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What to Do When Orthotics Don’t Work

If you are one of the thousands of people who support the $5 billion-a-year industry of orthotics, there is a good chance you are frustrated because they aren’t working. A January New York Times article asked Benno M. Nigg, a professor of biomechanics at the University of Calgary, whether orthotics work. His reply: “The idea that they are supposed to correct mechanical-alignment problems does not hold up.” Even a leading podiatrist blog questions orthotics usefulness.

barefoot running

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What orthotics do

Orthotics act as a shim to adjust for a leg-length discrepancy or for an imbalance in the foot (such as flat feet). Most orthotics, particularly the expensive ones made by podiatrists, are hard plastic. We have 26 bones in each foot because the foot is meant to move. As explained by the research barefoot runner enthusiasts often quote, the more “support” a shoe or orthotic gives, the worse the injuries are.

When I had my clinic in Scottsdale we treated hundreds of runners. Some were Olympic middle- and long-distance runners. All of the runners–yes ALL–who came in with orthotics got rid of them. They learned to walk and run in such a way that they no longer needed expensive orthotics—AND their injuries went away and their running improved.

After several pairs of orthotics, a runner learns that all the orthotics do is shift the strain to another part of the body. For a while some runners saw improvements, but inevitably, the injury would return or an injury would develop somewhere else such as their knees or back. A few tried strength training with the same results: some immediate improvements, then it got worse. Others had surgery which, sadly, often ended their running careers.

What can work

My approach is to start with the least invasive and least expensive approach: change your stride. Barefoot running works for so many people because it forces them to change their stride to the way our bodies are designed to move allowing their legs and feet to move as they are meant to move. With each stride the foot bends, stretches, and subtly flexes. When a person changes their stride, in most cases, whatever imbalance that caused them to try orthotics is gone.

You could go barefoot. More runners and clients of mine are doing it–and every single person whom I’ve spoken to about barefoot running won’t go back. That says something.

Good stretching or yoga can help as can specific massage designed to release the soft tissue. Here’s an insider tip: the tightness in the foot is not in the foot. It’s in the lower leg. The major muscles for the foot are in the lower leg. The foot itself gets tight from the fascia (the thin connective tissue) of the foot getting tight, which causes plantar fasciitis.

If none of the above suggestions are doing it, or you want quick results, try Rolfing. When the soft tissue is released, not only in the feet and legs, but the whole body, the feet stop taking the hit—and they stop hurting.

Owen Marcus, MA Certified Advance Rolfer, 30 yrs experience,, 265.8440. He also helps men build the life they want through is blog,

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{ 5 comments… read them below or add one }

Simon Martin January 17, 2013 at 11:17 am

I really don’t want to want to resort to this yet. So, do you know where some who is good at orthotics in Calgary? I’ve been looking around and I have yet to find one. It would be a great help if you could find a good one for me.


admin January 17, 2013 at 11:59 am

That’s a good question. I would say if he or she is open to alternatives and is not pushing expensive orthotics.


Irina December 7, 2013 at 6:53 pm

Is there ever a time when orthotics ARE helpful? For example, I have a bone spur and arthritis in my big toe as well as Achilles tendonitis. When I don’t wear the orthotics my feet feel so painful I can barely walk.


Owen Marcus December 7, 2013 at 7:19 pm


I once had an Olympic middle distant runner I recommended soft orthotics for because of her flat feet. The Rolfing changed her arch, but not enough.

In my experience when the cause of these issues are released the foot eventually heals. The cause often lies in the calf and the walk. In other words you need to get more movement, not less to heal it.

Good luck,



Irina December 7, 2013 at 7:37 pm

Thanks so much for your reply Owen! But, to clarify – isn’t the whole reason I developed hallux limitus and the bone spur because of too much movement in the foot?


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