Dear Dr. Roberts

Should I immediately replace the stock insoles of brand new, out-of-the-box shoes with the insoles I use to alleviate plantar fasciitis pain, or will the stock insoles do for a while?

Thank you!

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PK Beebe

PK,

This is an interesting question and I do not think there is a data-based answer that I can give you.

Irene Davis PT, PhD out of the Harvard biomechanics labs, has a slide in her presentations comparing shoe inserts to a neck brace – to be used for acute care support and then discarded as the tissue heals.  Dr. Davis is doing research on foot impact and differences in foot strike style on the forces transmitted up the leg during running.  She is younger than I, but we both trained clinically in the era of “arch support” to solve mechanics of the foot and leg.

My view of orthotic use has been influenced by her work and others, and I now look at inserts as short term “splints” rather than long term or lifetime equipment.  My views have also been influenced by the work of Lieberman, Brandle, Pitsiladis, and others.  You can access and read some of the work at this link: http://barefootrunning.fas.harvard.edu/.

So, to answer your question, I think your decision to replace the stock insoles should be based on your running style, your current state of ability/disability due to plantar fasciitis, and the type of shoe you wear.  If you are pain free, you might try going without the change.  If you are having recurrent problems with your plantar fascia, you might benefit from gait and running mechanics analysis to see if the plantar fascia is the victim of some other problem that might be corrected with manual therapy, muscle strengthening, or gait retraining.

I hope this helps.

Cheers,

Bill

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