Insoles are no doubt making a comeback in Singapore. Be it Dr. Scholl’s Orthotics for Plantar Fasciitis from Lazada, custom-made insoles from Happy Walker, or a podiatrist-prescribed pair of orthoses from the hospital, tons of options are available!
Before jumping in to buying your first pair to ease the pain at your plantar fascia and achilles tendon, it is always a good idea to understand your condition better first.
What is plantar heel pain?
Plantar heel pain is one of the most common symptom experience of the lower limb. While commonly attributed to sports participation (e.g., running), plantar heel pair also often affects sedentary individuals.
If you have plantar heel pain, you will be familiar with experiences of ache, soreness, or even sharp pain at the underside of the heel bone. It’s often most painful upon pressure, typically after a period of inactivity (e.g., first step of walking after sitting or getting out of bed).
What is the main cause of plantar heel pain?
Plantar fasciitis is the condition that often leads to plantar heel pain. Plantar heel pain strictly refers to the symptom experience of the heel while plantar fasciitis refers to a pathology of the plantar fascia.
Despite the -itis suffix, which is commonly used for inflammatory diseases, plantar fasciitis is NOT the result of an inflammatory process. As much as the sole of your foot or heel may feel painful or tender to touch, it is not inflamed.
Some patients with plantar heel pain may also have heel spurs that may contribute their symptom experience.
What is the main cause of plantar fasciitis?
The exact mechanism behind plantar fasciitis remains unclear. However, researchers have identified mechanical load and tissue capacity to be risk factors. This include factors such as obesity, training environment (e.g., running on hard surfaces), sudden increase in training volume (e.g., too much too soon), or even long periods of standing or walking.
While high arch is frequently suggested as one of the risk factors for the condition, research does not seem to support that the arch of your foot alone causes plantar heel pain.
It is important to note that most of the risk factors associated with plantar fasciitis or plantar heel pain are modifiable! This means you can take small steps towards walking pain-free!
How do I permanently get rid of plantar fasciitis?
If you are looking for an ultimate cure for your heel or feet pain, you are in it for a shock.
The latest clinical guidelines by American Physical Therapy Association was revised in 2014 and their recommendations did not take into consideration research that has surfaced between now and then.
According to them, interventions such as manual therapy (e.g., massage, IASTM), stretching, taping, foot orthoses, night splints, ultrasound, dry needling can be considered even though research supporting these treatments are lacking.
Their recommendation also include education and counselling for weight loss, which makes sense given the mechanical nature of the condition, as well as therapeutic exercise, which also makes sense given the “too much too soon” risk factors associated with plantar fasciitis.
There are exercises you can do to help with your sole pain. For example, eccentric contraction of the calf muscles, commonly confused as a stretching exercise, is likely to help more than 20 minutes ice packs and shoe inserts in the long-term.
If you are currently living with plantar heel pain, it would be a good idea to seek medical advice from an evidence-based chiropractor or physiotherapist to help you through your recovery. The research pertaining to the condition is grey and it will take a therapist with competent clinical reasoning to help you through this difficult time.
Do insoles help plantar fasciitis?
This is the million dollar question we are trying to address in this post.
Should you be spending $20 for a off-the-shelf Dr. Scholl’s insole or perhaps a more expensive $60 Spenco slippers? Maybe you have tried them both to no avail and you are wondering if a $400++ custom insoles would do you good.
Here’s the unfortunate truth: the latest research suggest that custom orthotics are no better fake/sham orthotics, and could potentially be inferior to your regular GP treatment.
A study published in British Journal of Sports Medicine two months ago found that custom-made insoles were no better than sham insoles or standard medical care.
In the study, 185 participants were randomised to receive treatments from podiatrists and medical doctors/general practitioners.
For the group that was receiving custom-made insoles, 3D imprint of the foot was taken and insoles were made accordingly to the discretion of the prescribing podiatrist. For the group receiving sham insoles, a 3D imprint of the foot was also taken. However, the insoles were made to have as a little mechanical effect as possible.
The GP group any non-surgical intervention that was deemed appropriate by the attending GP. This include medication or even corticosteroid injections.
At the end of 12 weeks, the participants who received standard medical care showed greater improvements than those who were prescribed with the orthoses.
While supporting the bottom of your foot may help you feel better in the short-term, research doesn’t suggest that it is superior to standard medical treatment.
Will you wear your custom insoles?
Regardless of whether insoles work or not work (at this point, it looks like they do not work), the bigger question to ask yourself is if you would wear them.
The same study revealed that almost half (43%) did not wear the prescribed orthotics on a daily basis and 8% of them did not wear it at all!
If you are thinking of getting a pair of orthotics for your supporting the arch of your feet, consider if you would be willing to wear them on a daily basis. While that may seem like an obvious thing-to-do, it could still be an uncomfortable change.
The current research doesn’t seem to strongly suggest that insoles will be your pain solution. However, remember that most of the risk factors that could contribute to your heel pain are modifiable. There is alway something you can do to start your first step towards recovery.
If you need more help with your plantar fasciitis, book in with an appointment with us via the form below and discover the difference the right care can make.