Do distance runners need foot orthoses? For many, orthoses are a mystery and/or unnecessary adjunct to their running. The following is intended to dispel some myths of orthoses and to assist with guidance in the wearing of orthoses for distance runners.
Enormous variation exists in what orthoses are issued to runners. Whether orthoses should be used –and the type of orthoses worn—depends on many factors.
When to use orthoses for distance runners
First, foot orthoses are used to support and control motion of the foot and lower limb. Orthoses are issued to off-load an injured part and assist with managing injury. In some cases orthoses are used to assist prevention of injury in those who have an extensive history of injury.
In my opinion, orthoses should only be worn by distance runners if there is a history of problems that relate to excessive motion and/or asymmetry. In managing distance runners, orthoses are never issued just because a runner is excessively mobile or asymmetrical. It is important to note that an injury history should be evident to justify the use of orthoses in runners. Having either high arched or low arched feet does not always indicate the function of the foot and a predisposition to injury, nor do they always indicate a need for orthoses.
For distance runners, orthoses may be used to assist to off-load an injured part. But as problems settle, it is not unusual to reduce support. This is important,so as to resume and maintain a running gait that the runner has adapted to over many years. Many runners have orthoses that are reduced to at least 50 percent of initial support after injuries resolve. Some runners, depending on injury history and strengthening, will revert back to not running with orthoses. For some , this can sometimes take up to three months from the initial start of wearing orthoses.
How to use orthoses for distance runners
As individuals, we all adapt to our own structure and function. Changing an athlete’s gait with orthoses is difficult and very specific and in many cases, should be very conservative due to years of an individuals’ adaption. Orthoses for distance runners should be conservative in the level of support. This is due not only to a runner needing to adapt, but also to the fact that running involves large repetitive forces. Making any change to runners with orthoses will have great effect on the mechanics of the lower limb due to the applied forces during running being repetitive and between two to three times body weight each step.
Of course, orthoses are not the only means of managing and preventing running injuries. The practitioner and athlete have to be aware that there are many factors to address, including training errors, footwear, surfaces, and efficiency through good postural control and running technique. Orthoses are only one part of an athlete’s measures for treatment and prevention of injury.
Strengthening and being able to run with an efficient gait and modifying training principles are the most important principles that must be adhered to in-conjunction with orthoses use in injury management.
To learn more about the clinical aspects of biomechanics and sporting injuries turn to Chapter 8 in Clinical Sports Medicine.
Jason Agosta is a Podiatrist of 25 years and is also a former Australian representative at the World Cross Country Championships. His pb’s are 13.48 5000m, 29m for 10km. He still runs approximately 50-60kms per week. The above is very much his opinion in managing distance runners. Learn more at www.ja-podiatry.com.