Do Functional Foot Orthotics Work? Yes!

Dear RunDoc: I read in the NY Times that orthotics often don’t work and I should try running barefoot to strengthen my feet. I tried and my feet got a lot worse. I know you wear orthotics and make a lot of them for your patients. Why do you think custom foot orthotics work in your hands?

RunDoc answers: Hmmm….Good question! I read the article in the New York Times and laughed then cried. They are so biased against orthotics that this is bout the tenth time in the last few years they are trying to make them voodoo. Fortunately, they are wrong and there is science behind it.

Many tens of millions of patients have been helped by custom-made foot orthotics over the past 50 years.

There are many studies published in peer reviewed medical journals showing the effectiveness of orthotics in reducing injury and relieving pain.

One of the most important factors creating the need for orthotics is that we usually walk on essentially hard, flat surfaces that do not exist in nature.

Walking or running barefoot does not change the above.

The science of biomechanics relating to orthotics is complicated and requires years of study. This is why you should have your orthotics made by a well-trained podiatrist in biomechanics and even better, one who has an understanding of your specific sport.

The process of getting an orthotic to be most effective is iterative, often requiring serial adjustments. This is because everybody is different and may not tolerate “perfect” biomechanics.

The conditions for which orthotics are prescribed often take years to develop. They are not going to disappear overnight with the use of orthotics.

Orthotics should not be chosen by how comfortable they feel. Often, they are uncomfortable at the beginning because they are “correcting” your biomechanics with an external device and you have to get used to them.

The reason foot impressions (casts) are taken off-weight-bearing is so the foot can be positioned in an optimal shape that will allow it to naturally bear weight on its own. A three dimensional scanner can also be used to get a “true” picture of the foot without a cast.

Orthotics are not arch supports. They guide the foot through a proper gait cycle, allowing the foot to achieve various optimal positions at the correct time and creating a means for shock absorption, weight bearing, and propulsion.

A flat foot by itself is not good or bad. A high arch by itself is not good or bad. How the patient functions with those features is the issue.

If you have been told you need orthotics and you’re in doubt, get a second opinion. If you have orthotics and they are not working, get them adjusted.

Correctly made functional foot orthotics work! I have built my reputation with them.

Run Happy! And in orthotics if you need them!

Acheive Your Fitness Goals!

The most common New Year’s resolution in the United States is to lose weight or improve your fitness. Let’s face it, even for the veteran marathoner or triathlete, the New Year gives us an excuse to refocus or give us just a little kick in the butt we need. We all need a plan to achieve our fitness goals or race success. I woke up on January first and realized it was 21 weeks until Ironman Texas. Wow! That crept up on me! Janet has been blogging for months about the road to Ironman Texas. I’ve been so busy working my butt off and being Mom, it crept up on me. Now it is time to refocus on my fitness goals, so I don’t perish on the streets of Houston on May 21st.

Maybe you are like me, a race is creeping up on you, or maybe you have just gained a few extra pounds from the holidays, or maybe you are like some of my friends who realized running up their stairs they get out of breath. This is a great time of year to refocus on your fitness goals. We all have obstacles; time, energy, financial, and our own self-defeating voice in our heads! Here are some tips that will help you focus and reach your fitness goals in 2011!

1. Know your goals: You need to start with the end in mind. What are your goals? Lose weight? Get faster? Get fitter? Get stronger? Body sculpting? Finish your first marathon? Finish your first Ironman? Whatever they are, start with small focused goals and build to larger ones.
2. Start Simple: Begin with a basic program. Make it a habit, and then you can build from it. Maybe you run for 30 minutes every morning at 5:30 am. Maybe you add a strength work out twice a week. Maybe it is as simple as adding a tempo run once a week. By starting simple, after 21 days you have now made a new habit to build on.
3. Write it Down: A goal not written down is a mere wish. Also, logging your workouts make them more real. It also makes any blank spots much more glaring! There are lots of logs or even phone apps to log your workouts and your nutrition. Use one! Include your goals at the top of each page of your log. I also find it helpful to leave myself sticky notes around the house. When you find a note that says “20 weeks to Ironman” on your bathroom mirror when you get up in the morning that is powerful motivation!
4. Enable Yourself: Make sure your equipment is working well. Time to get that new pair of running shoes. Time to tune up the treadmill and work on your bike. Buy yourself a new toy like a chin up bar or power meter for your bike. New toys make fitness goals even more fun!
5. Make it Fun: Find some workout peeps. Make sure you are having fun even when your muscles are screaming at you to stop. I find a weekly group run or ride, coupled with a weekly mostly social weight workout at the gym, makes the many solitary miles on my bike, treadmill or road a lot more tolerable.
6. Confuse your body: Mix up your workouts. Your body gets stronger and faster with small incremental increases in stress. This means changing speeds, changing routines and scenery to confuse you muscles to get stronger. Throw in a crazy yoga workout, a new routine or just a bunch of hills when you usually avid them. Change your energy levels for better success.
7. Be Committed and Consistent: Every year I see a whole gaggle of new people at the gym in the first week of January, and then they are gone by Valentine’s Day. Fitness goal cannot be reached in a month or two. You have to commit to your goals and work towards them. It may take a year to reach your goals. I started working towards my first Ironman two years ago. Now I am less than 5 months away. Rome was not built in a day. When you feel like quitting, pull out your goals and read them again. Start a mantra, “Pain is temporary and quitting is forever” is the one I use with my middle school cross country running daughter. I personally like, “It’s all about the finish line”. Find one that works for you. It really is true that the hardest part of a marathon is the first three steps out of bed in the morning! You will find that once you get up, the rest is easy!

If you follow these few tips, I promise you will reach your fitness goals in 2011! You will thank me! And I will live though Ironman Texas this year! Run happy and towards your goals!