Shoe modifications and orthotics
A supportive heel and stiff midsole are important components of any shoe for those experiencing heel pain, softer shoes fatigue the foot. Most fashionable shoe wear (high heels, boat shoes, flip flops) often does not provide sufficient support for the arch and further exacerbates the problem. In general, lace-up tennis shoes are recommended to maximize support.
Shoe inserts typically can be used with existing shoe gear. Orthotics may be purchased over the counter or can be custom made. In general, over-the-counter (OTC) and custom-made orthoses appear to be equally effective in treating plantar fasciitis A randomized, prospective study found that more supportive orthotics resulted in better pain relief when compared with softer, non-supportive orthotics; meaning floppy insoles do not work as well as their stiffer counter parts.
Many patients with low arches experience increased stress on the plantar fascia while walking and have a decreased ability to absorb the forces that are generated by foot strike due to pronation. Mechanical corrections for pes planus include taping of the arches, OTC arch supports, and custom orthotic devices. Studies have found significant benefit to these conservative treatments when they are used in appropriate patients, Low-dye strapping with athletic tape can be used as a definitive treatment or as a trial to determine whether the expense of arch supports or orthotics is worthwhile but is difficult to do and does not give lasting results. Taping may be more cost-effective for the acute onset of plantar fasciitis, whereas OTC arch supports and orthotics are better for chronic or recurrent cases of plantar fasciitis and for the prevention of injuries. Taping is just that, tape applied to the foot which only lasts in several studies for 45 minutes of peak relief. The other issue with taping is that it usually requires a medical professional to perform which can result in costly visits.
Custom orthotic devices are designed to control biomechanical risk factors such as flat foot, high arched foot, and limb length descrepency. A lot of athletes treated with orthotic devices usually require semi-rigid full-length orthotic devices with deep heel cups to control overpronation and metatarsal head motion.The main disadvantage to the use of custom orthotic devices is the cost, which ranges from $250 to $600 or more; frequently, these devices are not covered by insurance. Several studies have suggested that over-the-counter insoles are often as effective as these custom orthotics.