Observe your shoes for uneven wear patterns, which may indicate improper gait or other biomechanical problems. Is the wear pattern even between shoes? Major causes of asymmetrical wear are limb-length discrepancies and excessive pronation. The wrong shoe type can cause abnormal wear patterns. Look at different types of shoes you wear. If the abnormal wear pattern is consistent, then it is usually a biomechanical flaw. If only one style of shoes has abnormal wear, then look at the shoe with the abnormal wear for differences from all the other shoes. For running shoes, does the wear match the mileage? If the mileage appears to be low and the wear great, look for problems in the shoe.
If the upper looks like it is hanging over the outside of the shoe, it may indicate that the last (shape) of the shoe is too curved for the shape of the foot. If the upper looks like it is hanging over the inside of the shoe, it may be that the foot pronates too much or the foot may be too curved for the shoe. Abnormal wear through at the toe box means the shoe is sized too small. If the heel counter is tipped to the inside it usually means pronation. If there is excessive wear on the inside of the heel counter, it is frequently due to excessive heel motion within the counter indicating that the counter is too big for the heel.
The term "orthotic" can refer to almost any device which is worn inside a shoe. Shoe Inserts can be inserted into a patient's shoe easily and can provide support to the foot. These range from rubber or silicone heel cups to full-length shock absorbing inserts. Some have good arch support, while others are completely flat. Some even contain magnets or fluid-filled sacs. These inserts are usually inexpensive, but but do not last longer than 1 year. The can be difficult to fit the non-standard size or asymmetrical foot and do not do a very good job of correcting specific problems.
Custom orthotics are casted for each foot. A wide range of materials are available and can be chosen based on need. Specific corrections can be made for the individual's problem. These orthotics can last several years.
If you currently wear orthotics, be sure that your devices fit the criteria below:
If your orthotics do not fit the above criteria, follow-up with the practitioner who made them or consult a practitioner who has expertise in biomechanics and orthotics.
Orthotics can make a significant difference for any athlete who needs them. They will control pronation, support the arches of the foot and prevent excessive ankle and heel movement. They will also help improve gait, knee alignment and function and overall balance.
See my article Proper Shoe Fit for more information.
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