagnosis from the GP before going there. Even with the terrible expense, money well spent, for me.
If you call them for an appointment (I went on Saturdays, first thing when they were quiet) they will probably want you to take a sample of the kinds of footwear you’ll wear them in as they have to be trimmed/checked if you do decide to be fitted.
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@saffy Thanks. Really appreciate the thorough response. Think I’ll try them.
I’m a runner and having been plagued with chronic Achilles Tendinopathy for years now, I’m prepared to take a punt on some orthotics In conjunction with other rehab I’m doing.
Chuffed they worked for you. Fixes like that doesn’t happen very often!
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