Can Orthotics Make Plantar Fasciitis Worse?

Can custom orthotics make plantar fasciitis worse? Dr. Angela Walk

Orthotics have become a mainstay for treating foot conditions. Sadly, this type of orthosis only weakens the foot muscles long-term and sets you up for foot conditions such as plantar fasciitis.

Orthotics deny our feet the opportunity to work and creates "lazy feet". The muscles of our feet can begin to atrophy and not work as they were designed.

Extra orthotic support can be helpful in the acute phase of care where pain is more severe, but beyond that, they further weaken your foot muscles.

Orthotics are not the answer for resolving foot and gait issues. The solution is strengthening your foot core.

Let's start by reviewing the characteristics of plantar fasciitis, and then dig deeper into how to achieve real correction.

Dr. Angela Walk

The Plantar Fasciitis Doc

Specializing in Foot & Gait Mechanics

What Is Plantar Fasciitis?

Plantar Fasciitis is the most common cause of foot and heel pain. It involves a break down, or degeneration of the collagen fibers in the plantar fascia, a thick, fibrous band that runs from your heel to your forefoot.

Symptoms include pain at the inside portion of the heel that is worse after prolonged periods of rest and with the first steps in the morning.

The most common causes of plantar fasciitis are wearing footwear that narrows at the toe, a weak foot core, and calf inflexibility.

Plantar fasciitis is already so painful the last thing you want to do is make it worse. Orthotics can actually prolong recovery.

Can Orthotics Do More Harm Than Good?

Our feet are inherently strong on their own and do not need extra arch support or extra cushion. The more external support you have in your footwear, the less internal strength the the feet develop.

When orthotics are present in footwear, you rob your feet of the ability to function normally. Overtime, the intrinsic muscles of your feet become even weaker, and dysfunction and pain will eventually follow.

A good analogy would be casting your broken arm. The cast is necessary in the healing phase, but if left on too long, the muscles of your arm begin to atrophy and become weak.

The feet actually become dependent on arch supports because they’ve become so weakened and deformed by the shape and technology built into the footwear.

Do You Need Orthotics For Flat Feet?

Do orthotics work for flat feet? Dr. Angela Walk

Flat feet, also referred to as pes planus, or fallen or collapsed arches, is a condition characterized by a low or collapsed arch of the foot. It can be in one or both feet.

It can be a hereditary trait and begin during childhood or it can develop with wear-and-tear from extensive physical activity or simply flatten as we age.

Many of my patients have been told that their flat feet are unnatural and troublesome and orthotics must be worn for correction, however, flat feet do not need extra support.

Flat feet or low arches are a completely normal presentation and are perfectly capable of functioning normally.

The arches in your feet play a significant role in shock absorption, gait flexibility, balance, and maintaining problem-free movement while we are walking and running.

Flat feet are competent to fulfill their role in your walking and running gaits, however if the intrinsic muscles of the feet and arches are weak. this can set you up for conditions like plantar fasciitis.

The good news is that the arches in your feet are just like any other muscle in the body and can be strengthened and trained over time. See below to see how to strengthen you foot core.

Do I Need Orthotics For High Arches?

Having high arches is not an abnormal finding. High arches are a normal presentation and do not require arch support to correct.

Also, high arches do not cause plantar fasciitis. Arch height is NOT a factor in developing plantar fasciitis. Studies have shown that there is NO correlation to the height of your arch and the presence of plantar fasciitis.

It is true that neither flat feet nor high arches absorb impact as well as balanced arches, yet arch height is not the cause of the disorder in most cases.

Ensuring that the intrinsic muscles of your feet are strong is the key to healthy feet.

Do I Need Insoles For Running?

Most of my patients who are runners feel that the more cushioning they have in their shoes, the better it is for their feet while running.

The more cushion there is below ones foot, the more proprioception is hindered leading to abnormal biomechanics.

Proprioception refers to the ability of the foot to sense what it comes in contact with, and then signal the brain which fires the nerves to contract the appropriate muscles to position the foot and leg during locomotion.

When this pathway is disrupted, we see a disruption of shock absorption capacity which leads to an increased rate of injury.

Orthotics are not the solution for healthy feet. Strengthening the intrinsic muscles of your arch and feet is the only path to real correction.

Can You Rebuild Your Arches?

Weakness of the core intrinsic muscles of the foot is one of the most common causes of plantar fasciitis, Achilles tendinosis, and other lower extremity disorders.

The intrinsic muscles of your feet are located entirely within the foot and are responsible for the finer movements of your foot, and for helping support your foot’s arches.

If you’ve got dysfunctional or weak intrinsic foot muscles, you will experience imbalances in the foot altered gait mechanics. Your foot also starts to rely too much on surrounding musculature – including the plantar fascia and over time, the plantar fascia will begin to react to the additional stress.

The primary cause for weak intrinsic muscles of the feet is wearing footwear with a narrow toe box. This poor design feature shifts and compresses our toes and prevents our feet from functioning normally.

Our feet have 26 bones, 33 joints and over 100 muscles, tendons and ligaments. The human foot is amazing and complex.

When our feet and toes cannot spread and splay as we walk and run, this incredible group of muscles, joints, and tendons can no longer work to support our arches and gait.

With long-term exposure to conventional shoes, the intrinsic muscles of our feet begin to weaken, our toes start to deform, and our muscles shorten and atrophy.

The most important change to improve foot health is to transition to natural footwear. Let's take a look at the most effective way to make the transition.

How To Transition To Natural Footwear

Ill-fitting footwear is the #1 cause of most foot and heel conditions including plantar fasciitis, bunions, hammer toes, and Achilles tendinopathy. When discussing foot health, the design of your footwear should include critical criteria.

These are the design features required for healthy footwear:

A wide toe box to encourage natural toe splay and spreading of the toes
A flexible sole to encourage enhanced foot strength
A completely flat sole from heel to toe to encourage natural arch support
A thin sole that is not heavily cushioned

The transition from normal footwear to minimalist or functional footwear should be gradual to avoid soreness. You wouldn’t run a marathon without increasing your mileage slowly, right?

A smooth transition is important to avoid soreness. Listen to your body as you transition and let your feet adjust.

Wear your new footwear with wide toe boxes and zero drop for short periods of time and then gradually increase wear-time as your foot adapts.

The functional footwear I recommend most often are Altras, Flux Footwear, Xero Shoes, Vivobarefoot and Lems. Each of these brands check all the boxes for foot-positive footwear.

I have compiled a complete list of approved shoes for plantar fasciitis including running shoes, hiking boots, dress shoes, and the best shoes to wear around the house.

I've also included the shoes to avoid that could be causing your plantar fasciitis. You can find that here. Dr. Angela's Recommended Shoe List.

Can I Treat Plantar Fasciitis At Home?

If you have this debilitating condition, here are my top 3 recommendations.

Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram
Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery with wearing the wrong shoes.

Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.

Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.

These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.

In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.

Summary

Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence.

By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.

If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. We’re here to help get you back on your feet--literally.

Wishing You Health & Happiness,

Dr. Angela

P.S. I have written extensively on the topic of plantar fasciitis. Take a look at these other related blog posts: