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GEAR IN DEPTH

        

Orthotics and Inserts for Wilderness Travel—In Depth Analysis



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An added benefit of orthotics [besides correcting a variety of foot and joint problems] is the way they support the body’s natural movements. This reduces the demands placed on the muscles when the body is out of alignment. The result is less work by the muscles, which translates to less fatigue, fewer injuries, and higher performance.

—John Vonhof, “Orthotics,” Fixing Your Feet: Prevention and Treatment for Athletes, 4th ed., p. 127

 

It’s said by the boot fitting pros that skimping on a good quality footbed in your boots is like building a house and not bothering with the foundations. Fitted foot beds in most boots range from good to very poor indeed, with the best providing a good level of support and longevity, and the worst being little better than a slip of foam that will degrade and fall apart very quickly. Whatever the quality of the foot bed it’s never going to be as good as a second party design, as the manufacturer will not be able to provide the same level of quality and sophistication due to the fact that they are always trying to keep the cost of the boot as a whole down.

—unknown author

 

Central Issues Addressed in This Article

Should serious backpackers invest substantial time and money for custom-fit inserts and orthotics? A closely related question was posed in a Backpacking Light magazine article: “Can Arch Support Boost Trail Performance?” A similar question from a different direction: Do those who push the limits of their feet (e.g., ultra trail runners, hikers carrying heavy packs long distances) need more support than what is usually provided by boot and shoe manufacturers? Can quality orthotics and inserts improve upon natural biomechanics?

No Definitive Answers

There are no definite answers to the above questions unless one has frequent or chronic foot, knee, hip or back problems. Then the answer is an unqualified YES. The more serious the pain and discomfort, the more time and money must be spent on inserts. Experts are mostly agreed on this point. The experts also agree that foot problems often cause hip and lower back problems. For these kinds of problems, shoe and boot inserts should be seriously considered along with other potential causes and solutions.

There are no definitive answers to the questions raised at the beginning because each person is different in the structure of the feet, their footwear needs, their comfort levels, their pain tolerance and their performance standards. There are no definitive answers because many examples can be found of serious hikers and backpackers successfully using each of the following options for inserts:

·      the insole that came from the manufacturer

·      inexpensive off-the-shelf arch supports

·      semi-customized and preformed inserts

·      fully customized orthotics made by a professional

·      ultralight footwear with little or no support

Finally, there are no definitive answers because even the experts don’t agree. There is little or no scientific evidence that clearly favors one or more of these approaches over others. This is a controversial topic with many conflicting approaches, especially if one does not have serious foot issues and is interested mainly in comfort and performance.

Two Recommended Solutions

If there are no definitive answers, what is one to do?  The ideal would be to find someone with the following qualifications:

·      professionally trained in podiatric sports medicine

·      would not charge for their services

·      is a serious hiker and backpacker.

Finding someone fitting all of these characteristics is unlikely.

A second approach on the other end of the spectrum is to get a solid layman’s understanding of this subject (the main purpose of this article) and then experiment a lot, mixing and matching various options. There are obviously many approaches in between these two.

Is the second solution more reasonable? Even though there are no definite answers, my own experience and research says, “Yes” to all of the questions raised at the beginning of this article. Therefore, it would be well worth your time and money to take this topic seriously, learn as much as you can and get some expert assistance, either from a medical professional or from a specialty store for runners and hikers with a knowledgeable staff. If possible, visit several stores. Call ahead and ask when their most knowledgeable staff will be on duty.

The potential benefits of taking this topic seriously and doing your homework are many. Not only is comfortable footwear essential to pleasurable hiking, but well crafted inserts can be beneficial in a number of other ways. These are enumerated in the next section.

Potential Benefits of Inserts and Orthotics

Getting maximum performance from inserts and orthotics can cost a lot of time and money, especially if one does not get them right the first time. But the potential benefits are worth it. Based on my research and experience, inserts and orthotics can:

   Improve the fit and comfort of footwear especially when putting in a lot of trail miles.

   Take up excess space in the boot or shoe, especially for skinny-footed people; keep the foot in place to prevent sore spots and blisters.

   Provide a more stable footbed which helps prevent stumbling or falling which in turn prevents sprained ankles and knees or worse.

   Prevent the foot from elongating and widening as we move (more of a problem as we age) which helps to reduce foot fatigue, since the muscles and tendons have less work to do to maintain balance.

   Support the body’s natural movements, which in turn provides more efficiency and endurance.

   If competing, quality inserts or orthotics will likely provide an edge in performance for the reasons given above; world-class athletes commonly use customized orthotics.

   Provide cushioning and arch support to absorb shock; a flexible rather than a rigid arch support will absorb some shock and prevent injuries.

   Improve posture and prevent long term knee, hip and back problems; correct body alignment problems which have the potential to reduce knee, lower back and hip pain.

   Correct a large number of painful foot problems (e.g. plantar Fasciitis, flatfootness); avoid future foot problems.

   Correct or reduce the consequences of foot and leg abnormalities.

   Provide additional support and stability when used in worn-out shoes (i.e., get more wear from favorite footgear).

Which of the above claimed benefits are most appealing to you, if true?

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The above paragraphs provide a preview of the complete article (approximately 14 pages) available as a free download.  Click on the following to download in either a Microsoft Word or PDF format.

 Orthotics and Inserts for Wilderness Travel – Word Format

Orthotics and Inserts for Wilderness Travel – PDF Format 

The following sub-topics are developed in this complete article:

No Definitive Answers

Two Recommended Solutions

Potential Benefits of Inserts and Orthotics

“If it ain’t broke, don’t fix it!”

Two Disclaimers and Some Personal Experience

Definitions for Relevant Medical Specialties

Operational Definitions of Key Concepts 

Six Approaches to Designing and Fitting Inserts and Orthotics 

Going Natural: Rejecting Inserts and Custom Orthotics

Author’s Recommendation: Be Situational

Author’s Preferred Solution: Achieve a “Natural Foot” 

Summary of Conclusions and Recommendations


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