Orthotics Don't Really Work

Orthotics don’t really work. 

From the New York Times

That’s why Dr. Nigg says for now it is difficult to figure out which orthotic will help an individual. The only indication seems to be that a comfortable orthotic might be better than none at all, at least for the activities of people in the military.

So where does this leave people like Jason Stallman, my friend and colleague at The New York Times? Jason has perfectly flat feet — no arch. He got his first pair of orthotics at 12 or 13 and has worn orthotics all the time, for walking and running ever since. About a year ago he decided to try going without them in his everyday life; he still wears them when he runs.

Every medical specialist Jason has seen tried to correct his flat feet, but with little agreement on how to do it.

Every new podiatrist or orthopedist, he told me, would invariably look at his orthotics and say: “Oh, these aren’t any good. The lab I use makes much better ones. Your injury is probably linked to these poor-fitting orthotics.”

So he tried different orthotic styles, different materials, different orthotics labs with every new doctor.

That is a typical story, Dr. Nigg says. In fact, he adds, there is no need to “correct” a flat foot. All Jason needs to do is strengthen his foot and ankle muscles and then try running without orthotics.

Dr. Nigg says he always wondered what was wrong with having flat feet. Arches, he explains, are an evolutionary remnant, needed by primates that gripped trees with their feet.

“Since we don’t do that anymore, we don’t really need an arch,” he wrote in an e-mail. “Why would we? For landing — no need. For the stance phase — no need. For the takeoff phase — no need. Thus a flat foot is not something that is bad per se.”

So why shouldn’t Jason — or anyone, for that matter — just go to a store and buy whatever shoe feels good, without worrying about “correcting” a perceived biomechanical defect?

“That is exactly what you should do,” Dr. Nigg replied.

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