Orthotics are one of the most misunderstood treatments in healthcare. Some people swear by them. Others think they're an expensive scam. Podiatrists prescribe them for everything from heel pain to knee problems, while some physiotherapists argue you should just strengthen your feet instead.
The truth, as usual, sits somewhere in the middle. Orthotics are a genuinely effective treatment for specific conditions when prescribed correctly. They're not a magic fix for everything, and they're not needed by everyone. At our Camberwell clinic, our podiatrists take an evidence-based approach to orthotic prescription — which means we only recommend them when the clinical evidence and your specific assessment support it.
Here's what you need to know.
Orthotics (also called orthoses) are devices that sit inside your shoes to support, align, or correct the way your foot functions during standing, walking, and running. They work by changing the mechanical forces acting on your foot and lower limb, redistributing pressure, and providing support where your foot's natural structure falls short.
There are two broad categories: custom orthotics, which are made specifically for your feet based on a detailed assessment and 3D scan or mould, and prefabricated orthotics, which are pre-made devices available in standard sizes that can be modified to suit your needs.
At Upwell, we use 3D scanning technology to create custom orthotics that are precisely moulded to the contours of your feet. The scan captures the exact shape of your arch, the width of your forefoot, the alignment of your heel, and the pressure distribution when you stand and walk. This data is used to manufacture an orthotic that addresses your specific biomechanical needs.
Your feet are the foundation of your entire skeletal system. When they don't function optimally, the effects ripple upward through your ankles, knees, hips, and lower back. This is called the kinetic chain, and it's why a foot problem can sometimes manifest as knee pain, hip bursitis, or even lower back pain.
Orthotics work by modifying how forces travel through the foot during the gait cycle (the sequence of movements from heel strike to toe-off). Specifically, they can support the medial longitudinal arch to reduce excessive pronation (inward rolling), redistribute pressure away from painful areas (like the heel in plantar fasciitis or the ball of the foot in metatarsalgia), improve the alignment of the foot, ankle, and knee, provide cushioning and shock absorption in areas of high impact, and stabilise the foot and ankle for better balance and control.
The key word is 'modify', not 'correct'. Orthotics don't permanently change your foot structure. They work while you're wearing them, providing the support and alignment your foot needs to function better and with less pain. Think of them like glasses for your feet — they don't cure your vision, but they make everything work better while you're wearing them.
This is the most common reason orthotics are prescribed. Plantar fasciitis causes heel pain, particularly with the first steps in the morning. Orthotics support the plantar fascia by maintaining the arch and reducing the strain on the tissue where it attaches to the heel bone. Combined with stretching, strengthening, and sometimes shockwave therapy, orthotics can significantly reduce plantar fasciitis symptoms.
Not all flat feet need orthotics. Many people with flat feet function perfectly well without any intervention. But if your flat feet are causing pain, fatigue, or contributing to problems further up the chain (shin splints, knee pain, hip pain), orthotics can provide the arch support your foot's natural structure doesn't.
Orthotics can help offload the Achilles tendon by correcting heel alignment and reducing the demand on the calf muscles during walking and running. They're typically used alongside a structured rehabilitation program rather than as a standalone treatment.
Patellofemoral pain (runner's knee) and medial knee osteoarthritis can both be influenced by foot biomechanics. If excessive pronation is contributing to altered knee alignment, orthotics can improve the mechanical environment at the knee joint.
Orthotics can reduce the stress on the tibial bone and surrounding muscles by improving foot alignment and shock absorption during running and jumping activities.
Growing feet sometimes need temporary support. Conditions like Sever's disease (heel pain in active kids), flat feet with symptoms, and in-toeing can benefit from appropriately prescribed orthotics during key growth phases.
Custom orthotics are manufactured specifically for your feet based on a 3D scan and your podiatrist's prescription. They typically cost more, take 1-2 weeks to manufacture, and are tailored to your exact biomechanical needs. They're appropriate for complex biomechanical issues, significant structural abnormalities, conditions that haven't responded to prefabricated options, and athletes with high-performance requirements.
Prefabricated orthotics are mass-produced devices available in standard sizes. They can be modified by your podiatrist with additions like heel raises, metatarsal domes, or wedges. They cost less, are available immediately, and work well for mild to moderate conditions, general arch support, and initial treatment before committing to custom devices.
At Upwell, your podiatrist will recommend the most appropriate option based on your assessment. We don't default to custom orthotics when a good prefabricated device will do the job. That's not how evidence-based practice works.
If your podiatrist at our Camberwell clinic recommends orthotics, here's the process:
Assessment. A thorough biomechanical assessment including gait analysis, joint range of motion testing, muscle strength assessment, and 3D foot scanning using our VALD Performance technology. This takes about 20-30 minutes within your appointment.
Prescription. Your podiatrist designs the orthotic based on your assessment findings, specifying the type of device, the corrections needed, the materials, and any modifications.
Fitting. When your custom orthotics arrive (typically 1-2 weeks), you'll come in for a fitting appointment. Your podiatrist will check the fit in your shoes, make any immediate adjustments, and give you a wearing-in schedule.
Follow-up. A review appointment 2-4 weeks after fitting to assess how you're responding, make any fine-tuning adjustments, and progress your wearing schedule.
"Orthotics make your feet weak." This is the most common objection, and it's not supported by the evidence. Orthotics don't prevent your foot muscles from working. They change the mechanical environment so your muscles can work more efficiently. It's the same principle as wearing proper running shoes — they support your foot without making it weaker.
"You'll need them forever." Not necessarily. Some conditions require long-term orthotic use (like structural flat feet in adults), but many conditions can be managed with orthotics temporarily while rehabilitation addresses the underlying issue. Your podiatrist will discuss the expected timeline with you.
"Chemist insoles are just as good." For mild arch discomfort, a pharmacy insole might help. But they're not designed for your specific biomechanical needs, they don't correct alignment issues, and they won't address the underlying cause of your problem. If you've tried pharmacy insoles without relief, it's time to see a podiatrist.
At our Camberwell clinic, orthotics are never prescribed in isolation. They're part of an integrated treatment plan that typically includes manual therapy, exercise prescription, footwear advice, and where appropriate, collaboration with our physiotherapy and exercise physiology teams. Because we're a multidisciplinary clinic, your podiatrist can work with your physiotherapist to ensure the orthotic prescription complements your overall rehabilitation plan.
We use 3D scanning technology and VALD Performance force plates to take the guesswork out of orthotic prescription. You'll see exactly how your foot moves before and after treatment, with objective data to track your progress.
Typically 3-5 years with regular use, depending on the materials and your activity level. They should be reviewed annually to check for wear and ensure they're still providing the right support.
Yes, in most cases. Your orthotics are designed to work in the type of footwear you discussed with your podiatrist during prescription. Some people have multiple pairs for different shoe types (work shoes, runners, casual shoes).
Most private health funds with extras cover include orthotics, though the rebate amount varies by fund and policy. At Upwell, we process claims on the spot via HICAPS. Check with your fund for your specific entitlement.
There's usually an adjustment period of 1-2 weeks where your feet adapt to the new support. Your podiatrist will give you a gradual wearing-in schedule. If discomfort persists beyond the adjustment period, come back for a review and modifications.