This should be a simple question to answer – Can orthotics help my balance? As with most things in life, it’s not always black and white. What academics all agree on is that as we age, focusing on improving your balance is important to longevity and quality of life.
What is balance?
Perhaps surprisingly, those who deal with it have struggled to settle on a single definition. At it’s most simple, it can be defined as the ability to distribute your bodyweight over your base of support. However, balance is much more complex than this. It involves the interplay of several different body parts of the body including the nerves in our muscles, joints, eyes and ears. Often people talk about the “water level” in their ears – this is a far more complex network of nerves that make up our vestibular system – a sense that didn’t make it into the 5 senses song we learned in kindy. In combination with all of this is a feedback loop of balance and surroundings known as our proprioceptive system. It is responsible for sensing the body’s position in space, and is why you can put your finger on your nose with your eyes closed. Your proprioceptive system heavily relies on feedback from the feet. Any disruption in this feedback loop can compromise balance and stability.
Now that we are clear on balance, let’s look at the research about orthotics. The following articles outline the role of orthotics and balance in different populations.
Effects of orthotics and shoes on balance in older people
A large systematic review was completed in 2016 which revealed the best footwear for older people is thin, hard-soled footwear with high collars. It’s important to note that soft and cushioned shoes were possibly the worst for balance. The study also concluded that foot orthoses improved postural stability. Therefore, the use of footwear and orthotics can be an appropriate intervention to increase the balance in the older population and reduce falls.
Hypermobility and improved stability with orthotics in children
Joint Hypermobility Syndrome (JHS) in children, presents with increased joint range of motion and can lead to altered gait and reduced dynamic balance. Parents of children with JHS, often describe their child as being floppy and/or clumsy. A small study looked at the immediate effects of orthotics on balance and gait. Results of this study indicate that orthotics have a definite immediate influence on gait patterns in patients with JHS. Future studies should investigate the long-term effects of orthotics in this population and include outcome measures for symptoms such as pain.
Diabetic Neuropathy and improved with textured insoles
A recent study in 2022 supported the use of textured insoles to improve balance in people with peripheral neuropathy. The insoles are not like standard arch supports, they are thin and flat with little nodules on them. The researchers think the little nodules provide sensory feedback to the soles of the feet which in turn can improve proprioception and balance. It’s important to note that the people included in the study were neuropathic meaning they don’t feel the soles of their feet however they still benefited from the textured insole.
Using orthotics after a lateral ankle sprain
Research also supports the use of orthotics after a lateral ankle sprain. The people in the study reported more stability with orthotics and reduced postural sway in one footed balance test.
Old Man test
Ever wanted to test your balance? You can test it simply at home, it’s called the Old Man Test. It involves putting on your shoes and socks while standing on one foot. Record your time to see if you can beat it next time. As you improve your balance, you should feel more stable and be able to complete the task more quickly. Please note, do not try this if you are a falls risk or don’t have the strength to stand on one leg. Follow the directions below;
1. Start barefoot on a flat surface, with your shoes and socks close by.
2. Start your timer.
3. Balance on one foot while you bend over and pick up your sock.
4. While continuing to balance on one foot, put on your sock followed by your shoe.
5. Any time you have to put the elevated foot down for balance add a 5 second penalty.
6. To make it really difficult, try picking your sock up with your toes instead of your hand.
7. Switch feet and repeat on the other side.
Verdict
Foot orthotics can help improve balance, reduce falls risk, and improve stability in many populations. The important message it’s not a one size fits all and to truly address your balance you will have to work on several areas of your health. However, if you’re concerned about your balance then it’s best to see your podiatrist who can take you through an examination to see if they can help. Most times they can so why not make an
appointment with us. After all, your feet are your foundation, and we need to look after them to have healthy active lives.
References
1. Aboutorabi A, Bahramizadeh M, Arazpour M, et al. A systematic review of the effect of foot orthoses and shoe characteristics on balance in healthy older subjects. Prosthetics and Orthotics International. 2016;40(2):170-181.
2. P. McDermott, E. Wolfe, C. Lowry, K. Robinson, H.P. French, Evaluating the immediate effects of wearing foot orthotics in children with Joint Hypermobility Syndrome (JHS) by analysis of temperospatial parameters of gait and dynamic balance: A preliminary study,Gait & Posture,Volume 60,2018,Pages 61-64,
3. Seyed Javad Alaee, Kourosh Barati, Behnam Hajiaghaei, Banafshe Ghomian, Sedigheh Moradi, Marziyeh Poorpirali. Immediate effect of textured insoles on the balance in patients with diabetic neuropathy J Diabetes Investigations. 2023 Mar;14(3):435-440.
4. Kevin M. Guskiewicz and David H. Perrin. Effect of Orthotics on Postural Sway Following Inversion Ankle Sprain. Journal of Orthopaedic & Sports Physical Therapy 1996 23:5, 326-331
5. Araujo CG, de Souza e Silva CG, Laukkanen JA, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine 2022;56:975-980.