orthotics or better?

September 23, 2016 6:16 AM

Doctors agree: My feet are the flattest. An arch collapsed in one foot but not the other. Highly recommended, expensive insoles are good for the first 1,000 feet but don't make any difference thereafter. I wear a splint at night and losing weight. Aside from amputation, what should I be investing in or spending my time doing?
posted by parmanparman to Health & Fitness (14 answers total)

If you find that orthotic insoles help but your feet pound them flat in no time, maybe switch from expensive prescription ones to one of the better over-the-counter ones? That way when they wear out you're only out like $30 instead of $1000, and you can just get a new pair.

I also have flat feet, and when my prescription insoles wore out (after about 10 years; my feet are apparently not as punishing as yours) I started buying OTC insoles and they've worked just as well. They're also cheap enough that I can keep a dedicated pair in each set of shoes I have, rather than moving them around all the time. I like Powerstep Pinnacles a lot, and since your feet are "the flattest," I imagine the one for you would be the Powerstep Pinnacle Maxx. I also like Superfeet, but at least in my size they tend to cost about $10 more and I haven't noticed that they're any better than Powersteps.

Also, perhaps what's going on is that your arches have adjusted to your insoles such that you actually need a new prescription in order to continue providing support? I have no idea if this is even a thing, but it might be worth bringing up to your podiatrist as a question. If what you're looking for is the feeling that you get when you first start wearing orthotics, when your feet aren't used to them yet and you can really feel them pushing up into your arches with each step, then maybe you need a stronger prescription, so to speak. Just a thought, but possibly worth pursuing with a doctor.
posted by Anticipation Of A New Lover's Arrival, The at 6:34 AM on September 23, 2016 [1 favorite]

I too have the flattest feet that ever flatted. Orthotics were recommended, but the doc said sotto voce that Birkenstock insoles were probably just as good. And in my experience, they are. Much more permanent than the Dr Scholl's strips of foam or whatever. Might be worth checking out for the $50-70.

It's surprising what foot-friendly shoes or insoles work for me, or actually work against me. Keep looking, keep trying.
posted by Capt. Renault at 7:21 AM on September 23, 2016 [1 favorite]

i've been using barefoot science insoles for a number of years now.
posted by osi at 8:40 AM on September 23, 2016

Flat feet are the worst. I have nothing to add on the insoles; I never did really figure them out, and instead focused on buying the most supportive granny shoes I could find. This worked a lot better for me personally, but you may find differently. I also found that simple foot exercises helped enormously. I worked through some yoga poses targeted at feet, but maybe some physical therapy might help, if you're really struggling? If you get serious about the weight loss, that will help lots, too. I've been eating a few too many cheeseburgers recently, and I'm really feeling it, even 10 pounds makes a big difference.
posted by backwards compatible at 8:41 AM on September 23, 2016 [2 favorites]

Another brand recommended by a podiatrist is Sole - they have different stiffnesses, and form to your feet as you wear them. At least as good as my old customs, and much cheaper!
posted by dbmcd at 8:45 AM on September 23, 2016 [1 favorite]

Go to a physio therapist for exercises/strength work for your feet. I'm also pretty flat footed (from birth). This has lead to some crappy ankle tendon issues (photos of my heels while I was standing in what felt like a neutral position look like the ankle had been broken or collapsed inward).

Initially I needed electrial stimulation along the muscle while "trying" to exercise the muscle to really train my body what to do. While doing that, I pretty much needed to clench all of my other leg muscles, and usually my arms/hands/core as well. It's progressed to the point where when I activate the muscles along my arch/ankle I only also clench my calfs, and can do some balance work while doing this. I don't really have much of an arch, but my ankle is rapid approaching what should be a strong neutral position.
posted by nobeagle at 9:08 AM on September 23, 2016 [1 favorite]

I have orthotics that were the expensive made just for me kind to help me with my foot/ankle/knee issues. They are amazing. Anyway just wanted to say that maybe you need to find a good orthoticist (is that even a word?). Mine basically told me to come back to me when they are getting worn out and the price I paid includes him fixing them. He stands by his product and wants it to last. So, in addition to trying out the over-the-counter stuff, maybe search around, see if there's a good orthoticist in your city? Mine was highly recommended by my orthopedist and I'm so glad I found this guy. Making insoles is all he does so he wants people to be happy with his product.
posted by FireFountain at 9:42 AM on September 23, 2016 [1 favorite]

Does your insurance cover orthotics? Has your podiatrist checked? Mine were considered medically necessary because of my high arches. I would imagine very flat feet would also be covered?
posted by vivzan at 10:03 AM on September 23, 2016

In terms of insoles wearing out quickly, one thing to try is rotating your insoles and shoes, so that you don't wear the same pair 2 days in a row.

I use the superfeet green insoles. They're cheaper than prescription orthotics, and I can often find them on sale for somewhere between $30-$40. Amazon (US) often has sales on them. Super feet has a range of insoles, but the green is one of the most supportive ones, and they are what's worked best for me. I don't know if I have intrinsically flat feet, but I do know my arches would flatten out a lot when I walked. I have a job where I'm on my feet for between 4-12 hours in a day, and before I got the superfeet, I was in horrible pain after a couple hours. (I get the best results using them in running shoes; I'm fortunate to have a job where that's acceptable.)

I do run through a pair of shoes and insoles at least every 3 months, but that's probably in large part because of the number of hours I spend on my feet. Fortunately, the insoles are not too terribly expensive. (I can tell that I need to swap them out when the pain starts flaring up again.)

It's hard to know what else to recommend without more info. What kind of shoes are you wearing? What do you consider expensive for insoles? (I know custom ones can be several hundred dollars, but I'm not sure if you consider $40 too expensive.) Also, is it that the insoles are actively wearing out? It might also be that you need to ease into wearing them, if they feel okay at first and then stop working shortly after you first start using them. However, I do find the type of shoes I'm wearing also make a big difference. The superfeet help somewhat in boots and non athletic sneakers, but I need my running shoes to get the full benefit. (Without the superfeet, running shoes are only slightly less painful than some of my other shoes.)

Also, Birkenstock sandals are pretty much the only shoe I can wear without the superfeet. I wouldn't wear them for a long time or when I'm walking a ton, but they are better than most of the other shoes I have because of their arch support.

I also agree with the recommendation to look into physical therapy.
posted by litera scripta manet at 10:23 AM on September 23, 2016 [1 favorite]

I used to have fairly flat feet, and I noticed after doing workouts for a while that they had noticeably more arch. I wouldn't be surprised if it's fixable with exercise/PT.
posted by zug at 12:27 PM on September 23, 2016

I am also this flat-footed, and had shin splints from it for years. I used to wear insoles but not anymore — a combination of yoga and ballet exercises built up enough strength in my foot that I now have something vaguely resembling an arch.

in yoga, the mountain pose (the first pose in the sun salute sequence) is key. to do it right, you have to learn to grip the floor with your feet. the ballet exercises helped a lot, oddly, because this is actually a problem a lot of ballet dancers have. extreme turnout of the feet can cause the arch to collapse. Alexander technique and chi kung also might be able to help, depending on what kind of resources you have available to you.

I had teachers to help me learn the proper form for these exercises, and that's important. for this to work, you'll likely need to relearn some deeply ingrained habits when it comes to your posture. also, depending on what kind of shape you're in, you might want to talk to a doctor (or equivalent) before trying anything like this.

good luck with it!
posted by spindle at 2:39 PM on September 23, 2016

Your doctor is wrong - I have the flattest feet.

Being serious now - Not saying this is the solution for everyone but I've gone the opposite direction for daily footwear. If I'm doing a lot of walking, running shoes designed for overpronators and/or some orthotics seem to make it easier on my knees. In my experience the shoes are much more effective than the orthotics. But, if I'm not doing some serious walking, I find the less support the better. My feet seem happiest if I just allow them to be the pancakes they are. I'm most comfortable in something like Merrell Barefoot or Vivobarefoot
posted by Carbolic at 3:30 PM on September 23, 2016

Just jumping in - I have great prescription/custom orthotics and a wonderful doctor. Maybe you have had multiple opinions - and I don't know your body's needs - but if not, I echo the recommendation to speak with someone else. Good luck!
posted by anya32 at 7:30 PM on September 23, 2016

Response by poster: It turns out I don't have plantar fasciitis. That's good. But in really I have aggravated a tiny bone in my foot and it needs time and space to heal or else will turn into arthritis. I have been told to get wider shoes and am getting fitted for orthotics. It means a lifestyle change, getting used to the shoes which are big and heavy. Any recommendations for light, wide shoes for professional and leisure activities would be very useful. I have started on a plant based whole food diet which might help my foot. Any thoughts are useful!
posted by parmanparman at 1:12 PM on October 23, 2016