In a search for a solution to foot pain, marathon runner Naomi Epstein once shelled out big bucks for a pair of custom orthotics to slide into her running shoes. She’s also tried name brand insoles and an over-the-counter orthotic—both of which promised to offer support for her metatarsal bones, the long bones in her foot. None of them worked.
“I’ve spent about $250 give or take,” the Florida masters runner said of all the orthotics she tried. “I felt like it alleviated my pain for about a mile but made my shoe feel so tight and uncomfortable it wasn’t worth using.”
When it comes to orthotics, Epstein’s story is not unusual. Runners and experts are largely divided on the benefits of orthotics, with some swearing by their benefits and others seeing the inserts as a waste of money. “I personally believe that custom orthotics are not necessary for the overwhelming majority of runners,” said Dr. Christopher Segler, a sports medicine podiatrist who specializes in running injuries and running biomechanics.
Segler works with runners via webcam through his Doc On the Run site. He says marathons and ultramarathoners aren’t necessarily inclined to need orthotics just because those runners log heavy mileage. Even longtime or masters runners may not be prime candidates for orthotics. “It’s not the volume. It’s not the distance,” he said, adding that however, some injuries and specific problems may benefit from orthotics.
He recently saw a marathoner who had a flat foot deformity and posterior tibial tendon dysfunction, where a calf muscle tendon becomes inflamed and cannot provide stability. The runner needed to add volume to his training, but he couldn’t run without pain from the instability. He needed custom orthotics Segler said.
“Custom orthotics will help him achieve [more] because they will realign the bones in his foot in a way that decreases the stress on the soft tissue structures in the foot,” shared Segler.
But that could be a more rare case than originally thought. “Orthotics are not necessary, but they may be very beneficial, especially for those with lower body alignment issues,” said Dr. Barry Woods, vice president of operations and product development for Surefoot. “Anyone with clear pronation or supination in the ankle will benefit from wearing orthotics.” That’s exactly why Laura Spern, a Michigan masters runner, turned to a pair of orthotics.
“I am flat-footed and pronate, so I was having some pain and discomfort sometimes,” she said. She visited a sports medicine clinic in her area and had custom orthotics made. “I love them,” she said. “I wouldn’t run without them.”
If you are in that percentage of people who may need custom orthotics, expect the cost to range between $225 to up to $500. “Cost does not necessarily equate to quality,” Woods said. “Look for custom orthotics that can be made on the spot, where the technician working with your feet are the same technicians making your orthotics and installing them into your shoes.” If you want to try a more affordable over-the-counter orthotic, Segler recommends runners stay away from the softer supports and try Superfeet Green orthotics or Sole custom insoles. A pair can last as long as four years, depending on mileage.
Many runners swear by custom orthotics and find that the insoles keep them from getting injured so they can keep training, Woods said. “There is no doubt that many clients benefit from the use of these devices to help maintain a more neutral position within the shoe,” he said. “Aligning the foot from the bottom is like building a house with a proper foundation. Everything about this point has a better chance of maintaining alignment with a proper foundation. “Proper alignment is the key to long-term injury prevention and maximum performance.”