An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.
They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.
If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.
If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.
We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.
Every physical and medical intervention carries a risk of ineffectiveness, even surgery as the most extreme form can fail. There is substantially more scientific evidence for the efficacy of bespoke foot orthotics than not, and our clinicians have successfully treated countless patients for a range of conditions over the years, all using our bespoke orthotic insoles.
It is important to acknowledge the difference between custom-made insoles and pre-fabricated, ‘off-the-shelf’ insoles which can be purchased cheaply. We offer an orthotic insole service that is thorough and takes a detailed look at your feet using advanced orthotic technology and software. We believe this gives us a leading advantage over other clinics. That combined with our highly qualified team means we can design orthotic insoles of the best quality and see them through to their manufacture, all onsite, which means the chances of finding a successful resolution to the problem are greater.
You can, and in some circumstances, a non-custom pair will resolve symptoms if the main problem is mainly to do with cushioning. Bespoke orthotic insoles provide an effective alternative once you have tried off-the-shelf orthotics and you can see some improvement in your symptoms, but not enough to feel like you can go about daily activities or return to sport for example. At this point, increasing the biomechanical support of the foot could be a way forward.
Most people visiting running shops are offered insoles as part of a deal when buying new trainers but often do not have anything necessarily wrong with their feet, they are asymptomatic. The insoles supplied by most running shops have standard contouring under the plantar surface – or the sole – and will be determined by looking at the foot on a treadmill. Normally you will be given one of three grades of insole that have a non-specific profile. They are designed to be more flat, so that they do not cause any problems when you start running in them.
At best, they can offer cushioning, but they are unlikely to treat any specific conditions or symptoms you may be suffering from, as ultimately runner shop insoles are not manufactured for you, they are a stock product with light customisation.
The Paromed technology and software we use at LOC uses a 3D scan to take a precise copy of the bottom of your foot to work out the exact distribution of pressure, no two insoles we produce will look or perform in the same way.
Insoles are made from varying densities of a plastic called ethylene-vinyl acetate (EVA) which is a plastic that can be reinforced if necessary. The density changes depending on the amount of cushioning and support required, and can be split throughout any insole. Higher density EVA will often be used towards the back of the foot, where more support is generally required, and lower density EVA to the forefoot where more cushioning is needed.
We can also produce insoles from carbon fibre which are suited to more supportive orthoses, however carbon fibre cannot be manipulated once it has been milled out. While it provides excellent support, it is not always the most appropriate of materials.
No one fully knows what causes bunions to form, certainly family history plays a part, as do ill-fitting shoes and shoes which are too narrow but also a mechanical history of overpronation when the foot rolls inwards as you walk, can be a factor.
The technical term for bunions is hallux valgus, and although more studies are required, anecdotally we have seen that bunions can be aided by an insole holding the medial arch up for longer while walking, which can slow the rate at which a bunion develops or worsens. Although we cannot help with the hereditary aspect, we can advise on footwear and determine if the mechanics of the foot can be improved through biomechanical assessment.
It largely varies dependent on the patient’s individual requirements, but often our insoles can be made on the same day or as quickly as the next.
We do offer our express insole service which takes 2 hours from initial assessment to manufacture and fitting. We open late on Monday, Tuesday and Thursday evenings late until 19:00 to accommodate for people who would like the express service after working hours.
Many common foot conditions can lead to irregular posture, back pain and gait (walking pattern) including plantar fasciitis, bunions, overpronation (when the foot rolls inwards as you walk) or supination (foot rolls outwards). Compromised posture in the back, particularly in the lower back, can often be a result of poor alignment in the feet.
In theory, any biomechanical malfunction in the foot or ankle can result in poor posture and back pain, as well as the knees and hips. If a bespoke insole can realign the joints and allow the soft tissue in the back to heal, this can reduce pain. Once we have carried out a biomechanical assessment, we can establish whether you would benefit from bespoke insoles.
Usually, about 3 years, though this will be longer if two pairs of insoles are being used at the same time.
If symptoms change or return, that’s normally an indicator that the insoles are beginning to bear down at which point you will need them replacing. Though this varies from patient to patient, and is dependent on activity level, bone density and the problem experienced in the first place. Runners insoles are made from lower density material and will experience higher usage, so may wear down more quickly.
No, they do not need adjusting over their lifetime unless they become ineffective or damaged.
They may require adjustments before they are effective so we review all patients at 6 weeks and give them open access to the clinician treating them prior to that 6-week review, should any adjustments be required. At 6 weeks, we hope to have a patient who has been using the insoles continuously between 2-4 weeks and we can then establish how they are using them and evaluate their efficacy long term.
It depends upon when the problem occurs. If you are only having problems during high-end sport it may be that you only have to wear them during that specific activity. However often we recommend wearing them as much as you can, at least 70% of the time or more. We recommend you wear them in the shoes you typically wear for your highest level of activity or for the longest period of time. It is important to consider which shoes you wear the most often before your initial assessment.
Insoles can be made to fit into any shoe, but will be designed to be worn in one pair of shoes that you wear most of the time, or for a specific activity that aggravates your symptoms. Some shoes are easier to fit with orthotics than others, such as trainers, walking boots and flat plimsolls. Your choice of shoe also affects the way the insole is manufactured and will be discussed during your initial assessment. A men’s Italian dress shoe, for example, will require a smaller insole than that of a running shoe. We then must determine which one represents usage 70% of the time and then we can make an insole appropriate to that shoe.
Yes, over the years we have developed numerous insoles for those who need to wear high heels for work, or spend a lot of time in them. We have fitted insoles into ladies court shoes on several occasions, though the more fitted the shoe, the more difficult it is to wear an insole with it. The more specific the insole requirement, the more specific the insole must be. Speak to one of our clinicians if you would like advice on orthotics for a specific shoe type.
We rarely treat children under the age of two, and, normally between 2 and 5 if a child is experiencing painful symptoms, as the feet need time to develop. An insole can be used to abate symptoms if they are having a negative impact on their functional ability.
If there is a family history of foot problems or gross hypermobility, we can assess the child to see whether they are experiencing globalised pain across the whole body, at which point insoles may be able to help. When children are growing that should be considered as well. We see a lot of patients who have symptoms, particularly during an adolescent growth spurt, that becomes exacerbated because the feet are under a great deal more stress than they would be during early childhood, or once they become skeletally mature.
Yes – if insoles are prescribed incorrectly they can make existing symptoms worse or cause different symptoms to occur. Therefore it is essential that you have a consultation with a trained, experienced orthotist and return for a review soon after your initial fitting. And remember to contact us if your insoles start to wear out.
Proprioceptive insoles have specific adaptations, like nodes, added to the top surface of the insole in order to stimulate nerve clusters on the plantar surface of the foot in a different way so that when you walk, the nerves in the foot are stimulated to provide more feedback as it is bearing weight.
Proprioceptive nodes are not required for runner’s insoles but are helpful to patients with a neurological deficit. They help with sensory feedback to improve balance and give the brain more information about your positioning every time your foot hits the ground, which should help you walk more naturally.
Our Kingston clinic closes at 17:00 but we are available for evening appointments late on Mondays, Wednesdays and Thursdays until 19:00.
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