Q/A Pronation and orthopaedic insoles

Screenshot 2019-09-21 at 08.11.49

 

Of course. In addition to coaching, I used to be working a lot in a running shop counselling runners.

So, first thing to understand is the whole orthopaedic insole thing. It should be used in the same manner as a cast, in case of a fracture for example. To alleviate pain, immobilise and create external structure, then when the problem is gone, it should be eliminated. Podiatric insoles should not be used long-term, nor for lifetime ! It is the same like having a cast forever !

I have seen people working through shoes on a monthly manner, even with carbon insert orthopaedic insoles. Especially overweight, with heel strike and heavy pronation. Shoes get destroyed, very fast. It is because, very often, these insoles are higher and thicker and this makes the pressure lever longer, creating even more push down on that inner heel. The softer and the thicker the shoe is, the faster it will happen.

There is one single solution. Eliminating the problem. If the problem is muscular and cerebral, it can take only a couple of months and pronation can be totally eliminated. Reinforcing those muscles needed for proper posture and stride and imprinting good habits with them.

I am talking here of course a longer total process then simply a couple of months in case of a runner for instance aiming for over 100mile weeks, as graduality is key to long term success and injury free rehabilitation. But, pain and issues will be over in a couple of months and the real work can start.

When we talk about deep structural issues, like lower back and general spine deformation, shoulder hunch, maybe some hip and knee issues, but most importantly ankle and toe anomalies, yeah, the whole rehab and reeducation can take years.

A flat foot with bunions or squeezed toes are very often one of the causes of the whole pronation process. Ankle caves in, knees cross over, then hips try to recompensing with no results as they are tilted, then the runner sits back and a whole chain reaction of bad habits will imprint…

In this case, before running happens, feet and ankle rehabilitation should be done ! In many many cases surgery is necessary as that gigantesque bunion cannot be dealt with otherwise. Seen it in many men too ! The little muscles and the structural elements of the feet are very stubborn as they are calcified and strengthened on a bad way often throughout decades ! I mean 35years of bad happenings cannot be undone in 4 months !

However, just understand this. If you were 40 and worked on reeducation for 2 years extremely hard to eliminate your foot issues, to be able to run and live totally pain free till the end of your life, that is not a big sacrifice ! Still 58 strong years to go !!!

So, yes, to your question again. Orthopaedic insoles are a great great solution for many illnesses. But only for SHORT TERM ! It is to heal and alleviate pain ! In reality, it can really help to learn and create proper neuromuscular connections, what later on in the healing process will be advanced to non-insole practices ! No real running and no run racing should be done in them, ever ! Also as I said it should be part of the rehab process, not something you use 24/7 !

(That being said, correcting leg length discrepancies and birth defects are whole another subject.

Also, using no-motion-control natural 3D printed insoles personalised to your cycling shoes, racing flats and track spikes are a different subject too ! That is to avoid power leaks for instance !!! )

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