How Much Do Custom Orthotics Cost & Are They Worth It?

by Mark Paigen 8 min read


Are custom orthotics worth it?

Custom orthotics are big money and typically insurance doesn't cover them. So before you hand over the $200 to $800 they cost, make sure you really need them. And if you do, find out how to get the most for your money.


  • Custom orthotics are expensive, running anywhere from $200 to $800. Additionally, the office visits from initial evaluation to follow-up can add to the total quickly.
  • Making custom orthotics is a multi-step process that includes a thorough exam by a podiatrist, taking a cast of your foot, and the manufacture and fitting of your orthotics.
  • Lots of people think they need custom orthotics to solve their foot issues, but the truth is most people don't need them. Unless you have a complex foot disorder or diabetic issues, the right pair of over-the-counter insoles will solve your foot issues. 
  • Over-the-counter insoles that are the most like custom orthotics have a firm arch support that matches the contour of your arch as closely as possible. Tread Labs insoles come in four different arch heights and are made with medical-grade support for a close-to-custom fit.
  • We recommend Tread Labs Pace Insoles for firm support and a semi-custom fit.



The first step is knowing exactly what you’re paying for, so you can decide whether it’s a good fit for you. In this article, we’ll go over:

How Much Do Custom Orthotics Cost?

While the sticker price for custom orthotics runs from $200 to $800, you should also factor in additional costs. While these devices can last for years, the top surfaces will wear out and have to be replaced. This can cost $50 to $100.

Additionally, the plastic or EVA foam material used in the orthotic will give way after prolonged use. When that happens, you'll have buy another pair of custom orthotics. Over a lifetime, those costs add up to a big number.

Does Insurance Cover Custom Orthotics?

If you're health insurance covers the cost of custom orthotics, you'll usually only have to pay 10-50% of the total price. However, it's important to know that insurance often doesn't cover them. Before you consider having custom orthotics made, you'll want to check to see if your insurance plan will cover the cost.

Why Are Custom Orthotics So Expensive?

The manufacturing cost of custom orthotics (including materials) is normally $100 or less. So where does the hefty price tag come from, and are custom insoles worth it?

What You're Paying For When You Buy Custom Made Orthotics

Here's what goes into the total cost of prescription orthotics:
  • Examination – Remember, the podiatrist is doing a thorough analysis of your lower extremities, gait, and lifestyle. This can include X-Rays, gait analysis on a treadmill and other tests.
  • Casting – A podiatrist takes a non-weight bearing cast of your feet.
  • Mark-up – Feet, after all, are still a business.

As podiatrist Dr. Robert Eckles of Manhattan notes, “It's hard to see the value in the plastic.” But he reminds us that we’re “paying for a comprehensive diagnosis of present and future problems” and not simply the orthotic itself.

It is helpful to ask your podiatrist to break the cost down for you, so you can understand the exact cost of each element. A reputable podiatrist will be able to provide this for you.

If the price of your custom orthotic insoles is high but your podiatrist isn’t thoroughly examining your feet or even taking a cast, be wary.

What Physicians Have To Say About Custom Insoles

While podiatrists often promote the need for custom orthotics, some sports medicine doctors aren’t convinced they are worth the cost. Dr. William O. Roberts, a sports medicine physician in St. Paul, Minnesota says

“If your main business is feet, and part of your income is prescribing orthotics, then you might prescribe them 90, 100 percent of the time. It’s a financial issue, and I don’t think there's a huge need for custom orthotics.”

Orthopedic surgeons often agree with this line of thinking about custom insoles for shoes. Dr. John G. Kennedy, an orthopedic surgeon in Manhattan contends

“There is a big problem with orthotics out there and people are not aware of it. The number of orthotics that I see prescribed in this city is far greater than is warranted by the number of pathological reasons.”

One factor in this difference of opinion between medical doctors (MD) and podiatrists (Doctors of Podiatric Medicine, DPM) is their training:

  • Physicians attend school for four years, where they learn many general concepts before doing three years of highly-specialized residency.
  • Podiatrists go to four years of school, learning specifically about the foot and ankle before doing one more year of podiatric residency. While this can make them experts at anything foot- and ankle-related, they might miss other larger structural problems that a sports medicine or orthopedic physician will consider. Nevertheless, a good podiatrist will consider the overall picture before prescribing custom orthotic inserts.

What's The Difference Between Custom vs. Over-The-Counter Orthotics?

A 2009 study came to the following conclusion: "At two to three months and at 12 months, prefabricated orthoses were as effective as custom orthoses ... There is no evidence that custom orthoses are more effective than prefabricated ones."

With so many doctors and studies questioning the need for custom orthotics, you're probably asking yourself if you actually need them. The truth is, there are some people who absolutely do need custom orthotics. Dr. James Ioli, DPM, Chief of Podiatry at Brigham and Women's Hospital in Boston, says this population includes those with:

  • Complex foot disorders
  • Diabetes who have loss of feeling in their feet
  • Poor circulation
  • Severe foot deformities caused by arthritis 

But for the majority of people, particularly those suffering from Achilles tendinitis, plantar fasciitis, arch pain, heel pain, and kinetic chain pain, over-the-counter orthotics are the option that makes sense.

How Are Custom Orthotics Made?

Creating quality, custom-made orthotics is a detailed and involved process. As Richard M. Olsen, DPM, states, “The manufacture of functional foot orthotics is thus a multi-step process involving detailed and intricate cast correction, orthotic fabrication and application of additional items prescribed by your podiatrist for the treatment of your specific condition.”

Step One: Casting the Foot

After your podiatrist has completed a thorough exam of your legs and feet, taken the required measurements, looked at your shoes, and asked you about your lifestyle, you'll have your feet casted. 

When you're getting casted for custom foot orthotics, it is crucial that your podiatrist:

  • Take a non-weightbearing cast of your foot. You should be sitting or lying down.
  • Place your foot in a neutral position. Your podiatrist will need to see your knee in relation to your foot and set your foot into the desired position.

The most common method of taking this cast is by using plaster. Wet plaster strips are wrapped around the foot. The hollow, “negative foot mold” is then sent off to the orthotics lab. The lab will fill in the cast and discard the shell. The resulting “positive cast” looks like your foot.

While the plaster hardens (it usually takes 5-10 minutes), your podiatrist will watch your foot position to make sure it doesn't change. The plaster usually takes a full 24 hours to harden completely, so after your podiatrist removes the cast, it will be stored before being sent to the lab.

Step Two: The Lab

After your podiatrist takes the proper non-weightbearing cast of your feet, the negative foot mold and your custom prescription are sent to an orthotics laboratory.

Your prescription will include not only the materials, dimensions, and accessories to be used in the orthotics' manufacturing, but also the specifications for the correction of the cast. These measurements are taken from the in-depth exam your podiatrist conducted before casting your foot.

This is where custom-made insoles differ from a stomp-box model. Your podiatrist will specify exactly how the orthotic should be designed to correct for the biomechanical irregularities of your feet (shown in the neutral cast). A stomp-box will simply build those bio-irregularities into the orthotic itself.

Once the positive cast has been constructed, the lab constructs the orthotics through the following steps:

  1. Under extreme heat, your individual cast is pressed against a sheet of graphite or plastic material.
  2. A cover made of comfortable yet durable material is attached to the harder heel and arch structure.

Step Three: Materials

For your custom made orthotics to provide optimum results, they must be constructed from materials that can resist the various forces and motions you put on your feet. Materials need to be rigid enough to control for irregular injury-producing motion, while still flexible and comfortable enough to be compatible with your activities.

There are two main types of materials used for the rigid foundation of your orthotic:

  • Plastics – Most plastics come from the polyolefin family. Polypropylene is the most common plastic used.
    • Material thickness often ranges from 1/8” to 1/4”
    • Flexibility of plastics have a wide spectrum, ranging from very flexible to relatively rigid
  • Graphite – The graphite family is lighter and thinner than plastics.
    • Material thickness is half that of plastic (1/16” to 1/8”)
    • Also has a wide range of flexibility and rigidity

Cushioning materials such as Neoprene and open- and closed-cell forms are often used to complement the harder plastics or graphite and provide added comfort. Remember, these softer materials should never form the core structure of your orthotic.

The most common materials used to cover the plastic or graphite arch-support and heel cup come from the polyethylene foam family. These are closed-cell forms best for total-contact, pressure-reducing orthotics. Individual materials include:

  • Ethyl-vinyl cetates (EVAs)
  • Crepes/neoprenes
  • Silicones

A good podiatrist will take your lifestyle and body type into account when choosing materials for your orthotics. According to podiatrist Simon Spooner, PhD, two important factors are the patient’s weight and activity level. “I work with professional rugby players who weight about 280 lbs and can sprint nearly as fast as Usain Bolt. Trying to provide foot orthoses that can cope with those kind of forces is a challenge. You’ve got to pick the right horse for the right course.”

Your individual foot requires individual attention. Materials that are optimal for one person could be detrimental to another.

What To Look For In Over-The-Counter Orthotics

If you've realized you don't fall into the small group of people who do require custom orthotics, and you're considering buying over-the-counter orthotics instead, there are some specific features you'll want to look for to make sure you're getting the support you need.

  • Multiple Arch Heights - Arches are not one size fits all, so it makes sense that your insole shouldn't be either. The arch of your insole should match the contours of your foot and provide full contact from one end of your arch to the other whether you're a low arch or an extra high. 
  • Medical-Grade Support - High-quality, durable arch support comes from strong, firm support that holds up against the pressure you put on it. Cushy foam and gel do not provide the support your arch needs to address the foot fatigue or pain you're experiencing.
  • Deep Heel Cups - Your foot has a fatty pad under the heel bone that helps cushion each step you take. Look for an insole that has a deep heel cup that will help enhance your foot's natural shock absorption. You'll get greater comfort and stability from it.

As you're shopping around for over-the-counter insoles, check out Tread Labs selection. Our insoles offer a Million Mile Guarantee so you're arch supports are covered for life.

And, because our insoles come in two parts - the molded arch supports and the interchangeable top covers - you'll only ever have to replace the top covers when you need. Not having to replace the entire insole will save you lots of money over a lifetime.



Mark Paigen
Mark Paigen

Mark has always believed exceptional footwear can change lives. He's been in the footwear industry for over 30 years, working with podiatrists, pedorthists, foot care experts, and footwear makers. Mark started Chaco sandals in 1989 and developed a game-changing sport sandal that delivered comfort and durability. After Chaco sold in 2009, Mark ultimately started Tread Labs to continue transforming people's footwear so they can walk better, feel better, live better.

16 Responses

Dan - Tread Labs
Dan - Tread Labs

September 26, 2019

Hi Jamie,
Supporting your arches will help improve alignment, and take excess pressure off of tendons and joints.
Achilles injuries often occur when this tendon becomes overused and stretched. Taking pressure off them will help prevent this kind of injury.
If we can assist with finding the right insole for your needs, please don’t hesitate to reach out to us.


September 25, 2019

how can you help comfort for achilles tendon

Dan - Tread Labs
Dan - Tread Labs

June 03, 2019

Hi Daniel,
Tread Labs orthotic insoles are great for providing even weight distribution and will help improve alignment by supporting your arches.. The orthotic portion of our insoles runs from the ball of the foot through the heel. A podiatrist may be able to add a toe filler to the insole for you, but it would be worth checking in with your doctor or podiatrist to see if this is an option.
We do offer a 30 Day Guarantee, which allows you to try the insoles for a month before determining whether you would like to keep the insoles, exchange them, or return them for a full refund.
Please feel free to reach out to us with any questions you may about finding the right arch height, or any other concerns you may have.
Tread Labs

Daniel Hubler
Daniel Hubler

June 03, 2019

I have had all of my toes on both feet amputated. Do you have a product that would offer me support? I would like to resume easy jogging. Thanks.


April 30, 2019

Hi Peggy,
Tread Labs insoles work great for folks suffering with Plantar Fasciitis.
Our Stride insoles address both the cause and the symptoms of plantar fasciitis. While it is tempting to address heel pain with soft cushion insoles, these will only provide momentary relief. You need strong support to spread the weight evenly over your feet and support the plantar fascia.
Supporting the plantar fascia will help reduce the inflammation, which is the the root cause of the pain and discomfort your are experiencing.
We offer several arch heights providing a near custom fit for almost everyone. Determining your arch height is the first step in finding relief.
Please feel free to reach out to us with any questions you may have regarding finding the right insole for you.
Tread Labs

Peggy Jones
Peggy Jones

April 30, 2019

I have plantar fasciitis in my left foot. What do you recommend for my feet.


January 28, 2019

Hi Harry,
From flat feet to high arches Tread Labs insoles can provide a near custom fit for just about everyone.
Typically for flat feet we recommend our LOW arch supports. Using a higher level of support can often feel too aggressive and cause discomfort.
However, some folks with flat feet have a more flexible arch and can find the right level of support and comfort using one of our higher arch heights. You may want to take a look at this link which talks about measuring the arches flexibility;
Please feel free to reach out to us with any questions you may have, or if we can assist in any way.
Dan-Tread Labs

harry s.
harry s.

January 28, 2019

Would this type of orthotic be good with severe pes planus (flat feet)?

Dan-Tread Labs
Dan-Tread Labs

November 16, 2018

Hi Janet,
For your size I would suggest a women’s 9-10.5 with a Medium arch support. The insoles are designed to trimmed, so you’ll likely need to trim a bit off the top cover to get the right fit for your footwear. A trimmed insole can absolutely be returned/exchanged, so don’t worry about voiding the warranty if you do need to trim them.
Please give us a call at 781-435-0662 or send us an email at if you have any questions or concerns.
Dan-Tread Labs

Janet a
Janet a

November 16, 2018

I am size 10 medium. Women’s size

Dan - Tread Labs
Dan - Tread Labs

April 04, 2018

Hi Doug,
Thanks for taking an interest in Tread Labs.
We do not make custom insoles, what we do offer is 3 styles of insoles available in 4 different arch heights. Our semi-custom insoles can provide a near custom fit for almost everyone at a fraction of the cost of custom insoles.
If you’d like more information about how to best determine which style and height would be most beneficial for you please don’t hesitate to reach out to us at 781-435-0662, or shoot us an email at

Doug Sorenson
Doug Sorenson

April 02, 2018

I have casts of my feet, but the service that originally provided the orthotic cast is no longer in business. I need to find a new provider? I live in Racine Wisconsin.


October 04, 2017

Hi Bob,
Thanks for taking the time to reach out to us.
We completely agree with the points you have made here. There is a small number of people who need fully custom orthotics, which require the fine details and specifications you provide.
We are here to serve the vast majority of people who may not need a custom orthotic but are not finding the relief they need from most over the counter insoles.
Thanks again,


October 03, 2017

This post misses vital information. Generally orthopedists do not agree with orthotic management often because their business is high-volume surgery. A lot of times orthotic management contact for the need for surgery in a much more conservative manner. I am director of a foot orthotic laboratory The far majority of orders we received from podiatrists is significantly more detailed than the orthotic orders we see from orthopedists or chiropractors or other specialists. We actually have a separate division of technicians and handlers for the orders that come in from the podiatrists rather than the other specialist, because they require more detailed angled attention. We even have to charge them more for this but the podiatrists are fine with us because they know they are getting a superior product for their specialty. As opposed to the other specialists who order orthotics, their orders are very cookie cutter, run-of-the-mill generic arch supports that frankly probably don’t do much better than a good over-the-counter item. In fact to refute this article, About 70% of our business is comprised of orthopedists, chiropractors, physical therapists. 70% is comprised from podiatrists. Additionally, When our product sells to orthopedists, chiropractors and physical therapists, the more general product, we do not print the plate material with our name logo. We print our plate material only with our name local when he goes out to the podiatrist because it is of greater detailed fabrication. We don’t want our company’s name recognition if the product is not going to be of value. But as the article says, we are in business to sell orthotics. Frankly, we would sell to only Podiatrists but the volume would not be enough to keep us in business.

April 17, 2017

Hi Janet,

Thanks for reaching out to us.
Metatarsalgia can be caused by a number of factors, but the most common among them is poor fitting footwear. Improper fitting shoes can cause stress on the ball of the foot which can cause inflammation in the metatarsals.
Finding a shoe with a wider toe box and using an insole that provides full length support could be an easy solution. Metatarsal pads may also help relieve some of the pain you are experiencing.
If you’d like to discuss this further please give us a call at 781-435-0662.


Janet Helmer
Janet Helmer

April 11, 2017

I would need supports for marsalgia

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Tread Labs unique 2-part insole system is designed for the long haul. The molded arch supports are unconditionally guaranteed. Forever. The interchangeable top covers are easy to replace, as often as you need.  

Want proof? Try us for 30 days. If you’re not completely satisfied, send your insoles back for an exchange or full refund, we’ll cover US shipping.

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It can take time for your feet to get used to a new level of support. Wearing your new insoles for a few hours each day is a terrific way to achieve comfort. Our fit guarantee lasts for a month. Please give the insoles a chance to do their work.

Concerned about the fit of the insole in your shoe or the size of the insole relative to your foot? Give us a call, we’d be delighted to help you find the best solution.

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Heel Spur Vs Plantar Fasciitis: What’s The Difference?

If you've ever hopped out of bed in the morning and felt a bothersome pain at the bottom of the heel when you take your first few steps, you've probably wondered what what causing it. Even if it ends up going away later in the day. We'll explain what it could be, and what you can do to stop it from happening.


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Heel spurs and plantar fasciitis are two terms frequently used when discussing certain types of heel pain. And while they're actually very different issues, they can be addressed with the same types of treatment. 

Difference Between Heel Spur Pain And Plantar Fasciitis Pain

For one reason or another, there are some misconceptions about how plantar fasciitis and heel spurs are connected. People tend to think that heel spurs are a common cause of heel pain, however that's not the case.

The truth is that while heel spurs might be associated with pain, they are usually not the reason it occurs, as the Cleveland Clinic points out. Instead, the majority of the time, plantar fasciitis is the responsible party when heel pain strikes.

What is Plantar Fasciitis?

According to Podiatry Today, "plantar fasciitis is at epidemic levels with suggestions that one in six Americans may have the condition." As it has become so common, it's important to understand exactly what plantar fasciitis is.

The plantar fascia is a thick, connective band of soft tissue that stretches from the back of your heel to the base of your toes. As a ligament, it connects the bones in these two areas and it’s designed to be a shock absorber for the high amount of stress you put on your feet.

The plantar fascia is strong and can withstand a great deal of force, but too much pressure can damage or tear it. The body responds to this damage by becoming inflamed, and inflammation of the plantar fascia is called plantar fasciitis. 

Plantar fasciitis is usually described as a stabbing pain under the arch and/or on the bottom of the foot near the heel. This pain tends to be worse in the morning and after long periods of standing, exercise, or rest. There may also be some redness and swelling in the area.

Sometime plantar fasciitis can be confused with Achilles tendinitis. As the American Academy of Orthopaedic Surgeons explains, "Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of your lower leg becomes irritated and inflamed.

The Achilles tendon is the largest and strongest tendon in the body. It attaches the calf muscles to the back of the heel and allows you to stand on your toes when walking, running, or jumping. When you train too hard or intensely without enough rest, Achilles tendinitis can occur, causing pain at the back of the heel or directly above it.

What is a Heel Spur?

A heel spur, as explained by ScienceDirectis a type of bone spur, or calcium deposit, that develops toward the back of the calcaneus, or heel bone, where the plantar fascia inserts. These small, jagged bumps of bone usually develop in response to lots of trauma—or damage—to the heel.

This means that in most cases, heel spurs actually form as a result of plantar fasciitis. If the plantar fascia continues to be damaged for a long period of time, the body will eventually create a heel spur to provide additional support for the heel.

Heel spurs are associated with a similar stabbing type of sensation in the heel that is usually worse in the morning and comes and goes throughout the day. But the major difference here is that the heel spur itself is rarely the actual cause of this pain.

In fact, about 10% of the population has heel spurs whether they know it or not, but only 5% of those with spurs will have heel pain. The true reason for pain in most of these individuals, as you might have guessed, is plantar fasciitis.

Heel Spurs vs. Plantar Fasciitis: Similarities & Differences

Here is one of the easiest ways to remember how these two conditions are different: many people have heel spurs without plantar fasciitis or heel pain, but it’s rare to find someone with plantar fasciitis who does not have a heel spur.

According to one study, approximately 50% of patients with plantar fasciitis also have bone spurs. Since about 1 in 10 people would show a heel spur on an X-ray of their foot, they are only considered an incidental—or insignificant—finding unless there is also foot pain.

When a heel spur forms, it is usually not responsible for causing any foot pain on its own. Instead, the pain is due to the foot condition that caused the spur. So, if you have a heel spur and notice pain at the back of the heel, you probably have Achilles tendinitis.

If the pain is on the bottom of the heel, plantar fasciitis is most likely the reason. Many people have heel spurs without any symptoms at all, and experts are still trying to figure out exactly how spurs relate to heel pain.

Since both plantar fasciitis and heel spurs result from a similar process, the risk factors associated with them are shared in common. The following factors increase the chances of developing both conditions:

It’s also important to point out that although the symptoms of plantar fasciitis and a heel spur seem similar, there is one way to help tell them apart. Plantar fasciitis symptoms may be felt in the arch as well as the heel, some patients have it for a while before they notice the stabbing heel pain. In rare cases where heel spurs are responsible, the jabbing pain will be centered in the heel.

Treating Both Conditions with the Same Type of Approach

If you’re experiencing heel pain, your doctor will examine your foot and may recommend an X-ray to confirm the diagnosis. Although plantar fasciitis is the most common cause of heel pain, it’s important to rule out other causes like Achilles tendinitis, stress fractures, a broken heel, or tarsal tunnel syndrome.

With a diagnosis of either plantar fasciitis or a heel spur, nonsurgical treatments are always recommended first and are usually successful. These include:

For patients whose pain doesn’t improve after 6-12 months of trying these nonsurgical treatments, surgery is an option. 

Healing From Plantar Fasciitis And Heel Spurs

When it comes to heel spur vs plantar fasciitis conditions, it's important to remember that the latter often leads to the former. The good news is that more than 90% of patients with plantar fasciitis will improve in less than 10 months after following these simple nonsurgical treatments.

On the other hand, allowing the pain to persist or trying to push through it will only make matters worse and can lead to bigger foot problems.

With so many different options for treatment, it can be hard to figure out where to start. But, taking charge of your heel pain by finding one that works for you can have you experiencing more mobility and freedom as your heel pain gradually fades away.

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Do I Need Prescription Custom Orthotics?

If you're experiencing foot pain, you might be wondering if you need to invest in a pair of custom orthotics. You may have even already seen a podiatrist who has recommended you be fitted for them. But the expensive of custom made orthotics can be a hurdle for lots of people, especially since insurance may not cover them. That might leave you asking yourself, "Do I really need custom orthotics?" Let's find out.




Orthotic inserts are foot supports worn inside the shoe that provide more comfort and stability than the factory inserts that come in footwear. Scientific research has shown again and again that both over-the-counter and custom molded orthotics, or orthopedic insoles, are effective in treating lower-extremity injuries and pain. Insoles can also help correct biomechanical irregularities in your feet, and solve many foot issues like fallen arches and plantar fasciitis.

Sports podiatrist and Doctor of Podiatric Medicine (DPM) Richard Braver considers orthotics a “cure-all” for many lower-body injuries and pain. According to Braver, “orthotics can prevent and cure a problem by reducing and eliminating the stress that caused it.” Clearly, orthotics are important additions to our shoes. But what are custom orthotics?

What's The Difference Between Custom Orthotics And Over-The-Counter Insoles?

There are two types of orthotics: over-the-counter and custom-made orthopedic insoles (also called custom molded orthotics).

As the American Podiatric Medical Association explains, custom molded orthotics are insoles that have been prescribed by a doctor, often a podiatrist, sports medicine physician, or orthopedic surgeon after conducting a thorough evaluation of your feet, ankles, and legs. They are built for your specific foot and gait, and accommodate your individual foot structure.

Over-the-counter inserts encompass a variety of different foot products including arch supports, insoles, heel liners, and foot cushions. Not all prefabricated insoles are made alike, however, especially when it comes to the level of support they offer.

While scientific research has proven that that insoles help treat and prevent leg, foot and lower-extremity injuries, studies have not found a significant difference between prefabricated versus custom orthotics.

In fact, Dr. Braver believes that for most people, orthopedic or custom-made orthotics should be a last option. Think of it this way. If you have a headache, you rest, take an anti-inflammatory, and drink water. You probably don’t immediately rush off to get an MRI. It’s the same with orthotics. With prices from $300 to $500, prescription insoles are not necessarily the best option for everyone.

So who may be a good candidate for custom orthotics?

People Who May Need Custom Orthopedic Insoles

  1. Diabetics - Diabetes and poor circulation increase the risk of foot ulcers and infections. You might want to see a podiatrist if you have diabetes.
  2. High-performance athletes - Running an ultra-marathon is different than a completing a 5K. If you engage in sustained, high-level activities (particularly weight-bearing ones like running), you could benefit from an orthopedic insole.
  3. People with serious biomechanical issues and recurring injuries that aren’t addressed with over-the-counter versions - If you've tried many over-the-counter options and still suffer from plantar fasciitis, pain or other issues, prescription orthotics may be a good option. However, you'll need to first see a podiatrist or physical therapist to rule out other causes of foot pain such as tight muscles and improper footwear. 

If you don't fall into these three categories, the best over-the-counter insoles might be a better option.

The Types Of Custom Orthotics

  1. Functional orthotics - As William R. Olson, DPM, and former President of the American Academy of Podiatric Sports Medicine (AAPSM) writes, “The purpose of the functional orthotic is to accurately and precisely position the foot throughout the gait cycle so as to promote proper function.” These orthotics control abnormal motion. They also treat foot pain and injuries such as tendinitis and shin splints. Functional orthotics are often crafted of semi-rigid materials like plastic and graphite.
  2. Accommodative orthotics - Accommodative orthotics are designed to provide cushion and support. They are often custom-fitted for people suffering from diabetic foot ulcers or painful calluses on the bottom of their feet.

Getting Fitted for Custom Molded Insoles

Podiatrist and range of motion test for fitting orthopedic insoles

If you’ve decided you might be a good candidate for custom-molded insoles, it’s time to see a podiatrist. Here is what you can expect when getting fitted for your orthotics.

  1. A Range of Motion Test - Your podiatrist will measure the motion of all your lower-extremity joints (such as your hips, knees, and ankles) in order to identify any irregularities in joint motion like excessive flexibility or extreme limitation. Your doctor will also establish the weightbearing and non-weightbearing functional positions of these joints by testing them while you're standing and walking on them, and when you are lying down.
  2. A Muscle Examination - Your podiatrist well test the lower-extremity muscle groups like the quadriceps and calves to identify any overly weak or tight areas. This will show if your muscles are adding to your injury, symptoms, or biomechanical problems.
  3. A Non-Weightbearing Neutral Position Cast of the Foot - Your podiatrist will cast your foot to provide a model for the orthotic laboratory. As Dr. Olsen says, “The specific method of casting is critical and must be done accurately in order to achieve an accurate impression of the foot in its neutral position.” 
Because custom orthotics must be based on your foot in it's neutral position, stomp-box moldable orthotics are ineffective in treating biomechanical problems. They take an impression in a weightbearing position, thus incorporating any biomechanical issues into the build of the orthotic.

    Questions Your Podiatrist May Ask

    Your podiatrist should perform a thorough examination that includes all the elements listed above as well ask you questions about your pain and foot problems.

    A good podiatrist will ask you to explain the type, frequency, and duration of all the activities you engage in as well as your overall lifestyle. Are you on your feet all day at work, lifting heavy loads? Your podiatrist should know this. Have a long history of plantar fasciitis or stress fractures? This is important information.

    Your podiatrist should also look at the wear pattern of your shoes to understand your gait mechanics. Podiatrists look for the following patterns:

    A thorough examination is the foundation for effective, reliable custom-made orthopedic insoles.

    Well-made, custom-molded orthotics (a pair of orthotics made for a particular individual) are quite expensive ($300 and up), and there is a small group of people who will benefit from them.

    Custom-molded orthotics are designed to control pronation and increase the comfort and performance of footwear. There are many providers for custom-molded orthotics, and some are better than others. You’ll want to consider a few factors when searching for a provider.

    Finding The Right Custom Molded Orthotics Provider

    A stomp box is used to make custom molded orthotics
    1. Hands-On Evaluation – Great custom-molded orthotics cannot be made without a face-to-face visit. There are a variety of providers who will send out a "Stomp Box," a piece of impression foam in a box. You are instructed to step into the box with each foot and send the resulting impressions off to make your orthotics. Unfortunately, without an experienced provider to position your foot as it makes the impression, your dysfunctional biomechanics may be built into the design of your orthotics.
    2. Type of Provider – A certified Pedorthist (C. Ped) diagnoses foot problems and prescribes orthotics. C. Peds often have the most hands-on experience with orthotics and functional biomechanics. Podiatrists are doctors who specialize in feet. They can diagnose foot problems and prescribe orthotics as well as perform surgery to fix problems.  A chiropractor is involved with the diagnosis and treatment of musculoskeletal disorders. Some provide custom orthotics.
    3. Years of Experience – Getting custom orthotics right is a challenging mix of art and science. It takes years of experience to learn the subtleties of making custom orthotics that meet both the functional and the comfort needs of the client. Choosing someone with a long history of success will increase the chances that the orthotics will be right – the first time.
    4. Hands-On Fabrication – Some practitioners evaluate a client's needs, then transmit the info to a lab that creates the actual orthotics. While this system can work, having the orthotics made at the place of the diagnoses prevents errors in communication and insures that modifications can be easily made if necessary.

    If you’ve decided that custom orthotics aren’t right for you, or that it makes sense to try over-the-counter insoles first, you’ll find you have a lot of choices.

    How To Choose Over-The-Counter Insoles

    The most important thing to consider is that not all over-the-counter inserts are made alike. Their quality and effectiveness varies greatly. And understanding the difference between inserts and insoles is helpful.

    Think about arch supports, feet, and walking the way you think about eyeglasses, eyes, and seeing. Most people (especially as they get older) benefit from some kind of corrective lenses to improve vision. In the same way, most people benefit from arch supports to optimize their stride.

    Shoe Inserts

    Depending on your eyesight, you might need a specific prescription or a simple pair of generic reading glasses found at the drugstore. Generic reading glasses are similar to shoe inserts that don't have much variety in sizing and fit.

    The basic cushioned inserts you find at the drugstore may be cheap, but they lack any structure and they won't provide the needed support.

    Shoe Insoles

    If you require more than drugstore reading glasses, you will need an eye exam, after which you get a prescription for lenses. The prescription is written in a detailed scale because added precision enables better sight.

    Like with glasses, having precision sizing with insoles enables a higher level of support and better biomechanics. For many people, an eye exam and simple prescription is enough, much like aftermarket insoles with precision sizing works for most people in relation to arch support.

    There are different types of insoles:

    When you’re considering over-the-counter insoles as an alternative to custom orthotics, look for proper fitting medical-grade arch supports that provide comfort as well as support. They should control overpronation, prevent and relieve foot pain, and most importantly, support your active life.


    Best Supination Insoles For Underpronation Relief

    Having high arches can be a pain – literally. Foot shape affects pressure on other joints and, if not properly cared for, high arches can lead to knee and hip problems. Another thing affecting people with high arches? Supination.




    Are High Arches The Exact Same Thing As Supination?

    No. Supination is also known as underpronation, which occurs when the foot doesn’t properly roll inward upon landing. As part of a normal stride, the foot will roll slightly inward after the heel hits the ground (pronation). This cushions the impact and helps you adapt to uneven surface.

    A normal foot pattern rolls inward at around 15% during your stride. When you supinate, your foot rolls in under 15%. Most of your body weight lands on the outer edges of each foot. Conversely, overpronation is defined as the inward rolling of the foot over 15%.

    Supination can put too much pressure on the Iliotibial (IT) band. Some people who supinate will experience knee pain or Achilles tendinitis. Underpronation is less common than overpronation, with up to 10% of people in the U.S. supinating. Those with severe supination are prone to inversion ankle sprains, heel spurs and stress fractures.

    While supination is not the same thing as high arches, it is a condition often caused by them. Not all people with high arches will supinate, but many are at risk. Athletes with high arches should be particularly careful in order to avoid these injuries.

    Can Someone Have Very High Arches And Still Pronate?

    Yes. Though people with high arches often underpronate, that is not always the case. People with high arches can pronate and even overpronate.

    Who Underpronates and Why?

    There are three main characteristics of people who underpronate or supinate.

    1. People who underpronate are often heel strikers – their heel hits the ground first. Then, the foot rolls out, and the force of their body weight is unevenly distributed to the outer edge of the foot
    2. Underpronation is more common in, but not exclusive to, people with high arches. High arches are often more rigid and less flexible. When your foot hits the ground, your arches don't sufficiently flex to accommodate dynamic movement.The force of the stride then pushes the weight towards the outside of the foot.
    3. Tight calves and Achilles tendons magnify the movement of supination. The tightness in the back of the heel and up the leg pulls your foot outwards when it lands. If tight calves and Achilles tendons are the cause of your supination, stretching is an easy solution.

    If you're experiencing these symptoms and the associated pain, there is an easy way to get relief. A quality pair of supination insoles can help.

    I Have High Arches, How Can I Tell If I Supinate?

    According to Runner’s World, there's an easy, informal test you can do to see if you supinate. Simply take a well-worn pair of sneakers and place them on a flat surface. Look at the shoes from behind. Do they stand straight? Or do they lean to the outer edges? If they lean dramatically to the edges, there is a high chance that you supinate. See a doctor for confirmation.

    Injuries Associated with Supination

    Like any biomechanical irregularity, underpronation can cause specific injuries. Common injuries associated with supination include:

    Neutral Shoes and Shock Absorption

    Shoe shopping can be difficult for people with high arches. If you underpronate, you need to find shoes that accommodate your gait. Because the body weight is not distributed evenly across the foot, forces of impact remain concentrated on the outside of the shoe. When you push off, your smaller toes do most of the work. This is both inefficient and lessens your ability to properly absorb the impact of your stride. Most specialists recommend finding neutral shoes with extra cushion or shock absorption qualities.

    Other characteristics you should look for in a shoe include:

    Best Shoes For High Arches And Supination

    There are many brands and styles that work well for people with high arches. To find the best shoes for high arches and supination, it's important to try several pairs on in a store before you buy. 

    New Balance

    New Balance has great running and walking shoes for people with high arches. Many of their styles provide extra cushioning, which is important for shock absorption that high-arched feet typically don’t have on their own. New Balance’s cushion features their "ABZORB" technology, a proprietary blend of rubber and foam materials that is very lightweight and can endure many miles of wear.


    Birkenstock is a well-known comfort shoe brand. Their sandals provide arch support with a molded footbed. For many, their signature footbed helps redirect and balance pressure. Make sure to try out the sandals in the store. Birkenstock's firm one-size-fits-all footbed is heaven for some but too uncomfortable for others.


    Developed by the founder of Tread Labs, Chaco has been making sandals with robust arch supports for decades. Originally designed for river guides, Chaco now offers many styles for off the river too. The original Z/series of sandals has very good arch support, however some of the more recent models have less-pronounced support. Very durable, Chaco sandals will last for years. 


    Saucony also makes great running shoes for those with high arches. Like New Balance, they provide amazing comfort and cushioning. Their PWRGRID+ technology claims to provide 20% more cushion without adding bulk or weight. A selection of their shoes are designed for daily use for neutral or supinated feet.

    The Best Insoles For Supination

    Orthotics for supination can also be a great solution to help reduce underpronation, particularly if biomechanics (and not tight calf muscles) are the cause of underpronation. As most shoes do not sufficiently support high arches, they won't correct the underlying cause of your underpronation.

    Because high arches are closely correlated to supination, you need to find supination insoles that will support the arch during your stride. By supporting your arch, you prevent your foot from rolling out.

    An insole with a deep heel cup will stabilize your heel and acts as extra shock absorption. With the proper insoles for supination correction, you can prevent injury and develop a more efficient stride.

    Are High Arches Passed Down Genetically?

    Sometimes. There are many causes of high arches. People can be born with high arches or develop them later in life. Causes include:

    Do High Arches Change With Age?

    There are a few factors, including age, that can cause fallen arches in people who have very high arches. These include:

    A series of tendons and ligaments that attach leg muscles to the foot create the foot’s arch. When these tendons are injured or otherwise loosened, arches begin to fall. This change in foot shape can be painful. Feet will tire easily and put even more stress on knees and ankles.

    To prevent arches from falling, make sure you wear high arch support insoles and maintain a healthy lifestyle.

    The Bottom Line

    Millions of people in the U.S. have high arches. With proper foot care and footwear like shoe inserts for supination correction, you can participate in most sports and activities pain-free. Being proactive by listening to your body and being aware of any discomfort or changes can help you prevent injury.


    How To Treat Bursitis Foot Pain

    More common than you might think, bursitis foot pain is caused by a number of factors. Some are very easy to address while others take a little more effort. But, getting relief from bursitis in your foot will have a big impact on your daily activities and quality of life. Learn more about what causes foot bursitis and how you can treat it.

    Quick Summary ---


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    Your foot is equipped with its own cushioning system that helps reduce the impact of walking and running on hard surfaces. Orthopedic Surgeon and Sports Medicine Specialist, Dr. Jeffrey Tedder, explains, "The bursa is a fluid-filled sac that’s located around joints to help them function. When these are inflamed or irritated, it’s called bursitis, and can decrease the amount of motion in the joint. This most commonly occurs in the heel, hip, knee, shoulder, and thumb."

    If the bursa in your foot becomes inflamed from overuse or injury, you may experience pain, swelling, or bruising in your heel, arch, or metatarsal area (ball of foot). 

    Common Symptoms of Foot Bursitis

    Common areas impacted by bursitis

    What Causes Bursitis?

    There are many things that can contribute to the development of bursitis foot pain. The most common cause of foot bursitis is the overuse or improper use of your foot’s muscles, bones, and tendons. Other common causes include the use of ill-fitting footwear and other biomechanical issues in your feet.

    Overuse Injuries Can Cause Bursitis In Foot

    Repetitive activities like jumping, dancing, power walking, or running can lead to foot bursitis. This can be especially true if you don’t take the time to stretch and warm-up your body—especially your feet—prior to exercise. Always spend time stretching your body and feet prior to athletic activities to ensure your muscles and tendons are warmed up, with proper blood flow and oxygen.

    If you are not accustomed to strenuous activity, take things slowly when you first begin a new exercise regimen. While you may (and should) be enthusiastic about your healthy new routine, your body needs time to adjust to the new demands. Pacing yourself in the beginning is an important step in becoming fit and avoiding injury.


    Ill-fitting footwear is another culprit when it comes to bursitis. If you regularly run, jump, dance, or spend many hours at a time on your feet, be sure your footwear has:

    Biomechanical Irregularities In The Foot

    Sometimes, bursitis foot pain can be caused by an existing foot irregularity, like Haglund’s deformity—a bone spur that can develop on the heel. The bursa can become inflamed as it tries to cushion the heel and the spur from impact.

    Other conditions that may cause or contribute to bursitis include problems with thyroid levels, infections, arthritis, or diabetes. These medical conditions can be life-threatening if left untreated, so it is important to see a physician if you have symptoms of bursitis in your foot.

    How is Bursitis of the Foot Diagnosed?

    If your doctor suspects you may have bursitis, they will examine your foot and ask you about the symptoms, how often you exercise, when the pain began, and your medical history. To rule out an underlying illness, injury, deformity, or bone fracture, your doctor may order an X-ray, ultrasound, MRI, or blood work. If they suspect an infection, they may remove some fluid from the bursa to test it for gout.

    Note that bursitis foot pain is often confused with other foot conditions, including: plantar fasciitis, a heel spur, Achilles tendinopathy, Sever’s Disease, a trapped nerve, Haglunds’ deformity, or a stone bruise. Depending on the condition your doctor finds, they may refer you to a rheumatologist, orthopedist, or podiatrist.

    What Is The Treatment For Foot Bursitis?

    The good news about foot bursitis is that it can be easily managed with proper and prompt attention. A few common bursitis foot treatment options include rest, ice, elevation, stretching, a change in shoes, and adding insoles to your footwear.

    How Do Insoles Help Bursitis Foot Pain?

    Because footwear manufacturers design their shoes to fit the widest range of people, the vast majority of shoes have minimal arch support. Footwear makers do this because they expect that people who need additional arch support will add an insole. Insoles with firm arch support can help relieve bursitis foot pain.

    You'll get the most out of your footwear by replacing the factory inserts that come in your shoes with firm, supportive insoles. To get the most out of the arch support insoles you're adding to your shoes, look for ones that:

    Podiatrists recommend firm support to improve alignment, control pronation, and deliver long-term comfort. Insoles are a small investment in good lifelong foot health. Add them to your footwear and reap the benefits.


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