Can Orthotics Make Plantar Fasciitis Worse?

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?

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.