Orthotics as Morality Play

I saw my old podiatrist today. I would put this in the category of “getting out the big guns,” because my insurance doesn’t cover her. At the end of our appointment, I paid an amount that — to borrow a phrase from Katie — I’d prefer not to spend anywhere but Bloomingdale’s. I left hopeful but also very, very conflicted.

Back in 2008, this doctor made me orthotics as one part of treatment for plantar fasciitis. I was new to running and naive and had what seemed like an unlimited supply of money to spend on health expenses (best insurance situation ever, ask me about it sometime, especially if you work in HR and could set this up for your employees, because it was brilliant), and I think I would have done anything anyone told me to do. I’d been running for less than a year. I didn’t know anything about running, and — probably more crucially — I didn’t think I knew anything about running. I didn’t do research or read blogs or Runner’s World forums or subscribe to running magazines. When I went to a doctor, and that doctor said, “this is your problem, this is how we treat it, cool?” it was cool.

So I got orthotics, and I wore them religiously. I give them credit — a lot of credit — for getting me back to running pain-free. But in the years since, I’ve learned more about biomechanics and foot strike, and I’ve become aware of how much information is out there to contradict the traditional views of pronation and correction — barefoot! Newtons! zero drop! — and I’ve occasionally felt guilty about the little pieces of foam inside my shoes. I deeply believed that orthotics were the reason I could keep running. Simultaneously, I deeply believed that they were a band-aid solution.

When I hurt my IT band last summer, the “band-aid solution” voice started to win. It was the only running injury since my first that I couldn’t easily explain (me deciding to put myself in neutral shoes and then run a half-marathon doesn’t count; that was just dumb). I had a gait analysis that revealed some issues with my form, and I started physical therapy to try to strengthen those weaknesses. I also switched shoes, again — my long and tortured history with shoes is right over here — and after a few weeks, my physical therapist suggested that maybe I was being overcorrected. The striver in me was thrilled — I have fixed myself with single-leg squats! I am the American dream! I kept running in the Adrenalines with orthotics most of the time, but I also got PureCadences and ran a little bit in them — sans orthotics, gasp — and started looking at Ravennas.

And then this leg thing happened. And two different medical professionals called my orthotics “flimsy” and suggested maybe they were part of the problem. I knew, deep down, when I decided to go back to my old podiatrist what her answer was going to be. Whatever my own conflicts, I made the choice to see a doctor who has no reservations about orthotics being the solution, and there I was this morning, paying a hold-on-and-let-me-vomit-while-I-give-you-my-credit-card amount of money to try another type.

A couple of hours later, the sticker shock has worn off. There are a load of less-expensive ways I could have gone about this, with over-the-counter inserts and the like, but that’s kind of the “buy six pairs of crappy Old Navy pants instead of the one quality pair of J.Crew pants” problem, and I like to believe that in adulthood, I’ve learned to go for the quality. I pay this much yearly for contact lenses — another “elective medical treatment” my insurance doesn’t cover no matter where I go — and hell, those go in the trash every two weeks! The difference is, I believe in contact lenses. I can see when I wear them, and I prefer them in comfort and style to my glasses. There’s no moral gray area there.

Paying that much for something I don’t completely believe in? And then starting yet another quest for the super-perfect-magic-bullet shoes that I don’t think exist, starting with a list of shoes that seem heavier and more “built up” than anything I’d normally try? That’s a harder call. That approach worked for me once. That approach also failed me at least once. But so has every other approach I’ve tried.

The prevailing attitude reads, to me, that there is a Right Way and a Wrong Way to run these days. Right Way: less shoe, fix your biomechanics, get your own body to be strong. Wrong Way: more shoe, stiffer orthotics, rely on external products to correct your problems. To choose the wrong way feels like a failure: I tried to fix and rely on my body, but I didn’t do a good enough job.

For the past several years, when people have brought up the benefits/drawbacks of different running techniques and shoes and whatnot, I’ve tried to shut it down with, “whatever works for you is the right thing for you.” But when nothing consistently works for you? It’s a whole lot harder to be so flippant.

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7 thoughts on “Orthotics as Morality Play

  1. Diana says:

    At some point we should have the conversation: When and how should I change my foot strike. Additionally, I am looking forward to possibly spending an outrageous sum of money in Bloomingdales in Chicago in July 🙂

  2. Kelly says:

    that is so frustrating! Ive been wearing custom orthotics for years and think overall, they help. But I was stupidly wearing them in a stability shoe for a while, which I think played a big role in my IT band saga the past couple of years. Now I have them in a neutral shoe and so far, so good. I hope you figure out what works for you!

    • Kimra says:

      Me too — thanks! I’m glad you’ve found something that’s working! I am really concerned about overcorrection and about changing too many things at once, so I am already hard at work on my list of questions for when I see her next … in three weeks. That list is going to be scary by May!

  3. Karen Bee says:

    In my early twenties I wore orthotics following an injury that my doctor believed was due to a 1 inch discrepancy between my leg lengths. After awhile, though, I was tired of my feet being overcrowded in my shoes and just stopped using them. I took the time to find shoes that worked for me, and have been fine – no injuries since. I just wear a lightweight neutral shoe now that allows my body to correct itself.

    • Kimra says:

      I love hearing about people finding things that work! The only shoes I’ve ever loved are the ones this doctor found for me last time, so I’m hoping she works her magic again …

  4. Katie says:

    Blah. I feel you 100% on the orthotics crapola. (BTW, thanks for the shout-out! ;)) Like Kelly above, I was wearing an orthotic inside of a stability shoe (Brooks Adrenalines) up until very recently, so maybe that was an ish. Hell if I know at this point. But I did wander on into the running store last week and buy yet ANOTHER pair of running shoes, aided by one of their sales people/gait analysis peops. Why not, right? GOOD LUCK with your orthotics! I hope they magically cure you and then you can go back to running like the wind!!!

    • Kimra says:

      SO interesting – I’ve also had orthotics inside Adrenalines. (I’ve also had them inside other stability-ish shoes, sometimes with problems, sometimes not.) My doctor mentioned something about the shape of Adrenalines that makes them particularly tricky for support for some people — I’ll have to ask more about that. She’s having me try the Trance, which is in the same stability category but apparently shaped differently … but also physically heavier, which makes me nervous. AAAAH SHOES!

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