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:

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Naturally, a larger, longer study may have different results. But this is an excellent start, and we can now say with high confidence that barefoot running is not a panacea for running injuries.Unfortunately, you can’t count on wise prescription and skilled crafting: there are many unscrupulous and shoddy suppliers of these products who will prescribe orthotics for almost any problem, or none at all. The science is complex and incomplete. Regulation is a confusing mess. It is nearly impossible for consumers to know if they actually need any of these products, or where to get an expert prescription and a quality product. The good news: there are good sources Sadly no, probably not, and for all the same reasons that they aren’t exactly a magic treatment bullet. You should definitely be skeptical of any sales pitch for orthotics or custom shoes if you have no particular problem to solve. Many orthoses are sold with the promise that they will prevent injury. Even if prevention is not the main reason for the prescription, it is often thrown in as a bonus reason to buy. But it has been tested, with poor results. Running and walking shoes that try to be like orthotics In a recent clinical study, Superthotics wearers reported a significant reduction in their pain in as little as two weeks! Within 30 days of wearing Superthotics, wearers reported that:

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This was a large review of previously published research about the use of custom foot orthoses for the treatment of various kinds of foot pain. Unfortunately, in all that research, “There is limited evidence on which to base clinical decisions regarding the prescription of custom-made foot orthoses for the treatment of foot pain.” In other words, abnormalities matter less than many patients and professionals still assume, but they still do matter. Yes! Dr. Sutera recommends removing the insole that comes with the shoe and fully replacing it with the orthotic insole. Putting the insoles on top of each other can make the shoes ill-fitting, uncomfortable and possibly even more painful than before.Superthotics have been shown to relieve painful problems like bunions, stress fractures, hammer toes, shin splints, tendonitis and so much more.

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Telfer S, Gibson KS, Hennessy K, Steultjens MP, Woodburn J. Computer-aided design of customized foot orthoses: reproducibility and effect of method used to obtain foot shape. Arch Phys Med Rehabil. 2012 May;93(5):863–70. PubMed22541310❐ In any case, even a podiatrist skilled in the prescription of custom foot orthoses is still obliged to have them manufactured by someone else. For this reason alone, many podiatrists prefer to refer their patients to certified pedorthists/orthotists. Who “needs” orthotics? Anyone? 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! A middle-aged woman arrived at my office last week complaining of heel pain and carrying a bag of custom-made foot orthotics (orthotics are custom made arch supports that are fabricated from a mold of the patient’s feet). Each orthotic this woman had with her was expertly fabricated by a different podiatrist and yet none of them had come close to alleviating her heel pain. At first I thought maybe these podiatrists didn’t know what they were doing. But, when I learned their names, I knew this woman had seen competent, skilled and reputable physicians. 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.”A review of studies of foot orthoses to treat overuse injuries of the lower limb with a mostly negative conclusion: “no difference between custom and prefabricated foot orthoses” and “the evidence was insufficient to recommend foot orthoses (custom or prefabricated).” (One thin ray of light was that the evidence supposedly supports the use of foot orthoses to prevent a first injury … but, even if true, hardly anyone seeks out orthoses before they develop an overuse injury. And why would they be good only for a first injury? Makes no sense, therefore likely not true.)