People are often surprised when I offer orthotics for a back or knee problem. As a chiropractor, I have been using orthotics for over 20 years and work closely with our podiatrist. For some people orthotics will often solve their issues or reduce them to a manageable level. In most cases it is combined with some other treatment, but the orthotics are often a simple way of helping to manage some conditions.
Knee, hip and back pain often have roots far below the joints themselves—sometimes all the way down in the feet. One of the most common underlying contributors is over-pronation, a biomechanical issue that can set off a chain reaction of stress through the legs and pelvis, in fact right up to the shoulders and neck.
What Is Over-Pronation?
Over-pronation occurs when the foot rolls inward excessively as it strikes the ground. While a small degree of pronation is natural for shock absorption, too much causes the arch to collapse and the ankle to rotate inward. This changes the alignment of the entire leg.
The Chain Reaction to the Knees and Hips
When the ankle rolls inward, the shin bone (tibia) also rotates inward. This internal rotation pulls on the knee, altering how the kneecap tracks and placing extra stress on ligaments and cartilage. The rotation can travel further upward, tilting the pelvis and affecting hip mechanics, leading to overuse and strain in muscles such as the gluteals, hip flexors, and piriformis – this can present as back and hip pain. In runners, due to the greater forces involved, it often presents initially as ITB pain (down side of leg into knee) but will quickly refer to hip and low back.
Overpronation→ Misalignment→ Pain
How Orthotics Help
Foot orthotics (Insoles) are designed to restore proper alignment at ground level.
Mechanically, they:
1. Support the Arch – Orthotics prevent excessive collapse of the medial arch, reducing the degree of inward ankle roll.
2. Correct Foot Angle – By controlling the rate and extent of pronation, orthotics help keep the tibia in a more neutral rotation.
3. Align the Kinetic Chain – When the lower leg stays in proper position, the knee joint experiences less torsional stress, and hip and pelvic alignment improves, decreasing compensatory muscle tension.
4. Distribute Forces Evenly – Orthotics spread weight across the foot’s surface more evenly, reducing concentrated impact forces that can irritate joints over time.
How Can I Help?
I can supply customised and appropriate off the shelf orthotics or insoles as they are commonly called. By addressing over-pronation at its source, foot orthotics help re-establish natural biomechanics. This can reduce abnormal stress, help alleviate existing pain and prevent future injury. For people whose pain is linked to faulty foot mechanics, orthotics can be a deceptively simple yet highly effective part of treatment.
If you think orthotics might help you, then give me a call, email or pop into my clinic at Malcolm’s pharmacy. Mention this article for a FREE REVIEW.
