An Article Written By Cecilia Brennan
Podiatrist – New Step Podiatry.
When Do You Really Need New Orthotics?
Too many times in the clinic, I hear someone say they need new orthotics simply because their current pair looks worn out. But here’s the truth: if your orthotics have wear on the top cover or cushioning, you might just need a quick refresh (such as replacing the cover) rather than an entirely new set. On the other hand, sometimes orthotics that appear “fine” on the surface are actually no longer appropriate for your needs, especially if your body, activities or lifestyle have changed.
In this blog article, we’ll discuss five key signs that can help you determine if it’s time for a podiatrist to review—and potentially update—your orthotics. Before we dive in, let’s clarify what foot orthotics are and look at the various types available.
What are Custom Foot Orthotics?
Foot orthoses are commonly referred to as ‘orthotics’. Orthotics are shoe inserts that alter the functioning of the body’s structures (including nerves and muscles) to improve stability and function and reduce pain.
Their primary goal is to redistribute and offload excessive forces from stressed or painful areas, helping reduce pain, prevent deformity progression, enhance comfort, and support more efficient movement.
While research does not strongly support the idea that orthotics can permanently realign the skeleton, many people report feeling more “aligned” or stable when wearing them. Orthotics can be useful tool for addressing conditions such as:
- Heel pain
- Arch pain
- Chronic ankle instability
- Shin splints
- Ball-of-foot pain (metatarsalgia)
It’s also important to note that orthotics are just one component of a comprehensive treatment plan. Other therapies, such as exercise routines, joint mobilisation, medical laser, shockwave therapy, bracing, taping, gait retraining and footwear advice, can all play a role in reducing pain and improving function.
What are the Different Types of Orthotics?
- Over-the-Counter (OTC) or Pre-Made Orthotics
- Description: These mass-produced devices are made from generic moulds and generally use less durable materials.
- When to Use: Short-term relief or minor foot issues. Ideal for people on a budget or who need a quick, temporary solution.
- Considerations: They often lack the individualised shape, rigidity or corrective features that many foot types require. Typically available in either full- or half-length designs.
- Heat-Mouldable Orthotics
- Description: Prefabricated inserts that can be heated and custom-moulded to your foot shape for a closer fit.
- When to Use: A step up from OTC orthotics if you need a more personalised approach without full customisation.
- Considerations: They can be adjusted multiple times, tend to last longer than standard OTC devices, and are generally made in full-length versions.
- Prescription / Custom Orthotics
- Description: Created from 3D scans or casts of your feet, then milled or fabricated using a range of materials (e.g., soft EVA, 3D printed materials, semi-flexible polypropylene, or rigid carbon fibre).
- When to Use: Ideal for those with specific biomechanical needs or chronic conditions, as they offer the highest level of precision and durability.
- Considerations: Typically more expensive up front, but they often last longer. They can also be adapted to fit various types of footwear.
- Joeys / Precast Orthotics
- Description: Similar to custom orthotics, but instead of a 3D scan, tracings of your feet are used to create the device.
- When to Use: A budget-friendly alternative for individuals (often children) who still need significant support but are likely to outgrow their orthotics quickly.
- Considerations: Provide a high level of support and customisation at a reduced cost compared to fully bespoke prescription orthotics.
Regardless of the type, orthotics come in various lengths and profiles. They can replace your shoe’s existing insole (full-length) or only extend to the midfoot area (half-length/shell length) leaving more room in the toe box.
Here are five key indicators that it might be time for new orthotics—or at least a podiatrist’s reassessment.
Tip 1: Visible Wear and Tear on Your Orthotics
What to Watch For
Look closely at the top cover and the structural shell (if it has two or more layers) of your orthotics. Cracks, splits, or areas where the shell feels weak can indicate significant breakdown. Also pay attention to flattened or compressed cushioning, which happens when the insole layers lose their ability to bounce back. Small tears and fraying edges on the material can be signs that the orthotics are no longer providing the right amount of support and shock absorption. If the underlying materials or layers are exposed, your feet might not be getting the level of comfort and arch support they once had.
Why It Matters
When the structural integrity of custom foot orthotics is compromised, they can’t adequately offload pressure from key areas (like the heel, arch, or ball of the foot). Visible damage can lead to an increase in foot pain, plantar fasciitis, or shin splints, as the orthotic no longer delivers the stability and balance your foot needs. By identifying wear and tear early, you can avoid developing or worsening lower limb issues.
Podiatry Practice Pointer
If the top cover of your orthotic is worn but the underlying shell remains structurally sound, you likely only need a cover replacement—no need for an entirely new set. However, if you notice a significant crack in the shell, a whole new set of orthotics is more likely.
Tip 2: Return of Foot or Lower Limb Pain
What to Watch For
Be on the lookout for new or recurring pain in the heels, arches, ankles, knees or even the hips. If you’re suddenly noticing foot discomfort first thing in the morning or after standing for long periods, this may suggest your orthotics have lost their corrective function. In particular, flare-ups of chronic conditions such as plantar fasciitis, Achilles tendinitis, or shin splints can signal that your orthotics no longer reduce the stress on those areas effectively.
Why It Matters
Orthotics play a critical role in biomechanical correction. When they’re no longer doing their job, stress on the foot can increase, resulting in persistent pain or inflammation. Over time, this can escalate into more serious problems like chronic instability or changes in your walking pattern. Early detection and adjustment of your orthotics can save you from lengthy treatment plans and keep you mobile and active. A proper gait analysis at a podiatry clinic will confirm if your orthotics need a tune-up or if a brand-new prescription is necessary.
Podiatry Practice Pointer
Sometimes, the orthotics themselves can cause pressure points or localised tenderness. By identifying these issues early, your podiatrist can make minor modifications, such as grinding, heating, or adding padding, so your foot orthotics remain comfortable and supportive.
Tip 3: You’ve Changed; in Lifestyle or Health
What to Watch For
We all change throughout our life. Significant shifts in weight (gain or loss), a new exercise routine or an occupation that involves standing or walking for extended periods can influence how your feet bear weight. If you’ve recently taken up running, basketball, or tennis, the added impact may outpace the current limits of your orthotics. Similarly, foot structure changes over time, especially after events like pregnancy or surgery, can mean your old orthotics no longer match your body’s needs.
Why It Matters
Each lifestyle change alters your biomechanics, impacting the way your foot loads during daily activities. Without updating your orthotics accordingly, you could experience increased strain on your arches, heels, or ankles. Preventing new injuries and maintaining optimal foot alignment often requires rechecking your orthotics when big changes happen. By consulting with your podiatrist, you can ensure your inserts provide enough support and cushioning to handle your new level of activity or changed foot structure.
Podiatry Practice Pointer
After major lower-limb surgeries, such as knee or hip replacements, it’s often recommended to have your orthotics re-evaluated about four to eight months post-op. Significant changes in leg alignment can occur during recovery, and it’s also wise to check for any limb-length discrepancies at that time. Sometimes after major surgeries we assess that orthotics aren’t even required anymore and just supportive footwear, so there is no need to assume you need new orthotics.
Tip 4: Poor Fit in Your Footwear
What to Watch For
Notice if your orthotics are slipping, sliding or rocking inside your shoes. Sometimes they may feel like they’re not making stable contact with the entire sole of your foot. If your orthotics feel loose, or that the orthotics aren’t sitting flat, or there’s an uncomfortable space between the orthotic’s edge and your shoe, that’s a red flag. Additionally, if you have to constantly readjust your shoe laces or tighten them more than usual, it could be a sign your orthotics no longer fit properly.
Why It Matters
A secure fit is essential for ensuring your orthotics provide consistent arch support and alignment. If they move around, your foot can end up in the wrong position, defeating the purpose of wearing orthotics in the first place. Poorly fitting orthotics can exacerbate ankle instability or knee issues, as they fail to keep your foot stable. Updating your orthotics or having them professionally re-fitted helps maintain proper foot function, reducing the risk of injury and discomfort.
Podiatry Practice Pointer
Children often outgrow their footwear—and orthotics—rapidly. Orthotics designed for smaller feet can become ill-fitting once a child’s shoe size increases, making slipping or instability more likely.
Tip 5: Uneven Wear Patterns
What to Watch For
Examine the bottom of both your orthotics and your shoes. If you observe one side wearing down significantly faster, or a distinct area losing tread more quickly, it’s a likely sign that your foot alignment has shifted or the orthotic is no longer distributing pressure evenly. Look at the heel and forefoot regions—unequal wear could indicate overpronation or oversupination is no longer being corrected effectively.
Why It Matters
Uneven wear patterns can expose underlying biomechanical imbalances that might lead to worsening foot pain, knee pain, or even hip and lower back issues. Your podiatrist can do a thorough gait analysis and adjust your orthotics to correct these imbalances before they cause more complex musculoskeletal problems. Addressing abnormal wear early is key to maintaining healthy posture, reducing injury risk, and ensuring you get the most mileage out of your orthotics.
Podiatry Practice Pointer
Uneven shoe wear at the very back of the heel may not be addressed with orthotic therapy. Sometimes it can indicate a limb length difference, inappropriate footwear choices and gait and postural issues.
Need a Podiatry Orthotic Assessment?
If you recognise any of these signs, or it has just been a bloody long time since your orthotics were last checked, schedule an appointment with our podiatry clinic.
Ultimately, the best way to tell if you need new orthotics is attending a podiatrist every 6-18 months for reassessment, depending on their advice.
Our podiatrists will perform a biomechanical evaluation and gait analysis to determine whether your orthotics can be adjusted, refurbished, or need replacing altogether. Staying proactive ensures your foot orthotics continue to support pain-free, efficient movement—so you can live, work, and play with healthy, happy feet.
Do You Have Orthotics?
Our podiatrists are here to ensure those in Canberra have access to quality services that can help individuals get the treatment they deserve.
