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The Mysterious Foot Orthotic

Orthotics Sales Approach $5 Billion Per Year


The term “Foot Orthotic” refers to everything from the inexpensive drugstore pre-fabricated insoles to costly, custom-made devices specifically molded to the foot. Podiatrists generally consider orthotics to be custom-made devices, specifically made from a mold of the patient. Podiatrists spend a great deal of time and energy understanding the biomechanics of the foot and when designing an orthotic for patients, consider the patient’s biomechanics and other factors. The CMAJ article quoted a study by Global Industry Analysts showing that the orthotics market is booming and could reach total sales of nearly five billion dollars in the next few years.

I Discussed the Problem of Possible Muscle Atrophy

The CMAJ article quoted me in saying that “You can’t guarantee anything is going to work for everyone, because people are so variable. Orthotics can do amazing things for many people, but not for everyone.” I stated that “there isn’t even a consensus on what an orthotic is,” and discussed the risk of foot muscle atrophy when relying on orthotic devices. “When you brace the foot, that may alter the function of the foot for the better, but in doing so it negates the need for many of the muscles in the foot to do anything. Common sense tells us that if you don’t use a muscle, it’s going to weaken.

The Mechanics Of Orthotics Are Still Largely Unknown

Benno Nigg, professor of biomechanics and codirector of the Human Performance Laboratory at the University of Calgary, Alberta stated that there is no conclusive evidence of the actual mechanism of function of orthotic devices. “Orthotics can work and can have fantastic effects, but we don’t know how they work,” adding that “we don’t really understand what we do.” Nigg wrote about the hypothesis that orthotics may assist in the shifting of improper alignment of the overall skeleton. “Maybe we should not think of pushing the skeleton around, but rather about finding ways to give signals to the body to do the right thing,” Nigg said.

Dr. Nigg has just published a new book, Biomechanics of Sports Shoes, and I’ll be posting a review of that work in an upcoming blog.

  • Run Stronger

    You obviously missed the research from one study that actually showed an increase in muscle strength with foot orthotic use and the other study that showed no change. Certainly no sign of foot orthotics weakening muscles as you claim.

  • Dr. Nirenberg

    Thank you for providing an alternate viewpoint on the long term effects of using foot orthotics on muscles.

    As noted, orthotics are a 5 billion dollar a year industry and there are a grand total of perhaps 2 studies “show” an increase in muscle strength. One study, as you should know, only could show 2 of the 19 muscles in each foot and 10 more from the leg entering the foot had any increase – what happened to the rest? With 5 billion bucks, there should be at least a 100 studies showing how great orthotics are for our muscles! Of course, it's hard — even for a 5 billion dollar industry — to refute common sense.

    You might be interested in another site…. If you Google Running Barefoot is Bad you will find a site by a podiatrist in tune with you.

  • Brahim

    Thanks for the post. I am wondering if you could provide a citation for the CMAJ article that discusses the 5 billion market?

  • Owen Marcus

    Over the last 30 years I have also found that for many Orthotics don't work.

  • Markburgan

    I am in complete agreement with good Dr. Nirenberg.  Orthotics, according to the American Academy of Orthopedic Surgeons, are completely useless and may even be detrimental to the foot.  Also, Dr. Harry F. Hlavac, author of the book: “THE FOOT BOOK; Advice for Athletes,”  states on page 8 that orthotics do not correct feet, they correct gait.  Blogger  “Run Stronger”  is either egregiously ignorant and/or may be a schill for the podiatric  “industry.”  Orthotics will never have the foot muscles develop stronger. Use of orthotics are a  “crutch”  and will sentence an individual to a lifetime of dependence to them, so there goes his contention that orthotics make your feet stronger. When it comes to muscles, foot or otherwise, it’s  “use them or lose them.”

  • zoya

     Thats an interesting post and art too.I love art work and if it is in on orthotic foot wear then it just awesome to have that kind of footwear.Thanks for sharing the post.

  • Carter

    It works for most people. I had foot pain and foot orthotics pulled through pretty well for me.