What is a Custom Orthotic? - SF Running Podiatrist Explains - DOC

What is a Custom Orthotic? – SF Running Podiatrist Explains

Custom Orthotics by San Francisco House Call Podiatrist


Custom Orthotics by San Francisco  House Call Podiatrist

Custom Orthotics by San Francisco Running Doc

As a sports medicine podiatrist (and an active Ironman triathlete) who focuses on runners in San Francisco, I get lots of inquiries about custom foot orthotics. By understanding exactly what an orthotics is, you will learn how a custom molded foot orthotic can help you run faster and with less risk of injury. 

Many runners have heard of custom orthotics and think of them as simply customized arch supports. In a sense this is true, but actually orthotics are much more than an arch support.  

An orthotic is a custom made device that is prescribed by a foot and ankle doctor. It is custom made based on an actual cast and mold of your foot. Custom orthotics work by re-aligning the bones in the feet to control abnormal motion such as pronation and supination. 

Pronation and supination are complicated, but natural motions in the foot. Pronation helps your foot absorb energy and decrease impact when you walk or run. 

When your foot hits the ground and your knee starts to pass over your foot, your ankle rolls inward, the arch collapses, and the foot becomes flexible. This allows you to adapt to uneven surfaces. In a sense, pronation is your natural shock absorber.  But when you have too much pronation, you run the risk of arch pain, tendonitis and flat foot deformity. 

Supination is the opposite of pronation. Supination increases the height of your arch and locks all of the bones in the midfoot. This allows your foot to turn into a rigid lever that can propel you forward as your run. 

Although many people think pronation is due to a weak ankle, it is actually the joint beneath the ankle (called the subtalar joint) that is really moving. You can look at the back of the heel and easily tell how much pronation and supination is happening. This is why the people at your local running shoes store often want to watch you walk when helping you determine which shoes are best for you. 

When a sports medicine specialist like me makes custom orthotics for you, we measure all of the angles and positions of the bones in your forefoot, rearfoot, ankle and legs. Based on those measurements we can then make the ideal adjustments to your orthotics to correct for any imbalances or incorrect alignment. In the simplest terms, your custom orthotics will bring the ground up to your foot so that you can run, walk or cycle more naturally.  

After we perform your biomechnical exam and take all of these measurements, we then put your foot in a corrected position while we create a plaster mold of your foot. Once the mold is dry, the orthotics lab fills that plaster mold with solid plaster to create an exact replica of your foot in the correct alignment.  The orthotic lab then uses your foot model and the podiatrist’s prescription to build your custom orthotic to fit your foot perfectly.  

You will then use the custom orthotic as a replacement insert in place of the arch supports and foot bed that came in your shoes.  

If done correctly, custom orthotics will help you run faster by saving the energy you are currently wasting on excessive pronation or supination. These corrections and realignments are key to decreasing your risk of common overuse injuries like plantar fasciitis, peroneal tendonitis, posterior tibial tendonitis and stress fractures. 

Because I am an active Ironman triathlete myself, I see lots of runners and triathletes here in the Bay Area.  One question I often get is whether or not everyone needs orthotics.  The answer is no.  However those runners who experience tendonitis, chronic injuries, stress fractures, or tendonitis may certainly benefit from custom foot orthotics


Dr. Christopher Segler is an award winning foot doctor practicing podiatry in San Francisco.  He specializes in running biomechanics and makes house calls in San Francisco, Marin, Oakland, Berkeley, and Palo  Alto to help busy athletes who don’t have tim to get the foot doctor.  If you are a runner with a history of stress fractures, arch pain, flat feet, or tendonitis, he can make custom running orthotics for you that will not only decrease your risk injury but are also guaranteed to help you see a new marathon PR. If you are a runner who has a nagging injury slowing you down, you can have San Francisco’s sports medicine podiatrist come right to you!  If you just have a question about custom orthotics made for runners, you can call Dr. Segler directly at 415-308-0833