Advice on Foot Care

What is the difference and which one do you need?

An insole is the inside liner of the shoe which sits directly below the foot - the innermost sole of the shoe. Almost all shoes come with insoles either stitched into the shoe or unattached and removable. Insoles are generally thin, flexible, soft and designed for protection and comfort. An insert is any device which you place in your shoe and can be an insole or an orthotic. Insoles can cost between $5-$20 and can be found at the drug store. Insoles are a good choice when extra cushion is needed in the shoe and the main goal is comfort.

Orthotics are devices which also slip into shoes and can aid in foot comfort, but it is important to distinguish between an insole and an orthotic. An orthotic is designed to control abnormal motion and correct foot function. A prefabricated (prefab) orthotic is a pre-made device designed to fit the most common foot types. A prefabricated orthotic needs to be purchased at a sports store, as opposed to a drug store, and can range from $25-$40. A prefabricated orthotic is much more rigid than an insole and is designed to control abnormal motion in the foot, distribute pressure between the heel and forefoot and support the arch. Many inserts & insoles function like an orthotic by distributing weight and controlling motion, but won’t be labeled “orthotic”. This makes the process of choosing the appropriate insert confusing. The key is to check for a semi-rigid sole (generally plastic or polypropylene) on the bottom of the insert or check for flexibility. If the insert folds in half, it won’t be supportive. Those with plantar fasciitis, Achilles tendonitis, neuromas, metatarsalgia, hallux limitis, general arch pain, knee pain and back pain and with those with mild flatfeet may do very well in a prefabricated orthotic or more supportive insert.

A custom orthotic is made by taking a mold of the foot. After the mold is taken the doctor will prescribe corrective wedges, pads and covers to be built into the device based on each individual foot. Custom made orthotics are rigid to help control motion and distribute pressure. Individuals with severe flatfeet, resistant plantar fasciitis and tendonitis, unique foot deformities or specific knee, hip and back problems may need custom made orthotics. The orthotic should make standing, walking, jogging or running more comfortable. Custom orthotics will generally last 7-12 years before needing to be replaced, and can cost between $300-$600.

In summary:

• For those looking for a little extra cushion and comfort, a cheaper, soft and flexible insole found at the drugstore should work.
• For those with general foot or arch pain, a prefabricated orthotic or more supportive insert may work well. We recommend Superfeet.
• For those who want a little extra custom fit, heat moldable insoles may be helpful. We recommend ArchMolds Heat Moldable inserts because they are stiffer and have a more aggressive arch support. Heat moldable insoles are not the same as a custom made orthotic. 
• For those with more collapse of the arch and rotation-in of the foot (pronation) a more rigid orthotic will work better. The best prefabricated device for foot problems is a Prolab orthotic. They are rigid and designed to control abnormal pronation and improve foot function. In the images below, the picture on the left demonstrates a pronated foot. The picture on the right shows the corrected position with a posted orthotic.

• For severe flatfoot, severe cavus feet, posterior tibial tendon dysfunction and resistant cases of plantar fasciitis and tendonitis, a custom made orthotic is recommended.

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