1. A Foot Orthotics Guide
What are Custom Insoles?
Posted on June 30, 2014
By Josh Pettit

2. Orthotics, Insoles or Inserts. Whatever you call
them, they are the small insert inside your shoe.
 Custom Orthotic Inserts are all the rage right now. You
see websites advertising custom insoles, custom
orthotics and custom inserts popping up everywhere.
Ebay, Google shopping, Amazon, every legitimate power
seller has some form of custom orthotic inserts on sale
as big as life. However, most people still don’t quite know
they exist.

3.  You can find blogs far and wide, defaming and affirming
these products. It’s really hard to get accurate information
about what a custom insole is, what it does for you, and
how it works. In turn, it is very hard to market
custom orthotics insoles which was a task I was assigned
with many months ago. Doing a ton of market research
and a little bit of personal research, I feel comfortable
now calling myself an insole expert.

4.  A shoe is an item nobody second guesses. It’s easy to
understand what a shoe is and why it’s there. Thus, it’s
easier to sell a shoe. Shoes are fun. Custom Insoles are
not. They are “grudge” products. They are products that
the customer doesn’t want to purchase until they
absolutely have no other choice.

5.  Usually custom insoles address some sort of specific
ailment, or they are recommended by a doctor. Plantar
Fasciitis, for example, can only be treated with Plantar
Fasciitis Custom Insoles because they have a plantar
fascial groove to relieve pressure on the plantar fascia
during high impact activities.
 People don’t want to have Plantar Fasciitis and they don’t
want to have to spend good, hard earned money treating
it. Thus, it is the marketers job not only to espouse the
benefits of Plantar Fasciitis Inserts (or custom insoles in
general), but to also educate the customer (or patient) as
to what custom insoles actually are.
Plantar Fasciitis insole

6. What are Custom Orthotic Insoles?
 Custom insoles are devices made out of dense rubbery
foam that replace the thin factory innersoles that come
with most shoes. They are made by taking a mold or
scan of an individuals feet and entering that data into a
computer. The computer then mills out an exact mirror so
there is a perfectly mated surface between the custom
orthotic and your foot. This reduces movement of the foot
inside the shoe and also alleviates pressure points. It can
also correct your stride if you tend to lean or pronate as
you walk.

7.  High end custom insoles usually have multi-density
components designed to absorb impact, keeping high
impact activities like running from having negative affects
on one’s spine, joints, bones and the foot itself. It’s best
to imagine your shoe like a box spring for a bed. It
cushions some, but its primary purpose is to support the
mattress. A factory innersole is like a very thin layer of
hay on top of your box spring. A custom insole is more
akin to a very thick and dense mattress that you bought
after you got that new job and threw away the hay.
Multi-density
components

8.  So if your shoe is a box spring and your insole is a
mattress, you start to see how it can affect comfort, joint
and bone health. It really is a perfect analogy. Custom
insoles prevent things like shin splints, runners knee and
small bone fractures that come from running barefooted
or with a worn out factory innersole.
=

9.  We call custom insoles a lot of different things. Custom fit
custom orthotic inserts is a fancy name for these things.
Custom insert, orthotic, custom orthotic, etc. They are all
custom insoles. If you had to be fitted to get them made
and they go in your shoe (and they cost a lot), they are
custom insoles. Standing on a kiosk at Wal-Mart is not
being fitted. Fitting requires a mold from a foam box of
some sort, or a laser scanning machine. To be custom,
the insoles must be manufactured based off of your foot
impression.
Foot Impression BoxPublic Kiosk

10. How can an Orthotic Insole benefit me?
 Custom Orthotics have a lot of benefits. They improve
performance in sports by reducing fatigue and allowing one to
run longer and harder. Competitors often describe running in
bare shoes like “running in sand” compared to custom designed
multi-density insoles. The biggest health benefit would be
reducing joint and spinal damage which is a cumulative result of
high impact aerobics. They also eliminate pressure points by
having a near 100% mating surface. That means they improve
circulation which reduces swelling by definition. Arch support is
probably the first thing people notice when they use custom
insoles. If you’ve never had a custom insole before, you have
never had arch support in your shoe.
These are 3D images of actual feet in the some common
Orthotics Modeling software

11.  Fatigue is worth examining closer, because as your
circulation is improved, your muscles get oxygenated at a
much quicker rate, allowing them to perform better and
recover quicker. It’s simply science, but when you hear
these things you may not relate them to your foot.
Remember the primary surface of any shoe is the insole.
What shoes get credit for, insoles actually do. Shoes are
the box spring, not the mattress. Great insoles in bad
shoes are fine; the other way around, not so much.

12.  Custom inserts also reduce pain from pre-existing
conditions. They act very much like a trampoline on a
smaller scale. If your knees or feet hurt, you will
exacerbate that injury less if you are jumping on a
trampoline than if you are jumping on rocks. Thus is the
nature of a thick and springy insole.

13. Why do custom insoles cost so much?
 Some people just like to charge for expertise. $500 dollar
custom insoles are not unheard of. Good Custom insoles cost a
lot to manufacture because custom insole companies usually
employ C-Peds, or certified pedorthists. Some inaccurately call
them foot doctors but that’s close enough. I prefer foot experts.
A computer program can get a close up of how an insole should
be shaped, but there are some important anatomical differences
in each human foot, and most companies require that a foot
scan be examined by a C-Ped before the insole is milled. The
C-Ped will change met placement, arch height, pronation and
many other factors before the insole is milled out and delivered.
The Milling
Process
Computer
Aided Design

14.  Also, because these are custom products, they must be
fitted. So, the fitting instruments and overhead are also
included in the cost. Foam box impression, shipping if
done mail-order, the cost of the laser scanning time and
software, and the cost of transmitting this data are all
cumulative. Assuming a company uses the foam box
method, mail order and a good tri-laminate EVA, their
average manufacturing cost for 1 pair of insoles averages
about $90.00 before overhead and marketing costs.
Foam Impression Box
Computer Aided Design

15. Can non-custom insoles benefit me?
 Because of the high cost and trouble associated with
custom insoles, many people turn to items called
“prefabs” or prefabricated insoles available in big box
retailers. These prefab insoles often have a gel coating,
or some sort of punch out system Some of these insoles
can be had for as little as $50.00. However, one must
remember that these insoles are not custom and they do
not have the same benefits. Universal insoles often have
little or no arch support and since they aren’t customized,
they create pressure points which can exacerbate
injuries.
This is a kiosk that sells prefabs. These are not
custom insoles.

16.  Prefabs can be better than your stock insoles, however. If
you can’t afford quality insoles, then these prefabs are
better than nothing. Remember, the goal is to get that
thin blanket off your box spring (shoe) and put a real
mattress on there. Some prefabs are thick and will
generally mold to fit your foot shape. They cannot
address foot pain or foot conditions, and they aren’t as
thick as a quality custom insole can be. Also, they tend to
be made out of either very non-durable material, or very
hard material. The worst offenders use polymer instead
of EVA and can cause things like micro fractures in the
fibula and other things associated with too little
cushioning while running.
Prefab Foam Insoles
Custom EVA Insoles

17. What are the best custom insoles?
 As a general rule, the best insoles are those designed for you by
a certified pedorthist. You can get these insoles
online. Footmindbody.com (who averages about 15,000 pair a
year sold) and a few other companies offer this service standard
with each insole. A certified pedorthist examines your foam box
impression and scans and then adjusts the CAD drawing during
the manufacturing phase to adhere to your specific foot issues.
Always use companies that employ Certified Pedorthists.
Otherwise, you are likely to get a layman, or worse, an assembly
line worker, milling out your insoles strictly by computer
generated guidelines. Pedorthic input is key.

18. What are insoles made out of?
 Custom insoles are generally made out of a material called
EVA. This is usually a closed cell hyper dense foam. Closed cell
means that water can’t permeate it. EVA is hyper-dense,
meaning it is very hard. If EVA is too soft, like the innersoles
that come with your shoe, they wear out very quickly. That’s why
the “gel” type insoles aren’t up to par (along with the fact that
they store heat). A good durable insole, must be made out of
EVA.
These are EVA blanks. They are used
to make insoles.

19.  A tri-laminate insole is an insole with 3 layers. Each layer
has a different density and hardness. Density and
hardness shouldn’t be confused. These layers are either
glued together (cheap) or vulcanized (expensive). The
best possible insole material out there is made of tri-
laminate multi-density vulcanized EVA. They are durable
and address each section of the foot with a very
specifically designed material density.
Tri-laminate insoles plus an
anti-microbial top cover

20.  EVA can also be milled very easily, and is an ideal
building material. EVA starts off in large blocks and is
then milled down with a large milling machine specifically
designed for whatever tasks the EVA is to take on, in this
case insoles. EVA is also utilized in padding for
motorcycle helmets, and many other applications where
stiff, durable padding is applied.

21. Where can I get custom insoles?
 You can search custom insoles on the Internet. The largest
company out there is FootMindBody.com they develop these
insoles for medical use as well and they employ a large
percentage of the C-Peds in the southeast United States. All of
their insoles are C-ped guaranteed; they are mail order for
convenience (they send you a foam box and a questionnaire,
and you send it back to them). They also use tri-laminate multi-
density vulcanized EVA with exotic coatings that do things like
prevent bacterial growth, keep your feet cool, and wick
moisture. They are reasonable price-wise, and they offer a
money back guarantee which will replace or refund your insoles
if they don’t suit you no questions asked.

22. Do I need to see a certified Pedorthist,
aka c-ped?
 You don’t need to see one, but you need to make sure
that the company doing your insoles employees one. C-
Ped examination of the 3-D image is vital to creating a
proper insole. I’m not a guy that goes by titles. I don’t give
trust freely to any marketing agency, just for employing a
salesman with MD after his/her name. That said, it’s the
law of large numbers. If a company can use the lowest
common denominator, they will. Hiring C-Peds shows
that a company is serious about their business. It also
shows that they aren’t doing business out of their trunk.

23. What causes pain in the heel of your foot?
Do I have plantar fasciitis?
 Almost certainly. Foot pain comes in two categories; Plantar
Fasciitis and everything else. PF is huge, and the top prescription
is a plantar fasciitis custom insole. A select few companies out
there offer custom insoles for plantar fasciitis. They are very hard
to make as they require a C-ped to identify the plantar facial
groove. They double as insoles for flat feet. So if you have
Plantar Fasciitis or Flat Feet, you should definitely consider a
quality custom insole. They are expensive, but anyone who has
ever had to tiptoe out of bed in the morning, knows the value of a
surcease to that pain. (diabetes#1) Plantar Fasciitis is the
number two reason people look for and buy custom insoles. Flat
feet is number three.
Plantar Fasciitis insoles before top cover
has been added

24. What is the best insole for foot pain?
 A lot of companies promote two types of foot pain insoles.
Medical pain (the plantar fasciitis/flat foot style insole) and the
comfort insole. If you work, if you stand all day, if your feet hurt,
ie; nurse, law enforcement, then you need the latter. Look for
custom insoles designed for working people. Not insoles
designed for Plantar Fasciitis. All custom insoles provide
support for foot arches, but not all of them provide grooves for
the plantar fascia.

25. What is the difference between functional
and accommodative custom insoles?
 If you’ve ever seen Forrest Gump, you no doubt are
familiar with the braces he wears on his legs in the first
part of the movie. Those braces, known as LFOs or lower
foot orthotics, are designed to fundamentally change the
way someone walks over time. They are much like
orthodontic braces for a child’s teeth. They change the
FUNCTION of how one walks over time. These are called
functional orthotics. Functional orthotics require a
prescription and generally are only necessary for a very
small percentage of people looking for custom orthotics
insoles. All other insoles are called accommodative
insoles.
Accommodative insoles

26.  Accommodative insoles do things like prevent pain,
improve general performance and alter pronation. They
do not, however, fundamentally alter a person’s stride.
Stoke victims often need functional orthotics to walk
upright again.
Functional insoles
Accommodative insoles

27. I hope you’ve enjoyed this blog. There
will be more info on this as I get more
time to write. Follow me on twitter or like
me on Facebook. Don’t forget to
comment.
– Josh Pettit - Josh is an IT Administrator, Patient Care Representative, Insulin
Pump coordinator and marketing expert for The Diabetic Shoppe and several other
businesses in Mississippi and Alabama. He’s got a BA in Business Admin from Delta
State, with double majors in Insurance/Real Estate & General Business. He’s got 10
years experience coordinating marketing and insurance through call centers, online
social media and distributive advertising. He wears a lot of hats.
Phone 662-647-6605, Cell: 662-809-0713
Toll Free 888-571-3533 ext 6605
Fax: 888-377-2224, email: jpettit@diabetic-shoppe.com