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How orthoses improve your running gait and prevent injuries

Many runners struggle with achilles conditions and a flat-footed running gait. These issues can prove problematic to long-term running and lead to injuries. However, a solution may be found in running orthoses, corrective insoles in your running shoes designed to give you a correct running plane. Here's our guide to orthoses and orthotics.

Nowadays, when you take a trip down to your local running retailer, you’re quite likely to be offered a wider range of services – including clothing and footwear advice, video gait analysis, foot scanning, and even ‘orthoses’. The use of orthoses (corrective insoles) in your running shoes is gradually becoming more widespread as runners look to overcome problems with their gait so that they can continue with their favoured activity. However, many runners aren’t sure what orthoses are, how they work, and indeed whether they can provide any specific benefit to them. So, check out our guide – which provides an insight into the science of orthoses and answers these questions:

What are orthoses?
What options are available?
How can orthoses help my running?
What types of running conditions can orthoses improve?

Running orthoses and orthotics – what are they?
‘Orthoses’ are commonly referred to as ‘orthotics’ – but although the two words are linked, there is a distinct difference in meaning between them:

Orthoses. The term ‘orthoses’ covers a wide range of splints and supports for the body – but with reference to running and gait correction, orthoses are simply custom-made corrective shoe inserts. There are different types of orthoses, which can either be complete replacement insoles or smaller, partial replacements, depending on the nature of the correction. Generally, if you have orthoses, you remove the existing insoles from your shoes and replace them with your custom-made replacements. Occasionally orthoses can be worn together with existing insoles, but this is more common for ‘arch-support’-type orthoses or thin ‘heel-lift’-type corrections. Orthoses can vary from extremely rigid, cast insoles to more malleable and softer products that are ‘heat moulded’ to the shape of your feet.

Orthotics. Orthotics is the science of designing orthoses for the feet to correct postural problems, to overcome weaknesses and imbalances, and to improve the function of the body. Orthoses are commonly prescribed by a podiatrist, but as replacement insoles have become more mainstream, specialist practitioners – including some running retailers – also provide a ‘while-you-wait’ orthoses service centred around in-store gait analysis.

The ‘off-the-shelf’ running solution
If you require orthoses, the fitting process can be quite lengthy and involve casts being taken of your feet and repeat appointments. However, with technological advances, an increasingly popular option is to have corrective insoles made for your gait problem on a ‘while-you-wait’ basis. These insoles can last for hundreds and hundreds of miles – which means they will have a similar lifespan to your running shoes.

How do ‘off-the-shelf’ running orthoses get fitted?
The fitting process is straightforward, typically takes about one hour, and runs as follows:

Your running style is assessed, which will usually involve video gait analysis and pressure plate testing.
Leg functional flexibility tests are conducted to build up a comprehensive picture of your particular requirements.
Your replacement insoles are heated in an oven to make them malleable so that they can mould to the contours of your feet.
The warm replacement insoles are placed either under your feet or into your shoes.
When you’re either standing on a special jig or wearing your existing running shoes, your feet are then realigned into the correct position by a specialist.
While you maintain the correct position, the insoles gradually cool and harden. Note that the insoles are still flexible, comfortable and maintain their cushioning properties when they’ve cooled.
Once the insoles have cooled, your foot will now be prevented from any excessive pronation or supination movements, resulting in correct alignment. Initially, wearing the insoles can take a little getting used to – but you’ll find that your body, gait and running style rapidly adapts.

How can orthoses help my running?
Many runners have imbalances or gait problems which, if left unattended, can result in discomfort, pain and also injury – particularly during the repetitive action of running, when the foot hits the ground typically a thousand times every mile. If a runner has a gait problem, distance running can eventually take its toll, resulting in injury. However, by realigning the foot, ankle and lower leg into the correct position and preventing extraneous movement, correctly prescribed orthoses can resolve a number of gait problems and prevent injury. For example, a runner who has a biomechanical problem with their gait can benefit from orthoses because they will be able to:

Reposition their feet into the correct plane so that their feet move through the gait cycle correctly.

Ensure that their weight is more evenly distributed.

Restore their natural foot function.

These corrections can alleviate pain and discomfort when standing or walking but can also be extremely helpful in the more dynamic action of running, where the movement of and the forces on the feet are more pronounced.

Which running conditions can orthoses help?
Orthoses can help a wide variety of foot and lower leg conditions, from problems with the sole of the foot such as bunions and blisters to more biomechanical conditions such as excessive pronation or supination (i.e. excessive movement of the foot during the gait cycle) – plus they can also help a wide variety of injuries right up to the knees, the hips and even the lower back. However, orthoses are frequently most effective when prescribed in conjunction with rehabilitation exercises such as specific stretches or exercises to correct muscle imbalances. So, if you are being fitted with corrective insoles, it is important to ensure that a comprehensive biomechanical assessment of your limbs is also carried out.

Here are two conditions that orthoses can help with:

Achilles tendonitis. Pain and inflammation of the achilles tendon at the base of the calf can be exacerbated through excessive pronation (where the foot rolls inwards too much before toe-off). This pronation problem can be addressed via a corrective insole which stabilises the foot by preventing the excessive inward roll. However, achilles tendonitis is rarely caused by excessive pronation alone. Inflexibility is often a contributory factor too, and so stretching exercises and possibly sports therapy to help return the tendon to its correct length are essential to fully treat the problem.
Flat feet. Flat feet are one of the most common conditions that orthoses can help. Flat feet are caused by fallen arches which results in an excessive inward rotation of the leg during movement. This unnatural rotation can lead to ankle, knee, hip, pelvis and lower-back injuries – and if you suffer from flat feet, a prescription of flexibility training will not help the condition, whereas orthoses will. A correctly prescribed pair of orthoses or replacement footbeds will support the arch and prevent the foot collapsing inwards. No physiological change is made to the body – so if you remove the orthoses from your shoes then the condition will remain, which is why it is important to always wear your orthoses when, for example, you change into different running shoes.

Orthoses helping your running
Either due to genetics or numerous imbalances, many runners suffer from problems that can frequently be traced back to a gait problem. It makes sense that if the foot is tracking incorrectly, the problem will have an effect on other parts of the body too, and potentially cause injury. Correctly prescribed orthoses and similar replacement insoles can make a huge difference to both a runner’s efficiency through the gait cycle as well as reducing pain and preventing injury. If you’ve never considered how orthoses could benefit you before, it might be time to consider a custom-made solution that could get you back running or simply keep you running for longer.