Do I need orthotics if I have flat feet?

If you have flat feet, you have probably been told that you might need orthotics. You might have questions like:

• Do I need orthotics?

• Which are the best orthotics or insoles for me?

• Do I have the right orthotics for me?

• Is my foot or knee pain because of flat feet?

• Will I get problems because of my flat feet and will orthotics help?

At Bondi Podiatry we know how to properly assess and manage flat feet and can answer questions about what having flat feet means for you and when orthotics are needed.

Are flat feet bad?

Flat feet are a common type of foot posture which can occur naturally in adults and the cause is often genetic. Although most people have flat feet due to foot posture and biomechanics, some people have problems such as arch collapse from medical conditions. Some medical conditions which cause flat feet include posterior tibial tendon dysfunction (PTTD), Charcot foot, and even pregnancy.

Sometimes flat feet can increase the risk of developing conditions such as plantar fasciitis and other types of heel pain due to the increased pressure on the foot from rolling inwards excessively (pronating). Conditions such as posterior tibialis tendon dysfunction and others can cause your feet to be strained and result in tears, pain, and damage to muscles, tendons, ligaments, and even bone (resulting in an increased risk of arthritic changes).

It can be complex to determine the cause of flat feet and whether the foot is excessively or appropriately pronating, that is why it is important that you get your foot biomechanics assessed by a podiatrist. The podiatrist can then explain what is occurring in your feet and whether it is concerning or just the way you walk. Most of the time it is nothing to be concerned about.

Although your risk for some foot problems and pain may be increased, it does not mean you will experience foot pain and problems. Many people with flat feet never experience pain and discomfort and maybe more mobile and have an increased ability to shock absorb. Some with flat feet may experience more fatigue and only ache after lots of walking or running, but may not experience pain generally.

Which orthotics or insoles are the best for my feet?

When looking online or in a pharmacy it can be impossible to identify the best orthotics for your feet and to know which orthotics are suitable for your arch profile and condition. Off-the-shelf orthotics come in all different colours, textures, shapes, arch heights, different levels of heel correction and some may be completely soft while others are very firm.

How flat are your feet? You need to establish how flat your feet are and what the cause is of the flat feet and any associated pain. As podiatrists, we aim to offload the structures to reduce the strain on your feet, and picking the wrong orthotic can mean it may provide inadequate support or at worse put more strain on your feet.

What shoes are you going to wear with the orthotics? Do you get pain while running or walking? How many hours will you wear them for? Are your work shoes narrow and slim? Do you need a custom orthotic to wear to work? An orthotic is often only as good as the shoe it goes in. That’s why it is so important to get a professional opinion from a podiatrist who can work through these factors with you to determine the best option for your feet.

What type of orthotics are there?

Off the shelf orthotics - These orthotics or insoles are what you see at the pharmacy and online. They are not made for your feet specifically and are a good short-term option on a budget or when minimal support is needed. Your podiatrist can advise you on which specific off-the-shelf orthotic can provide the best support for your feet after conducting a biomechanical assessment.

Semi-custom orthotics - Heat molded orthotics can be produced on the spot and are designed to provide arch support. They are not able to provide significant rearfoot control but can be useful when just custom arch support is needed. Accommodations and additions can be glued to this type of orthotic to provide extra support and offloading if needed. Your podiatrist will advise you if this is a suitable option for you.

Custom orthotics - These types of orthotics are the best and most expensive, they are made and prescribed specifically by a podiatrist for your feet. They are often worth the investment as they tend to last the longest out of all the orthotic options. A podiatrist will take a 3D scan of your feet and formulate a prescription specific to your foot posture, bone structure, conditions, tendons, ligaments, and biomechanics with materials and shapes for the activities you plan on doing with the orthotics. This type of orthotic can be made slim-line to fit in work shoes and padded with moisture-wicking materials for athletes. They will be custom designed with the specific features you need to reduce the pain, stress and manage your problem so that you can achieve your goals.

If you want or need a custom orthotic, the podiatrist will take time to take a full medical history, conduct a holistic biomechanical assessment and video gait assessment. Your feet will then be scanned for custom orthotics with a 3D scanner, the scans will be sent to a lab for production with specific instructions from the podiatrist on any modifications which are required. Custom orthotics require time to produce and a follow-up consultation will generally be booked 2 weeks after the orthotics have been ordered to ensure adequate time for them to be produced.

At Bondi Podiatry we are experienced at providing custom orthotics as part of a comprehensive treatment plan in managing pain and discomfort.

At Bondi Podiatry we partner with a variety of orthotic labs and manufacturers to provide you with a wide selection of orthotic options. After conducting a complete biomechanical assessment we can guide you as to the best options for your foot profile, conditions, and even your budget.

We treat feet from all over Sydney, particularly the Eastern Suburbs. As podiatrists in Bondi Junction, we are happy to treat anyone that comes to our Sydney clinic. Our local area includes Bondi Junction, Bondi, Bondi Beach, North Bondi, Rose Bay, Tamarama, Coogee, Randwick, Bellevue Hill, Dover Heights, Vaucluse, and Edgecliff.