Put Your Best Foot Forward
Orthotics can be an important component to healthy jogging.
Identify the Cause continued...
Even if the patient's foot has some biomechanical abnormalities, it could be
the ground surface or the patient's shoes that are actually causing the
"One fellow ran a marathon on a crowned highway, so one foot was turning
in for 26 miles," Olson says. "To make orthotics for that person would
be a mistake. I told him why he was injured and to avoid circumstances like
Worn-out shoes can cause similar trouble. Most people don't wear down their
shoes perfectly evenly. As times goes on, the uneven wear causes the whole foot
to tilt, and could lead to an injury.
Once podiatrists rule out other causes, they can then focus on correcting
the athlete's biomechanical makeup. To do that, they often suggest specific
shoes that can help control some of the causes of the abnormal biomechanical
A committee of the American Academy of Podiatric Sports Medicine evaluates
shoes and maintains an online list of the best ones for different sports at www.aapsm.org.
Over-the-counter arch supports can also help. But when the standard sizes
don't work, Olson prescribes custom orthotics to correct the athlete's specific
To design an orthotic insole, the podiatrist takes an impression of a
person's feet and makes models of them, which the podiatrist then alters to
counteract any problems the person is having.
Orthotics can be made from a hard material such as graphite or a softer,
rubber-like material. The choice of materials is an economic decision, not a
medical decision, Olson says. Harder orthotics last longer, but are more
expensive. The total cost can range from $300 to $500.
Spending the money could make a big difference in the game, says orthopedic
surgeon James Garrick, M.D., Orthopedic Consultant for the San Francisco Giants
and Director of the Center for Sports Medicine at Saint Francis Memorial
Hospital in San Francisco.
"There's no question in my mind that in some cases, custom-made
orthotics can make a big difference and even cure some problems," Garrick
But only if you really need it, says sports podiatrist Perry Julien, D.P.M.
-- the Atlanta sports podiatrist who coordinated the podiatry services for the
1996 Summer Olympics. "It's the single most promising treatment I can offer
patients," Julien says. But he adds, "I don't need to offer it to every