The purpose of creating this platform to educate people about what interests me as a physical therapist is to create a positive, educating source of information that people can easily relate to and use for their own benefit. One of my main clinical interests is foot and ankle rehabilitation. I think there is a lot to be explored in this area of rehab. My hope is that in twenty years we are doing things a lot different than we are today in regards to optimal foot health because we have learned an infinite amount more on how our feet work. Today’s post will address a common question people have in regards to foot health with the use of orthotics to address foot pain.
My main mission as a physical therapist is to create a functional, independent human who has the tools and resources to allow their body to operate in the best way possible. A huge component of this is to give people the education and exercises to allow them to have the most autonomy and control of their physical health as possible. I don’t think relying on a healthcare provider to “fix them” implements a good sense of control in a person’s health. I want you to have the tools and understanding to know how to help yourself, with having me as a resource if you need additional help.
Applying an external brace or support to a joint decreases the inherent mobility, stability and strength of that joint, as it is not allowed to operate on its own as it was intended to. Sometimes we need external support for TEMPROARY periods of time. This is okay to use as long as you continue to work on the mobility and strength deficits that are accompanying your underlying issue. This is the main problem I see with the use of orthotics. People are “subscribed” orthotics at some period in their life and think they are a lifelong tool they have to use every time they put their shoes on. If you were to hurt your shoulder throwing a baseball as a kid, you wouldn’t be wearing a shoulder brace for the rest of your life. Adding an external support without addressing the underlying issue is like taking the batteries of a smoke detector that is going off because of a fire. Sure, your pain may change or go away (the noise of the detector) but you forgot to address the underlying problem (the fire). This will lead to future problems down the road, including stress being shifted to different joints of the body.
Majority of people have weak and immobile feet from wearing improper shoes their whole life. I was one of those people as I graduated physical therapy school in 2017. Although I didn’t like to hear this, and I am sure most people don’t like to get that message, it was one of the most crucial pieces of advice in altering my views on health and my career. I have tried orthotics, heel cups, stability shoes, motion control shoes and other interventions to address my various foot and ankle problems. It wasn’t until a variety of physical therapist that I communicated with educated me on to move more often and improve my foot health that I started to see results. Your body was designed to move optimally throughout life without need extra cushioning and support under its feet. Babies aren’t shoved into shoes the minute they are born. Most people feel better when they kick their shoes off at the end of the day or walk barefoot through the grass in the summer. Adding an external support to the bottom of your foot doesn’t make sense if you are trying to improve your foot mobility and strength. In fact, it is most likely taking away from it.
If you have gotten this far in this article, you are most likely related to me or agree with being barefoot is better. I will add a small caveat for those people who must have some sort of arch support. If you absolutely must wear some sort of orthotic in your shoe for whatever predetermined reasons you have, please know the research shows no support for custom orthotics working any better than over the counter ones. Unless you have a money tree out back, spending $500 every 2-3 years to have a custom brace for your foot does not make any sense when it has the same outcomes as a $30-40 over the counter product.
If you truly want to help your foot pain, your plantar fasciitis, your bunion or your throbbing ankle, please find a qualified health professional (like an orthopedic physical therapist like myself) to help you address these symptoms. A very minimal cost approach of going barefoot more, a wealth of education and the proper exercises to help your foot and ankle symptoms will go a lot farther than some of the current approaches to foot dysfunction. As always, if you want to know more, feel free to reach out to me to continue the discussion!
Note: I have the same Instagram account, with just a different account name (performancedocbroback). You will find out why this is in the near future. Stay tuned! I still will discuss all things foot and ankle rehab on my forums as usual.
Tom Broback, DPT, CSCS
Facebook: Tom Broback, DPT