Two questions really… how long do they last and is there a cheaper alternative?
I have some custom orthotics that are crazy expensive ($400+) that have 464 miles on them (about 10 months of running with significant time off due to injuries). It uses a polypropylene piece for stiffness that runs from the heel to the midfoot. I have had no issues with them, but wonder how long they last, as they have been used only for running. I’m 6’1" 176, and a midfoot striker as reported by an impartial running coach. I like to replace my shoes after about 350 miles, probably could last longer, but I dont’ push it. i.e. I don’t think I’m overly harsh on my shoes.
In the spectrum of supportive insoles, what is the most supportive of the non-Rx/over the counter brands could I sneak into if I balk at the $400 bill in the future? I originally got the orthotics because of tendonitis on the sides of my ankle after a major sprain (small fx) and because I have pancake flat feet and pronate like its going out of style. The ortho seems to have addressed the tendonitis on both anterior and posterior thingys on either side of the ankle that are suseptible to sprains rolling outward, but I wonder if I can find a cheaper option, esp now my running has improved in both form and fitness.
After looking for a few years for fast, affordable custom insoles that we could do entirely in-house, we came upon a French orthopedics company called Sidas that makes a line of products for running and cycling (and skiing) that are heat moldable called Conformables. They do insoles for world cup skiiers and such out of their North American affiliate in Vancouver. We do running and cycling insoles for $125-135 that are completely custom molded. They say you can get 3-4 pairs of running shoes (depending on use, obviously) or a couple of seasons of cycling. This is our first season with them, but so far so good.
They don’t use super stiff medial posting but believe in allowing a little more motion than that, claiming they have some studies showing better results for insoles that allow some natural motion of the foot.
What I like about them is we don’t have to send them away with faith that they will be cut properly by a lab somewhere and clients can walk out with something to use right away at a cost that allows them to replace the insoles regularly. What I see in practice is clients who hang on to insoles (or orthotics, for that matter) far beyond their useful life because the cost and lead time of new ones is so great.
Depends upon the thickness of the polypropylene, but really, the shell should last 10+ years. The rearfoot (or forefoot) post and topcover material if present tends to wear off in 1-2 years, but most orthotic labs just charge a nominal fee (like $15) to recover and refurbish them.
Unless your foot changes shape significantly (like the progressive posterior tibial tendon dysfunction you likely have), they will likely end up being cheaper than 10+ years of buying OTC orthotics/devices.
Since I am – obviously – not a physician/licensed anything I’m curious about this whole “do orthotics wear out” issue. Foot people (who I will broadly define as medical professionals who do a lot of work with feet) have told me that most people should periodically update/get new orthotics but don’t. You are saying that’s not true, and I’m curious as to why. Does it depend on what material the orthotic is? I would like to learn more about this since it’s a question that comes up during our fittings frequently.
What we offer is an insole – not an orthotic, since it’s not prescribed – which can be updated more frequently (say, every 1 or 2 years) based on use and as the foot/gait changes. Is this misguided for an affordable OTC insole product in your opinion? Since you (rroof) probably have forgotten more about feet than I’ll ever know (or want to??)…
The “wearing out” issue is mostly a factor of 2 things: materials/design and profit.
Profit is obvious.
As for materal - lets take the extreme examples. Some “orthotics” are made to simple protect the foot (like for diabetics) out of an open cell material of a low durometer (like Plastizote). These are Medicare approved at 3 sets per year since they loose their effectiveness very quickly - like in 4 months on a minimally active adult.
The other end of spectrum would be an old stainless steel or ruhador (old German plastic polymer that lasted forever but not available any more) orthotic. Here, the material has basically an infinite fatigue life for a foot orthotic and only a topcover (if present/used) would need to be replaced.
Now, most of the OTC or semi-custom orthotics are made of a material that actually does compress or “wear out”, there may very well be an actual material issue. But, for most, the main reason would be that the reason for the orthotic has changed.
Think of it exactly like eyeglasses. Occasionally your prescription may change, but not very quickly and there is certainly no set time for this to occur. To blindly say you need new glasses every 18 months would not be terribly correct. Will your “prescriptions” eventually change? Sure, and same with the foot but a much lesser degree and will much less objective measurements to boot.
My experience with my prescription orthotics has been that they last more than a year, but less than two. Mine cost about the same as yours and I am very reliant on them. I got my last pair in January 2006 after neuroma surgery. I finally replaced them (probably later than I should have) this past summer. I don’t keep track of my running mileage (it’s not real high) but I used them to train for one marathon and one IM last year, and a second marathon early this year - plus quite a few shorter races. I think I went through five pairs of running shoes during that period. I also used the orthotics everyday in my regular shoes. I replaced them because they were falling apart - too much exposure to rain and sweat.
I have some experience in the life of the custom orthotics question you raised, as well as some experience on the Conformables that Tim mentions - I have both.
First - I have the custom ‘hard plastic’ orthotics that I use in - running shoes, cycling shoes, and Nordic Ski Boots (both classic and skate). I also have the Conformables in my Telemark Ski Boots.
I have used the custom orthotics in everything but the High Ski boots for about 6 seasons now and the only thing that has worn out is the top ‘padded’ portion. I need the custom orthotic to equalize a leg length imbalance and some canting issues. After using them every day in normal walking shoes and running shoes for 6 years I now need the tops on one pair redone. I had my other pair redone early this season.
I started to use the Conformable insole in my ski boots before I went to a doc regarding the leg length issue. I continue to use the confomable because I also have custom molded liners in some of my boots. Regarding life of the these I have about 10 seasons of use in them averaging about 60 ski days a year (I teach(ed) telemark skiing about 7 of those seasons).
IMO if you do not need any type of ‘correction’ the Conformables are fine, and Tim is correct, they are a less expensive alternative. If you need to correct other, more complex issues, like i did (do), the Orthotic approach really is the best way. My knees thank me that I now have orthotics.
IMO also, if the Orthotic fixed the problem, I would not stray too far from using them.
Thanks for chiming in rroof. I asked this question to my podiatrist when she was taking my casting. She also said 10 yrs +, but she wasn’t a runner and didn’t specialize in athletes, so I wasn’t sure how accurate this was or if she was quoting the salesperson. The infinite fatigue life makes sense to me as a materials guy, depends on the polypropylene (high density it seems) I suppose.