Thursday, 2 March 2017

Do You Need Insoles? (Final Part)

Type of insoles

Cushion and support
The simplest are cushioned inserts, designed for people who merely want to reduce shock. "Maybe they like the flexibility of their shoes, but their feet are not used to getting bruised or pounded," Mieras says. "Or they're older and finding that the padding on the bottom of their feet isn't what it used to be." The ideal cushioned insert, should be lightweight, flexible and made of materials that won't break down within a few miles.

If you want to try something a little more customized to your foot, another option is a heat-moldable footbed, which can be conformed to your foot by first warming it up (typically in an oven at low temperature), then standing on it while the plastic is still warm (but not too hot). When molding the insert, make sure you're standing straight, with your foot pointed forward so that your second toe is directly in front of your shin. Also, be careful not to press down too firmly on the inside edge or you'll squash down the intended arch support. 

Toe splay

Metatarsal pad
Metatarsal pads are simply cushioned lumps that fit behind the metatarsal heads (the ball of your foot), distributing weight and forcing the toes to spread. This serves several functions. In McClanahan's minimalist theory (if you have a broad enough toe box), it lets your toes splay to keep you from overpronating, in a far more natural manner than a full-length arch support. The pads also take pressure off the metatarsal heads. "If you have a neuroma or pain around the metatarsal heads, (pads) can help," Mieras says.

Many full-length arch supports include metatarsal pads, among them a pressure-relief insole, but several companies sell standalone inserts with adhesive backings that glue the pads into your shoes. If you use a metatarsal pad, it's important to get it in the right place. "It's critical that it doesn't touch the metatarsal heads," McClanahan says, noting that if you put the pad too far forward, it raises the metatarsal head rather than spreading the toes, opening the door to stress fractures and other injuries. "They can do harm if they're not in the right spot," he says.

Heel lift

Heel lift pad

The final common type of shoe insert is a heel lift. Typically these are used to take pressure off an injured calf or strained Achilles tendon. As with metatarsal pads and forefoot pain, the pain-relief effect can be dramatic. Not that this means a heel lift can instantly cure your injured Achilles: It merely takes the strain off while it heals. You still need to do the normal stretching and rehab work, Mieras says.

Also, if you use a heel lift for too long, your Achilles tendon will shorten and you'll discover you need the insert simply to function normally. "You can use it for a few weeks," Mieras says, "but then you need to wean yourself off of it." To make this easier, she adds, don't use the heel lift all the time. And as your injury heals, you can shift to smaller and smaller lifts. One way to do this is with layered felt pads.

Who needs insoles?

Based on the latest science, anyone looking to enhance the comfort of their running shoes may want to consider trying a running-specific insole with a dynamic design to improve pressure distribution. This can range from someone dealing with an injury, to an elite athlete looking to gain a legal performance edge during workouts and races.

Some people aren't going to get relief without expensive inserts. Others will do just fine--and possibly even better--with a less expensive option. "There are a wide range of inserts, all the way from something to cushion your foot to something that's going to change how you land," says Jamie Mieras, a podiatrist at the Boulder Valley Foot and Ankle Clinic in Colorado. 

Who does not need insoles?

If you do not find the insoles you try to be more comfortable or comparable to your shoes with the original sock liner, then they may not be for you. 

If you want to try, look for...

A running specific insole designed for the unique motion patterns of running. Comfort is king. A zero mm drop is ideal so they will not interfere with your running shoe’s design. Visit your local specialty running retailer to try several options available and discuss how the varied designs will affect how your favorite running shoes perform. 

Before you buy, press on the arch of the insert, Braver says. If it collapses, it's not supportive enough. Also, don't buy half-insoles that just go under your heel. "You push off the ball of your foot, and that's when your foot pronates and collapses inward," Braver says. "So the insole needs to cover this area." 

If you find an insole that helps--but not 100 percent--take them to a podiatrist, who can customize them. It's cheaper ($75 to $100) than a prescription orthotic, and may work just as well, Braver says. In fact, a study published in the July issue of the American Orthopaedic Foot and Ankle Society's journal found no significant difference in the incidence of foot problems between users of custom orthotics and those who wore over-the-counter devices.

Step it up If all else fails, custom orthotics are probably the way to go. Not only are they molded specifically for your foot, but the materials chosen to make the orthotics reflect your particular running needs. Custom-made orthotics should last at least five years, and podiatrists can also refurbish them every couple of years to prolong their lives. 


Run On!

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