Orthotics can be an important component to healthy living.

Where their running shoes are concerned, runners may need to think beyond the blinding myriad of coloured stripes and patterns. It’s no longer just a question of shock-absorbent gel or strategically placed air pockets.

When you’re considering premium footwear to prevent injuries, sports medicine specialists say that orthotic insoles, or “orthotics” – bespoke support for your particular feet – may be the way to go, especially if your problems are connected to the type of foot with which you were born.

“There are foot structure issues that seem to have a relationship with lower extremity injuries,” said Dr Richard Shaffer, a senior member of a US Navy health research centre. Shaffer and his colleagues have studied how foot structure is related to overuse injuries in Naval recruits during training. Their results were published in the American Journal for Sports Medicine.

Shaffer’s team found that recruits with flat feet or with high arches were more likely to suffer a stress fracture – one of the most common injuries among runners – than those whose arches have an average curve.

While orthotics may be the solution to the woes of some runners, the specialised insoles aren’t a necessity for everyone.

Identify the cause

Specialists first need to go beyond foot structure and hone in on the source of the problem, says sports podiatrist Dr William Olson.

Identifying training errors – which can compound the effects of an athlete’s body structure – is the first step in evaluating fitness injuries, Olson says. The most common training mistakes are cranking up the intensity, duration or frequency of training too quickly, not properly rehabilitating old injuries and failing to warm up and stretch adequately before working out.

The next thing to look at is the athlete’s particular body structure and motion – or “bio-mechanics” – and how they may have contributed to the injury. Podiatrists use a simple examination technique: they watch their patients walk, both barefoot and in the shoes they use while training.

Even if the patient’s foot has some bio-mechanical abnormalities, it could be the ground surface or the patient’s shoes that are actually causing the problem.

Olson recalls one man who ran a marathon on an uneven road surface, so one foot was turning in for 26 miles (approx 42km). “To make orthotics for that person would be a mistake. I told him why he was injured and to avoid circumstances like that.”

Worn-out shoes can cause similar trouble. Most people don’t wear down their shoes evenly. As times goes on, the uneven wear causes the whole foot to tilt, and could lead to an injury.

Making corrections

Once podiatrists rule out other causes, they can then focus on correcting the athlete’s bio-mechanical make-up. To do that, they often suggest specific shoes that can help to control some of the causes of the abnormal bio-mechanical function.

Over-the-counter arch supports can also help. However, when the standard sizes don’t work, Olson prescribes custom orthotics to correct the athlete’s specific bio-mechanical deficits.