I've got insoles but now my legs ache, why?

It's not uncommon for someone who has a reduced arch in their foot to have been given some form of orthotic (insole) to correct this, but does this change come with any consequences?

Everyone has 3 natural arches to their foot, as seen here on the left. The most common form of reduced arch is the medial arch, shown in the image as A-C. You may refer to someone as such as flat footed

Someone with a reduced medial arch may look like the image on the far left and in the image above. You may have heard of the term pronation. This is way the foot rolls inwards, the opposite is supination, where the foot rolls outwards.

An orthotic may be given to you by a podiatrist or an orthotist for example, to raise this arch and give you a "normal" foot print and foot alignment, as seen in the image on the left.

Problem solved right? Well, no! The problem is, people assume this is due to a collapsed arch and not a congenital reduced arch

In other words, in most cases, they were likely born this way and their body has developed in a way to accommodate this!

Just because something doesn't look right, doesn't mean it has to change, remember the old proverb:

Identifying you have a reduced arch may not necessarily be a problem! Are you in pain? Are the insides of your feet hurting? Are your knees hurting? Are your hips hurting? If you answer NO to any of these, then don't wear orthotics!

Now this does not mean I am against people wearing orthotics, because that is not the case! Orthotics have their place in some cases, providing they are given corrective exercise!

Why do I need corrective exercise?

Altering your foot position, affects the whole body. If has an effect on the anterior and posterior kinetic chain. The image on the left is the posterior kinetic chain.

Stand up!

Allow your foot to pronate (roll inwards) can you feel any muscle changes in your legs? Your back? even your upper body? I can instantly feel a muscle ache in my foot muscles, my calves, my knee and in my hip. Imagine being born like that. Your muscles will have grown and adapted to your foot position and you would walk without pain. Now allow your foot to supinate (roll outward) and walk 5 steps. I can instantly feel an increased pressure on the outside of my foot, the pressure in my knee moves to the outside, and it makes my gluteals (buttock muscles) work harder. I'm pretty sure my back would start to ache if I continued to stand and walk like this! This is what we are doing with someone who has congenital reduced medial arches. What may look like normal foot position with orthotics will feel like you walking on the outer borders of their foot, and suddenly! If orthorics are necessary, which they are in some cases then corrective exercises are needed too! I've seen too many people both in my private clinic and through the NHS recently who have been given orthotics to correct a foot problem and no corrective exercises! And they're presenting to me because they're suffering multiple joint pain!

If you find yourself in a position whereby a clinician is telling you, you need orthotics, ask them: "What exercises will you give me to address and combat my altered gait?"