A good quality controlled test of customized orthotics for Achilles tendinitis, compared to a sham of off-the-shelf orthotics. This is a solid, straightforward design, and it has plenty of statistical power, with 140 subjects in two groups. The report on it was even refreshingly well-written. So this is a rare case of a study that actually produced a persuasive answer, instead of just more low quality evidence that has to be taken with a huge grain of salt. Superthotics are the medically designed shoe inserts made with patented technology designed to relieve pain, align your feet and provide unbeatable comfort Superthotics® was developed by doctors with a patented innovation that instantly corrects your foot and ankle alignment, so the rest of your body can be relieved from pain from your feet up all the way up throughout your entire body. Most consumers assume a foot doctor is a good source of orthotics. Unfortunately, this is far from guaranteed. Many podiatrists are qualified for it, but probably most are not, as suggested by this rather chilling story from Dr. Michael “America’s Podiatrist” Nirenberg: A little: “Currently, there is gold level evidence for painful pes cavus and silver level evidence for foot pain in juvenile idiopathic arthritis, rheumatoid arthritis, plantar fasciitis, hallux valgus.” But silver-level evidence is really not great, and I find that terminology annoying because it invariably makes evidence sound better than it is. For plantar fasciitis, the authors also comment that it is “unclear if custom-made foot orthoses were effective.”

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Wait-list groups are a crappy control. They suffer from “frustrebo” — poor outcomes caused by disappointment of knowing that you are not getting any treatment (see Power). This is a major flaw. As Dr. Stephen Ward tweeted, “ Waiting list control, schwaiting list control.” Instantly realigns your feet to relieve pain, restore balance and provide stability and comfort through your whole body T.Moffitt,C.Ped.(c) CertifiedPedorthist,Edmonton,Canada Caveat emptor! Many orthotics are poorly made and for the wrong reasons The problem must then be correctable at least in principle. Quite a few problems simply cannot be fixed by orthotics. It depends on the problem.Different people, feet, shoes and activities require different materials,” says Dr. Sutera. What works for one person may not work for another. Because there isn’t a one type fits all insole, consider your foot shape, medical history and end use before purchasing, as these factors can dictate which material is best.

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The Pedorthic profession in Canada is moving in a great positive direction with integrity, attracting only University educated individuals to become certified pedorthists,” says Paul Rauhala of OKAPED in Canada’s Okanagan Valley. That training translates into an impressive experience for the patient: I have been a patient at OKAPED in the past, and was blown away by the thoroughness and technical expertise of their assessment, which included slow motion video. My own limited training in orthopedic assessment gave me just enough knowledge to realize how much more Mr. Rauhala knows about it than I ever will — in the leg, anyway! Hawke F, Burns J, Radford JA, du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008;(3):CD006801. PubMed18646168❐ Do runners with anatomical quirks get more injuries than symmetrical and aligned runners? This study was another attempt to settle an old question that just won’t die. Munteanu SE, Scott LA, Bonanno DR, etal. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med. 2015 Aug;49(15):989–94. PubMed25246441❐You must have a diagnosable biomechanical problem, probably something really obvious, because anything more subtle and you’ll probably get different diagnoses from different professionals. What you might not realize is that the problem almost always starts with the improper alignment of your feet. When your feet are out of alignment, your whole body is out of alignment and that causes pain! Many chronic problems like shin splints, plantar fasciitis, sports injuries, stress fractures and others, can cause immobility and put a damper on your everyday quality of life, when they just don’t have to.