To Wear (Or Not to Wear) Orthotics: That Is the Question

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The topic of orthotics (and their efficacy) is an often highly debated topic in the strength and conditioning community – right on par with whether or not steady state cardio is ideal for fat-loss or figuring out who’s hotter: Jamie Eason or Jelena Abbou?

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For some reason, as I was watching THIS interview between Jon Stewart and President Barack Obama last night, I couldn’t help but notice the ever-so-subtle tension between the two as the topic of health care reform took precedence. While both parties were very respectful and forthright, you could tell that if given the chance, they would rip each other apart like two cocks in a cock-fight. Bad analogy, I know. But I think you get the gist

Anyhoo, when discussing orthotics, we seem to have two camps of thought. On one hand, you have those who feel everyone (and by everyone, I mean e.v.e.r.y.o.n.e) needs to wear them; and on the other, you have those that feel they’re just a tad overrated, maybe even unnecessary given the context.

I, for the record, tend to fall in “eh” category. Of course, one needs to make the distinction between a structural abnormality and a functional abnormality with regards to the foot. If the former – meaning someone picked the wrong parents and was born with flat feet – then I would wholeheartedly agree that an orthotic would be an option and could help improve one’s quality of life. If the latter, however – meaning someone has been wearing shitty shoes all their life (as an example) – then I would have to question if the orthotic is just playing into the dysfunction. I mean, for most, we weren’t born with flat feet, right? If someone loses their arch, they can definitely get it back. It will just take some work and a little thinking outside of the box.

UPDATE: I’ve been corrected (thanks Kim) – we actually ARE born with flat feet. Our foot posture isn’t fully developed until we’re 7-8 years old. Either way, we don’t just miraculously lose our arch. We learn to lose our arch due to the crappy footware we wear 24-7.

Still with me? Okay, good. Furthermore, who’s to say that it’s the foot that’s actually the problem?

My inclination would be to look at things from the hips perspective, which is something Mike Robertson alluded to in Muscle Imbalances Revealed.

Think about it: most people live in anterior pelvic tilt. Anterior pelvic tilt leads to hip internal rotation, which in turn results in femoral internal rotation, which then causes tibial internal rotation, which then, you guessed it, leads to torque being “converted” through subtalar joint pronation. So, in essence, we could look at this whole scenario from the hips point of view. Lengthen the hip flexors, strengthen the glutes and hammies and get them to do their jobs more efficiently, and things tend to work out.

By doing so, you reverse the process: glutes/hammies fire and help to posteriorly tilt the pelvis, which externally rotates the femur, which then externally rotates the tibia, which then causes more supination of the foot, and magically, people get their arch back – sans the orthotics, which really just serve as a crutch.

Now, I’ll be the first to admit that my expertise on this matter is pedestrian at best, and that I have a VERY simplistic view – but I feel it’s a valid view nonetheless. Again, just to reiterate, there are certainly cases where people have a legitimate congenital or structural issue which warrants the use of orthotics, but I think those are few and far between.

I just find it a bit “shady” that many (not all) orthopedists and chiros are quick to fit people for special footwear which, at the end of the day, just ends up feeding into the problem in the first place. Put another way: I think someone’s got an expensive car payment (wink wink, nudge nudge). And, as I alluded to above, many times it’s not even the foot that’s the problem!

In any case, I’m sure I rubbed some people the wrong way with this post, and I apologize for that. I’m just trying to get people to look at the bigger picture is all. You do realize that when you’re wrong you get defensive, right? Oooh, oooh, you’re getting defensive. You’re wrong! I win!

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