As you read this, there are literally millions of people going about their day with custom orthotics in their shoes. There are of course also millions of people wearing generic insoles in their shoes who paid a fraction of the amount. Without doubt there will be people in both camps experiencing great benefits. The majority of these people will have found themselves wearing orthotics or insoles because of some pain or complaint they developed at a certain point in time. The reasons people wear insoles and orthotics include everything from plantar fasciitis and knee pain through to back pain, ankle pain and hip pain.
It is very hard to say with absolute certainty who has less pain and greater benefit as a result.
Research.. What Research?
The question of ‘how much benefit’ when it comes to custom made orthotics is not always as easy to answer as you might think. This is because custom made orthotics are designed to reduce the strain of concrete and paving on your joints and soft tissues over long periods of time. It could be compared to attempting a study on the long term benefits of drinking 3 extra glasses of water a day across the full spectrum of health issues we face long term, not easy research to do because of all the other variables in each persons life.
In order to study this comparisons between insoles and custom orthotics scientifically in a way that a firm conclusion could be drawn, you would need a lot of expertise, a lot of money and a lot of time. Then once you had results you would need to convince someone else to find at least the same resources and put them into verifying your results by repeating the study. That’s how the data game is, and sadly no one has done this kind of research at this kind of level for you… as yet.
The simple but inconvenient truth is that it is not easy to quantify the difference in ‘tissue stress’ between one device for flat feet and another, especially over long periods of time, this is not an easy thing to measure.
So rather than pretend that we have any comprehensive and reliable data to cover all the possibilities within this complex issue… I am simply going to offer the thoughts and reflections I have developed over a lot of years of experience.
Some Personal Observations
It has certainly been my experience that those who have a high quality custom made orthotics tend overwhelmingly to get better long term pain outcomes than those wearing generic insoles for flat feet. My observations over a couple of decades are not the same as offering scientific proof.. but they do count for something.
The classic patient who typifies this pattern is the person who turns up in my office nearly on a daily basis wearing some generic insoles that they usually purchased in a shop or pharmacy. The conversation nearly always goes the same way word for word. I express that I assume they have helped and the patient responds with words to the effect of ‘yes I think they have helped a bit‘ or ‘I think they might have helped‘. The general vibe is positive but one of very marginal improvements. These exact same patients at some later stage will usually express far more emphatically how great and how different their custom orthotics have made them feel, along with decisive reports of significant pain reduction.
Another near daily observation is a kind of ‘aha moment’ when people who have had insoles first put they’re custom orthotics in. It is a moment not unlike the one where the prescription sunglasses go on and things come into focus for the first time in a long time.
If these observations (and countless others like them I left out to prevent this becoming a somewhat cumbersome post) had been occasional happenings they might not count for much. The fact is they are very predictable and steady observations made on the majority of relevant cases over a long period.
All this being said you can get lucky with the right generic insole. If a generic insole for flat feet is stiff enough and happens to have the correct amount of arch height for you it could in some instances be about as beneficial to you as custom made orthotics for flat feet. These cases are generally the milder instances of pain and misalignment.
The Worlds Greatest Bargain
It is my belief that the greatest bargain product in all of creation is the fire alarm. Bear with me here I do have a point to make…
Consider for a moment the fact that my friend Dave once spent $12 on a small plastic device containing some simple circuitry called a fire alarm. A year after Dave invested his $12, that device woke him to a house filling with smoke at 2am. His $12 investment saved his life, the lives of his wife and 3 children, his dogs life and his goldfish’s life. It also saved 3/4 of his worldly belongings from being burned and made the difference between the home he built needing repair or being burnt to the ground. I challenge you to think of a better value proposition per dollar spent on an item than that fire alarm.
At the other end of the value spectrum Dave could so easily have passed on the expense of the fire alarm, and spent that $12 on 2-3 bad extracted cups of coffee in any number of cafes within walking distance from his lovely home. I believe bad coffee is one of life worst value propositions.
Now I am certainly not going to claim that custom made orthotics can compete with the value proposition of the fire alarm.. because virtually nothing can. But I am going to say that in my experience, custom orthotics for people with significant knee pain, ankle pain, hip pain and even back pain are often way closer to the fire alarm end of the value spectrum than you might think. Like i said, I have developed this perspective slowly and cautiously over many years, observing changes in people under different conditions and with different interventions.
The significance of the fire alarm analogy is that there are few times in life where a single purchase that could be afforded by almost anyone can have long lasting meaningful positive repercussions at the foundational levels of a persons wellbeing. It has been my observation that custom orthotics are often one such purchase. They still can’t hold a candle to that fire alarm though .. not without it going off and trying to save the word for $12 again :)
One Undeniable Value Of Custom Orthotics – Wearability
One value aspect of custom orthotics that is pretty hard to debate is their wearability. The most useful orthotic or insole for flat feet is the one you are actually wearing. If I had the choice of giving you a decent insole that I knew you would wear almost 100% of the time vs giving you fancy custom made orthotics that you were only going to wear half the time I would take the generic insoles every time. This is because when it comes to orthotics consistency is king. Consistency generally becomes a lot easier for most people when they make the shift to modern custom orthotics, this is because they are designed to fit neatly in your shoes and provide support without taking up too much space.
Cost is really only ever assessable relative to comparable spending activities and to tangible value added to a life. Custom made orthotics generally cost less than many minor dental procedures. So for about the price of 1 hours root canal work you now have a device in your shoe that reduces strain in your joints. A device that often lasts well in excess of 5 years and serves your feet for 10’s of millions of steps.
The bottom line in this topic is really a question of what your gut tells you, once you have undertaken an investigation into what you can do for your pain. Remembering there could be a lot at stake of course.
Your investigation may need to include going to the trouble of reading further or even talking to others about their experiences with custom made orthotics or cheaper insoles for their flat feet. One such investigation I would urge you to undertake is the act of pressing down on the arch of any given generic insole you are considering with the tip of your finger. As you do so ask yourself if it is going to support your entire body weight pushing down through your arch 10,000 times per day. Whatever orthotic or insole you end up wearing it should be capable of preventing your arch from collapsing. If you can squash it with your finger I would suggest it isn’t going to support your body weight.