One of the most common reasons for back, neck, shoulder, and even knee pain begins at the feet. While having low arches or flat feet does not necessarily cause back and neck problems, asymmetry of the feet is an inherited trait. You look like your parents and probably walk like them too because of genetics. Some of us need help to be more symmetrical in how we walk and move about which reduces stress on our bodies. What do foot orthotics do? [caption id="attachment_3359" align="alignleft" width="134"] Overpronation[/caption] Foot orthotics level the hips. While they do provide arch support as well to the main medial and forward arches, posting, which is what controls the forefoot while walking will prevent overpronation or toeing outward while the foot falls in. This has the effect of causing the functional short leg, which is what lowers the hip on one side. Over time, we will adapt to this but the effects on the fascia which is the connective tissue, and how we distort the pelvis is the mechanism behind knee, hip, shoulder lower back, and neck problems as well as many other musculoskeletal complaints regularly seen in doctors offices. In order to understand why someone hurts, the doctor should take a deep history and begin their evaluation by looking at your feet. Failure to do so will likely result in an incomplete understanding of why you hurt in the absence of trauma. Most overuse injuries are a result of poor movement patterns, tight fascia, and poor adaptation while we increase the forces on the body through athletic activity. When thinking about overuse, ask yourself why is it overused for you when another person does what you do injury-free. Off the shelf vs. custom. Which is best is a matter of opinion. In our offices more than half the custom foot orthotics we see from podiatrists either do not properly correct the patient, distort the hips further, or fail to fit the person's lifestyle. The right foot orthotic is the one that fits your lifestyle and levels your hips. The advantage of off-the-shelf prescription orthotics is that the doctor can hand you the device which you can begin wearing immediately. The right device if it lasts 6 months can be replaced immediately at a lower cost than the custom one you have waited three weeks for. The other consideration is cost. A custom device can cost $600 or more, and a casting error may make the device unusable. An off-the-shelf prescription device that you replace 2x per year for $85 dollars is going to do the same thing without a casting error. If off-the-shelf inserts wear out in 3-4 months, we will recommend a custom orthotic which is a stiffer device that will be more cost effective. Unless you have unusual feet where the sizing is different or if you are very wide, off-the-shelf inserts typically work for most people and offer convenience and effectiveness at a much lower cost. Growing children should never have custom orthotics made, as they will grow right out of them and may already have grown before they are received three weeks later. Keep it simple with growing children by using prescription off-the-shelf inserts. What about sandals Think of sandals as foot orthotics that is off the shelf that you can buy in a store. The important thing to understand is that once you find a footbed that works for you, it is likely you can reliably by that same brand over and over for years and be properly corrected. Which one is best for you? The one that levels your hips and the one you are most comfortable with. Our office regularly helps patients figure out which sandals work during their first or second visit. This eliminates the guesswork of trying to figure out if your device is correct for you. Can my body correct over time so I no longer need to wear foot orthotics? Self-correction of the body can occur after many years of wearing foot orthotics. Wolf's law states that bones form according to the forces placed upon them. Corrective foot orthotics can over many years correct over pronation on some patients who find themselves level without them. I have seen this happen to a number of patients over the years and it happened to me. If your chiropractor is evaluating you properly, they can advice you to transition to shoes that do not have correction if this occurs. Do you need advice on foot orthotics and problems in the back, neck, legs, feet or arms. Seeing a chiropractor first may be a great one stop shop for accurate diagnosis of why you hurt. Chiropractors are holisic in how they evaluate and treat you and your problems. They are primary care for the musculoskeletal system. Request an appointment here.