A Foot Orthotics GuideWhat are Custom Insoles?

Posted on June 30, 2014

By Josh Pettit

Orthotics, Insoles or Inserts. Whatever you call them, they are the small insert inside your shoe.

Custom Orthotic Inserts are all the rage right now. You see websites advertising custom insoles, custom orthotics and custom inserts popping up everywhere. Ebay, Google shopping, Amazon, every legitimate power seller has some form of custom orthotic inserts on sale as big as life. However, most people still don’t quite know they exist.

You can find blogs far and wide, defaming and affirming these products. It’s really hard to get accurate information about what a custom insole is, what it does for you, and how it works. In turn, it is very hard to market custom orthotics insoles which was a task I was assigned with many months ago. Doing a ton of market research and a little bit of personal research, I feel comfortable now calling myself an insole expert.

A shoe is an item nobody second guesses. It’s easy to understand what a shoe is and why it’s there. Thus, it’s easier to sell a shoe. Shoes are fun. Custom Insoles are not. They are “grudge” products. They are products that the customer doesn’t want to purchase until they absolutely have no other choice.

Usually custom insoles address some sort of specific ailment, or they are recommended by a doctor. Plantar Fasciitis, for example, can only be treated with Plantar Fasciitis Custom Insoles because they have a plantar fascial groove to relieve pressure on the plantar fascia during high impact activities.

People don’t want to have Plantar Fasciitis and they don’t want to have to spend good, hard earned money treating it. Thus, it is the marketers job not only to espouse the benefits of Plantar Fasciitis Inserts (or custom insoles in general), but to also educate the customer (or patient) as to what custom insoles actually are.

Plantar Fasciitis insole

What are Custom Orthotic Insoles? Custom insoles are devices made out of dense rubbery

foam that replace the thin factory innersoles that come with most shoes. They are made by taking a mold or scan of an individuals feet and entering that data into a computer. The computer then mills out an exact mirror so there is a perfectly mated surface between the custom orthotic and your foot. This reduces movement of the foot inside the shoe and also alleviates pressure points. It can also correct your stride if you tend to lean or pronate as you walk.

High end custom insoles usually have multi-density components designed to absorb impact, keeping high impact activities like running from having negative affects on one’s spine, joints, bones and the foot itself. It’s best to imagine your shoe like a box spring for a bed. It cushions some, but its primary purpose is to support the mattress. A factory innersole is like a very thin layer of hay on top of your box spring. A custom insole is more akin to a very thick and dense mattress that you bought after you got that new job and threw away the hay.

Multi-density

components

So if your shoe is a box spring and your insole is a mattress, you start to see how it can affect comfort, joint and bone health. It really is a perfect analogy. Custom insoles prevent things like shin splints, runners knee and small bone fractures that come from running barefooted or with a worn out factory innersole.

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We call custom insoles a lot of different things. Custom fit custom orthotic inserts is a fancy name for these things. Custom insert, orthotic, custom orthotic, etc. They are all custom insoles. If you had to be fitted to get them made and they go in your shoe (and they cost a lot), they are custom insoles. Standing on a kiosk at Wal-Mart is not being fitted. Fitting requires a mold from a foam box of some sort, or a laser scanning machine. To be custom, the insoles must be manufactured based off of your foot impression.

Foot Impression BoxPublic Kiosk

How can an Orthotic Insole benefit me? Custom Orthotics have a lot of benefits. They improve

performance in sports by reducing fatigue and allowing one to run longer and harder. Competitors often describe running in bare shoes like “running in sand” compared to custom designed multi-density insoles. The biggest health benefit would be reducing joint and spinal damage which is a cumulative result of high impact aerobics. They also eliminate pressure points by having a near 100% mating surface. That means they improve circulation which reduces swelling by definition. Arch support is probably the first thing people notice when they use custom insoles. If you’ve never had a custom insole before, you have never had arch support in your shoe.

These are 3D images of actual feet in the some common Orthotics Modeling software

Fatigue is worth examining closer, because as your circulation is improved, your muscles get oxygenated at a much quicker rate, allowing them to perform better and recover quicker. It’s simply science, but when you hear these things you may not relate them to your foot. Remember the primary surface of any shoe is the insole. What shoes get credit for, insoles actually do. Shoes are the box spring, not the mattress. Great insoles in bad shoes are fine; the other way around, not so much.

Custom inserts also reduce pain from pre-existing conditions. They act very much like a trampoline on a smaller scale. If your knees or feet hurt, you will exacerbate that injury less if you are jumping on a trampoline than if you are jumping on rocks. Thus is the nature of a thick and springy insole.

Why do custom insoles cost so much? Some people just like to charge for expertise. $500 dollar custom

insoles are not unheard of. Good Custom insoles cost a lot to manufacture because custom insole companies usually employ C-Peds, or certified pedorthists. Some inaccurately call them foot doctors but that’s close enough. I prefer foot experts. A computer program can get a close up of how an insole should be shaped, but there are some important anatomical differences in each human foot, and most companies require that a foot scan be examined by a C-Ped before the insole is milled. The C-Ped will change met placement, arch height, pronation and many other factors before the insole is milled out and delivered.

The Milling Process

Computer Aided Design

Also, because these are custom products, they must be fitted. So, the fitting instruments and overhead are also included in the cost. Foam box impression, shipping if done mail-order, the cost of the laser scanning time and software, and the cost of transmitting this data are all cumulative. Assuming a company uses the foam box method, mail order and a good tri-laminate EVA, their average manufacturing cost for 1 pair of insoles averages about $90.00 before overhead and marketing costs.

Foam Impression Box Computer Aided Design

Can non-custom insoles benefit me?

Because of the high cost and trouble associated with custom insoles, many people turn to items called “prefabs” or prefabricated insoles available in big box retailers. These prefab insoles often have a gel coating, or some sort of punch out system Some of these insoles can be had for as little as $50.00. However, one must remember that these insoles are not custom and they do not have the same benefits. Universal insoles often have little or no arch support and since they aren’t customized, they create pressure points which can exacerbate injuries.

This is a kiosk that sells prefabs. These are not custom insoles.

Prefabs can be better than your stock insoles, however. If you can’t afford quality insoles, then these prefabs are better than nothing. Remember, the goal is to get that thin blanket off your box spring (shoe) and put a real mattress on there. Some prefabs are thick and will generally mold to fit your foot shape. They cannot address foot pain or foot conditions, and they aren’t as thick as a quality custom insole can be. Also, they tend to be made out of either very non-durable material, or very hard material. The worst offenders use polymer instead of EVA and can cause things like micro fractures in the fibula and other things associated with too little cushioning while running.

Prefab Foam Insoles Custom EVA Insoles

What are the best custom insoles? As a general rule, the best insoles are those designed for you by

a certified pedorthist. You can get these insoles online. Footmindbody.com (who averages about 15,000 pair a year sold) and a few other companies offer this service standard with each insole. A certified pedorthist examines your foam box impression and scans and then adjusts the CAD drawing during the manufacturing phase to adhere to your specific foot issues. Always use companies that employ Certified Pedorthists. Otherwise, you are likely to get a layman, or worse, an assembly line worker, milling out your insoles strictly by computer generated guidelines. Pedorthic input is key.

What are insoles made out of?

Custom insoles are generally made out of a material called EVA. This is usually a closed cell hyper dense foam. Closed cell means that water can’t permeate it.  EVA is hyper-dense, meaning it is very hard. If EVA is too soft, like the innersoles that come with your shoe, they wear out very quickly. That’s why the “gel” type insoles aren’t up to par (along with the fact that they store heat). A good durable insole, must be made out of EVA.

These are EVA blanks. They are used to make insoles.

A tri-laminate insole is an insole with 3 layers. Each layer has a different density and hardness. Density and hardness shouldn’t be confused. These layers are either glued together (cheap) or vulcanized (expensive). The best possible insole material out there is made of tri-laminate multi-density vulcanized EVA. They are durable and address each section of the foot with a very specifically designed material density.

Tri-laminate insoles plus an anti-microbial top cover

EVA can also be milled very easily, and is an ideal building material. EVA starts off in large blocks and is then milled down with a large milling machine specifically designed for whatever tasks the EVA is to take on, in this case insoles. EVA is also utilized in padding for motorcycle helmets, and many other applications where stiff, durable padding is applied.

Where can I get custom insoles? You can search custom insoles on the Internet. The largest

company out there is FootMindBody.com they develop these insoles for medical use as well and they employ a large percentage of the C-Peds in the southeast United States. All of their insoles are C-ped guaranteed; they are mail order for convenience (they send you a foam box and a questionnaire, and you send it back to them). They also use tri-laminate multi-density vulcanized EVA with exotic coatings that do things like prevent bacterial growth, keep your feet cool, and wick moisture. They are reasonable price-wise, and they offer a money back guarantee which will replace or refund your insoles if they don’t suit you no questions asked.

Do I need to see a certified Pedorthist, aka c-ped?

You don’t need to see one, but you need to make sure that the company doing your insoles employees one. C-Ped examination of the 3-D image is vital to creating a proper insole. I’m not a guy that goes by titles. I don’t give trust freely to any marketing agency, just for employing a salesman with MD after his/her name. That said, it’s the law of large numbers. If a company can use the lowest common denominator, they will. Hiring C-Peds shows that a company is serious about their business. It also shows that they aren’t doing business out of their trunk.

What causes pain in the heel of your foot? Do I have plantar fasciitis? Almost certainly. Foot pain comes in two categories; Plantar

Fasciitis and everything else. PF is huge, and the top prescription is a plantar fasciitis custom insole. A select few companies out there offer custom insoles for plantar fasciitis. They are very hard to make as they require a C-ped to identify the plantar facial groove. They double as insoles for flat feet. So if you have Plantar Fasciitis or Flat Feet, you should definitely consider a quality custom insole. They are expensive, but anyone who has ever had to tiptoe out of bed in the morning, knows the value of a surcease to that pain.  (diabetes#1) Plantar Fasciitis is the number two reason people look for and buy custom insoles. Flat feet is number three.

Plantar Fasciitis insoles before top cover has been added

What is the best insole for foot pain?

A lot of companies promote two types of foot pain insoles. Medical pain (the plantar fasciitis/flat foot style insole) and the comfort insole. If you work, if you stand all day, if your feet hurt, ie; nurse, law enforcement, then you need the latter. Look for custom insoles designed for working people. Not insoles designed for Plantar Fasciitis. All custom insoles provide support for foot arches, but not all of them provide grooves for the plantar fascia.

What is the difference between functional and accommodative custom insoles? If you’ve ever seen Forrest Gump, you no doubt are

familiar with the braces he wears on his legs in the first part of the movie. Those braces, known as LFOs or lower foot orthotics, are designed to fundamentally change the way someone walks over time. They are much like orthodontic braces for a child’s teeth. They change the FUNCTION of how one walks over time. These are called functional orthotics. Functional orthotics require a prescription and generally are only necessary for a very small percentage of people looking for custom orthotics insoles. All other insoles are called accommodative insoles.

Accommodative insoles

Accommodative insoles do things like prevent pain, improve general performance and alter pronation. They do not, however, fundamentally alter a person’s stride. Stoke victims often need functional orthotics to walk upright again.

Functional insoles

Accommodative insoles

I hope you’ve enjoyed this blog. There will be more info on this as I get more time to write. Follow me on twitter or like me on Facebook. Don’t forget to comment.– Josh Pettit - Josh is an IT Administrator, Patient Care Representative, Insulin Pump coordinator and marketing expert for The Diabetic Shoppe and several other businesses in Mississippi and Alabama. He’s got a BA in Business Admin from Delta State, with double majors in Insurance/Real Estate & General Business. He’s got 10 years experience coordinating marketing and insurance through call centers, online social media and distributive advertising. He wears a lot of hats.Phone 662-647-6605, Cell: 662-809-0713Toll Free 888-571-3533 ext 6605Fax: 888-377-2224, email: jpettit@diabetic-shoppe.com