Orthotics are a common and effective treatment for many ankle issues. They can be effective in both preventing and relieving ankle pain. But should you start using them?
What are orthotics and how can they help?
Custom orthotics are a shoe insert prescribed by Podiatrists. They are given to help manage a wide range of foot and ankle pain or injuries. The aim of orthotic therapy is to help correct biomechanical factors. These biomechanical factors refer to the way that the muscles and joints function as you walk and run. When there is an injury, weakness or deformity present, these factors put extra stress and strain on the feet.
Through helping these factors, orthotics can stop the development of chronic pain or injury. There is better efficiency in movement which helps to quality of life and activity goals. Orthotic devices can also be designed or modified in a number of different ways to take pressure off specific areas of the foot and ankle. When pressure is relieved, pain can be reduced and injuries are better prevented.
Ankle pain causes
The ankle joint is a really important structure as it is vital in allowing us to walk and run. There are a number of bones, joints, ligaments and tendons that all function together to make the ankle joint work efficiently. Unfortunately if we have injury to any of these structures, or they are not functioning correctly, we can develop pain and long term issues affecting our activity.
Some common conditions Podiatrist’s see around the ankle are:
- Sprained ankle ligaments
- Chronic ankle instability
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
- Arthritis
Sprained ankle ligaments
Sprained ankle ligaments are one of the most common injuries of the lower limb. They occur when you roll or twist your ankle and cause the strong ligaments around the ankle to stretch beyond their limit. They are injuries that typically occur during sport or activity, but can also affect people in day to day life. The severity of these traumatic ankle injuries can vary from a minor sprain to a full rupture of the supporting ligaments.
Orthotic devices can help get you back to activity faster by evenly spreading ground reaction forces to reduce pressure. This takes the pressure off the ankle joint to minimise load and helps to stabilise the ankle. It is really important to rehabilitate your ankle after an injury too. With the combination of foot orthotics and rehabilitation, you have better outcomes in strength, mobility, and there is less of a chance of this injury happening again.
Chronic ankle instability
Chronic ankle instability refers to an unstable ankle that either gives way often or develops long term pain. Custom foot orthotics can be very useful in people who have feelings of a ‘bad ankle’ characterised by instability and pain. By adjusting the position of your foot and offloading certain parts of the ankle, orthotics help improve your stability, help prevent ankle sprains and pain.
If you are finding you rely on tape or an ankle brace to play sport or even just at work, then a custom orthotic may be a more permanent and easy way to give you that support.
Peroneal Tendinopathy
Peroneal tendinopathy is an injury which affects one of the tendons on the outside of the ankle causing pain. The peroneal muscles and tendons help move the foot outwards and point the ankle down. They are also really important for stabilising the ankle and foot, and helping to prevent rolling too far over the outside.
Foot orthotics can be helpful in supporting the function of these tendons and preventing the onset of pain from overuse in the unstable ankle. This is commonly seen in people with a high arched foot or with chronic ankle instability.
Tibialis Posterior Tendinopathy
Tibialis Posterior Tendinopathy is a condition where there is pain on the inside of the ankle which can extend into the foot. It is commonly seen in people with a pronated foot posture (flat feet). The tibialis posterior tendon can become overloaded and painful which makes it difficult for the muscle to support the foot with each step.
We also see a number of sports people and runners who suffer pain on the inside of their ankles through overuse from training. For this type of ankle pain, a custom orthotic with good arch support can help reduce the load on the muscle and tendon which minimises discomfort.
Foot And Ankle Arthritis
Arthritis pain and stiffness can be present in any joint in the body. Foot arthritis can be particularly painful making it difficult to walk and run. The midfoot and rearfoot joints are commonly affected hee. Osteoarthritis and Rheumatoid arthritis are a frequent presentation to Podiatrists.
Symptoms of arthritis affecting the ankle can include:
- Pain with movement of your ankle
- Pain that gets worse with activity
- Aching in mornings or after sitting for long periods
- Soreness when touching the ankle joint
- Joint swelling, redness, heat
- Joint changes (bunions, toes hammering or clawing, arch dropping)
Who can benefit from custom orthotics?
Orthotic devices are designed to support and minimise the pressure placed on the ankle with the aim of improving function, minimising pain and preventing flare ups. Greater stability of the foot and ankle with a custom orthotic can help reduce the aggravating factors which stop people with arthritis from being active and healthy.
How can orthotics help with ankle pain?
Foot orthotics can assist with ankle pain in the following ways:
- Providing pain relief through ideal support
- Reducing flat feet or high arch feet angles
- Getting the foot closer to ‘neutral’ alignment
- Tissue stress theory (taking stress away from muscles, tendons and ligaments)
- Providing stability to the foot, ankle and leg
- Allows better function and mobility of joints in the foot, ankle, knees and back
- Preventing further joint deterioration with bunions, toe and arch deformities
Footwear advice
It’s important to consider the right footwear when it comes to ankle pain too. The right support is needed to cushion and align the ankles correctly. For example, a high arch foot requires a cushioned shoe. A low arch or pronated foot requires a neutral or stability shoe. If this gets mixed up it can result in over or undercorrection which can lead to more problems too. A Podiatrist will be able to assist with the right shoe choice for you and your feet.
Frequently Asked Questions
Should you wear orthotics all the time?
Wearing orthotics in most of your shoes is ideal to help your foot become accustomed to functioning in a slightly different position. Try to place them into your shoes wherever possible, especially for activity and being on your feet for exerted periods. This is where you will get the most benefit from your foot orthotics. However, we do understand it can be difficult in certain circumstances to wear orthotic friendly shoes and that is generally okay if it is not all the time.
Can orthotics worsen foot pain?
A number of factors go into producing a custom orthotic device. Having a good gait analysis and biomechanical assessment performed by a qualified Podiatrist is the most important thing to ensure orthotics do not cause any pain. Orthotics can be modified and different techniques used to rectify any issues if they do feel uncomfortable.
Can orthotic insoles cause ankle pain?
Yes, insoles can cause ankle pain! If they are not recommended to you by a qualified Podiatrist or they are not functioning in the way they are supposed to. It is important if you think your orthotics are contributing to ankle pain that you seek guidance from your Podiatrist.
Do orthotics help with chronic ankle instability?
Yes, orthotics can certainly assist with helping chronic ankle instability. Whether it is poor function of the ankle joint or it is painful, an orthotic device can help with both issues.
Can orthotics prevent ankle sprains?
As an orthotic provides extra support and stability to the foot they can assist in preventing an ankle sprain. It is important to have rehabilitation in conjunction with an orthotic for the best overall outcome.
