Orthotics are specialized shoe inserts, either custom-made or purchased over-the-counter, designed to provide biomechanical support and improved alignment for the feet. They work by redistributing ground reaction forces and supporting the longitudinal and transverse arches, which can alleviate discomfort associated with various foot and lower limb conditions. Achieving the intended therapeutic benefit relies heavily on ensuring the orthotic is correctly positioned inside the footwear. This guide offers clear instructions on proper placement to maximize comfort and functional effectiveness.
Preparing the Shoe for Orthotic Insertion
The first step before placing any orthotic is preparing the shoe’s interior by removing the existing factory insole or liner. Removing the original liner prevents “crowding,” where two inserts occupy space meant for one. Leaving both inserts in the shoe can lift the foot too high, causing the heel to slip out or the toes to rub uncomfortably against the top of the toe box, compromising the shoe’s intended fit.
The orthotic is engineered to sit directly against the firm sole of the shoe to provide stable support. Most factory insoles are designed to be removable and can be pulled out easily. If the existing liner is glued firmly into place, exercise caution when attempting removal to avoid damaging the shoe’s structure. Only if the factory liner is permanent should trimming the orthotic be considered, allowing it to fit directly over the original liner without causing discomfort.
Step-by-Step Guide to Proper Placement
Once the original insole is removed, the physical placement of the orthotic can begin. Start by guiding the toe end all the way forward into the shoe’s toe box. Ensure the front edge of the orthotic rests flush against the interior front wall, establishing the correct longitudinal position for the arch support and heel cup.
Next, the heel cup should sit snugly against the back inner wall of the shoe’s heel counter. The orthotic’s contour must align precisely with the shoe’s structure to maintain stability during walking. A heel cup that sits too far forward or is twisted will compromise support and allow the foot to pronate or supinate excessively.
The side-to-side orientation requires careful inspection to ensure the arch support is correctly positioned. The orthotic must be aligned so the medial (inner) side follows the corresponding curve of the shoe, preventing the arch from collapsing inward. Proper alignment ensures the highest point of the arch support sits directly under the foot’s anatomical arch structure.
After positioning, gently press down along the entire length of the orthotic to confirm it lies completely flat inside the shoe. Run a finger along the edges, especially near the forefoot, to check for any wrinkling or bunching of the material, which often indicates a poor fit or incomplete liner removal. The orthotic must maintain a smooth, flat surface to prevent localized pressure points or blisters. If the orthotic is slightly too long and curls up at the toe, a small, careful trim to the non-supportive material at the front end may be necessary, but only after verifying the heel is correctly seated.
Adjusting Orthotics for Different Shoe Styles
Fitting orthotics into different shoe types presents challenges. Athletic shoes and boots offer generous depth and width, easily accommodating full-sized orthotics. These shoes often feature a deep heel cup, and it is important to verify that the orthotic’s own heel cup fits securely within this space without shifting. Securing the orthotic helps maintain biomechanical function during running or high-impact activities where lateral forces are common.
The challenge increases when dealing with narrower, shallower footwear like dress shoes or flats. The thickness of a standard orthotic quickly occupies the limited space available in these styles. This can lift the foot too high, causing the heel to slip out of the shoe as the heel counter loses its grip.
For these shallow styles, individuals may need specialized, low-profile orthotics designed to be thinner and shorter than full-sized inserts. These slimmer versions utilize less bulky materials to minimize volume displacement inside the shoe. Even with slim orthotics, the reduced depth of dress shoes means the foot’s position is altered.
The orthotic must not compromise the upper fit or cause the foot to press uncomfortably against the shoe’s ceiling, especially across the dorsum of the foot. When using orthotics in open-backed shoes, such as mules or sandals, placement should be secured with adhesive to prevent the insert from sliding out of alignment, as these shoes lack a stabilizing heel counter. Proper selection based on shoe style ensures the orthotic delivers targeted support without creating new fit issues.