How much do we really need Orthotics?
Updated: Mar 27
Firstly, I’d like to start this blog by pointing out he fact that I am definitely not against the use of orthotics. In fact, I believe that under the correct circumstances, they can offer a massive biomechanical benefit and compliment a treatment programme nicely.
So, what are these circumstances? Well, I believe there are two. Firstly, let’s say that a patient has a permanent biomechanical dysfunction. Now, I want to be clear on what constitutes a ‘permanent’ dysfunction, as there are likely differences in what people think to be permanent, and some will probably have quite a loose definition of what it entails. For instance, a problem that has been going on for a long time won’t necessary be a permanent issue, it might just be that the true cause has not yet been isolated and treated, or if it has, pain may persist if the individual has not persisted with the appropriate level of aftercare. What is a permanent dysfunction then? I regard this as a biomechanical problem within the body that cannot be fully reversed, and the typical causes of this can be traced back to surgery or a trauma e.g. a break that has healed in the wrong position, or if the patient has some form of disability of congenital condition.
The second scenario where I believe orthotics are helpful is as a temporary measure to tempt the body into a more biomechanically neutral position. After all, as we go about our daily lives, we form habits (many of them bad for our postural health), which can be difficult to alter. Therefore, in this scenario, the orthotics can act as a cue for the body to remind the brain of how it should be moving, which will aid in our skill development so that it will get to the point where it helps the brain become accustomed to this movement, until the body is strong enough, and the brain is technically developed enough, for you to hold these better positions, and execute better technique; such as walking and running, without a second thought. However, a key point to make is the fact that the role of the orthotics here are only temporary, so this may only appeal to those who don’t mind spending a significant amount of money on a short-term, complimentary measure.
And that now brings me on to the main point I wanted to make – assuming that the patient is free from any significant long-term biomechanical dysfunctions, which at a guess, I would estimate this is case in about 7-8 times out of 10, then why should the orthotics be used long-term? As in these cases, if there is not a ‘mechanical’ issue going on, then the problem must be soft-tissue based (e.g. to do with muscle), which can be reversed if the appropriate aftercare is given to alleviate any muscular imbalances. Therefore, to what extent do we just use orthotics to treat the symptoms as an easy way out? After all, if you just rely on the orthotics to keep you stable, you are just learning to adapt to a dysfunction, and I would argue that if the dysfunction is still present, it will still be extremely detrimental to your long-term joint health. As humans, unless absolutely necessary, we shouldn’t be reliant on any external devices in the long-term to be able to move naturally. Think of it this way – when was the last time you saw a wild animal wearing orthotics just to be able to walk and run around naturally?
"to what extent do we just use orthotics to treat the symptoms as an easy way out?"