Orthotics are prescribed to help alleviate discomfort, address musculoskeletal issues beginning with the feet, and support better foot function. They are designed to provide long-term relief and improve mobility in conditions such as flat feet and plantar fasciitis. However, for some individuals, they don’t seem to work as expected.
If you are wondering why your orthotics are not working, there are several common reasons why, and you can likely fix them easily. Below, we explore five key reasons orthotics may not be working for you and what you can do to get back on the right track with your foot health.
Reason 1: Incorrect Prescription or Diagnosis
One of the most common reasons orthotics may not provide relief is that they have been prescribed based on an inaccurate diagnosis. If the underlying issue has been misidentified, the orthotics won’t be targeting the right problem.
For example, not all heel discomfort is caused by plantar fasciitis. According to the Australian Podiatry Association, heel pain can stem from a range of conditions including stress fractures and Achilles tendinopathy, each of which requires a different treatment approach. It could be due to a stress fracture or Achilles tendinopathy which require different treatments. Similarly, two people may have flat feet but for entirely different reasons, and each would require a different orthotic design. A standard or incorrectly customised orthotic won’t support your foot’s unique structure or address the root cause of your symptoms.
The Fix
If your orthotics are uncomfortable, or simply not helping, it’s time to revisit us for a new assessment. Gait analysis and pressure mapping are among the tests we’ll do to help identify the true cause of your symptoms. From there, your orthotics can be adjusted or redesigned to suit your specific needs.
Reason 2: Not Wearing Them Consistently
Orthotics are most effective when worn regularly. Many people experience some initial discomfort when first using orthotics, especially if they alter the way their foot moves which can feel unusual at first. If people don’t like this sensation, they’ll often only wear their orthotics occasionally.
However, inconsistent wear limits the benefits of the orthotic. Your body needs time to adapt to the new support. When worn sporadically, the orthotics cannot retrain your movement patterns or offer the consistent relief they are designed to provide.
The Fix
If you are new to orthotics, it is important to follow a gradual schedule to adjust to them. Start by wearing them for one or two hours per day and increase usage over the course of one to two weeks. Aim to wear them during all weight-bearing activities, including walking, standing, and exercising.
As your body adjusts, consistency is key. If you find them too uncomfortable to wear consistently after the first few weeks, this is a sign they may need to be reviewed by us.
Reason 3: Worn-Out or Damaged Orthotics
Just like any other piece of medical equipment, orthotics have a lifespan. Even high-quality custom orthotics are subject to wear and tear over time. Depending on your activity level, weight, and the materials used, orthotics typically last between one and three years. Over time, the structural integrity can degrade, resulting in reduced support and effectiveness.
Cracked shells, compressed padding, or loss of shape can make your orthotics less effective or even problematic if they alter your gait. Even if the damage is not visible, small changes can still affect how your feet align and function.
The Fix
Inspect your orthotics regularly for signs of wear. Look for flattening, cracking, or uneven compression. If you notice these changes or your symptoms have returned after a period of relief, it’s best to have them refurbished or replaced. We offer an orthotic check-up service where we assess your current devices and recommend adjustments or renewal as needed.
Additionally, keep track of when your orthotics were issued. If it has been over two years and you are using them daily, a reassessment is often advisable to ensure they are still serving your current needs. We will advise when they’ll need replacing when we prescribe them so make a note then.
Reason 4: Poor Footwear Choices
Even the most expertly made orthotic will be ineffective if it is placed inside the wrong type of shoe. Footwear acts as the foundation for your orthotic. If your shoes are unsupportive, too worn, or the wrong shape, the orthotic cannot do its job effectively. Common issues include shoes that are too soft, too tight, lacking arch support, or causing the orthotic to slip inside them.
Fashion shoes like ballet flats and slip-ons often do not offer the structure needed to support an orthotic. Some shoes may also be too shallow or narrow to accommodate the insole properly, leading to discomfort like rubbing creating blisters or misalignment.
The Fix
Choose footwear that is supportive, deep enough to hold the orthotic securely, and has a removable insole. Running shoes, walking shoes, and certain types of work shoes are generally better suited to orthotics. The heel of the shoe should be firm, and the midsole should not compress too easily under pressure.
Bring your orthotics with you when shopping for new shoes to ensure a good fit. Some specialist shoe shops and our clinic can assist in selecting orthotic-friendly footwear. Replacing worn-out shoes regularly is also essential, even if the orthotics themselves are still in good condition.
Reason 5: Ignoring Related Muscle Weakness
Orthotics are designed to support and guide proper foot mechanics, but they are not a complete solution on their own. Many foot and lower limb issues are linked to weakness or imbalance in the surrounding muscles, particularly in the hips, glutes, calves, and core. If these underlying weaknesses are not addressed, the benefits of orthotics may be limited.
For example, a collapsed arch may be due in part to weak intrinsic foot muscles or poor hip control. While the orthotic offers passive support, it does not replace the need for active strength and stability.
The Fix
Incorporate a rehabilitation or strength training programme alongside the use of orthotics. We can prescribe specific exercises to strengthen your foot and lower limb muscles. Common exercises may include calf raises, foot doming, single-leg balance work, and resistance band routines for hip strength.
Strengthening the muscles around the foot and ankle helps support the orthotic’s function and promotes long-term improvement in gait, stability, and comfort. Regular exercise also helps prevent dependence on orthotics over time, promoting a more balanced and functional movement pattern.
When to Follow Up with Us
If your orthotics are not working as expected, the first step is not to give up but to seek follow-up care with us. Discomfort or lack of improvement should not be ignored, especially if you have invested in a custom-made device. Your needs may have changed, the orthotic may need to be adjusted, or there may be a better approach altogether.
Follow up with us if you experience any of the following:
- Symptoms that persist or worsen despite regular use
- Discomfort when wearing the orthotic
- Visible wear or damage to the orthotics
- Difficulty fitting the orthotic into your shoes
- New symptoms that develop after starting to use your orthotics
We are trained not only to prescribe orthotics but to monitor your progress and make necessary adjustments along the way. Regular reviews are particularly important for children, athletes, and those recovering from surgery or injury, where body mechanics can change more rapidly.
At Optimise Health, we’ll create the right orthotics for you, help you find the best footwear, and keep an eye on your comfort throughout the process.
