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FREE WEEKLY Expert Advice. Login here every week to read Dr.Romanov's advice on various training related topics. You're welcome to email your questions to and we'll make sure to cover the requested topic. This section is updated every Tuesday.
November 15, 2005

It doesn't seem to go away and people constantly ask the same questions. People want simple answers. Nobody is listening to the reasoning about the use of orthotics. So I am going to write in a simple way as much as possible.

My recommendation is to stop wearing them. Return them and get your money back, and start thinking differently about this matter.

According to Dr.Lyle J.Micheli (The Sport Medicine Bible, 1995, p.p.121-122), orthotics are shoe inserts designed to correct some abnormalities, such as flat feet, high arches, feet pronation and as a treatment for the ITB (iliotibial band) syndrome and knee pain. According to medical community beliefs, orthotics are providing:
  • arch support for athletes with mild fallen arches
  • support for the long bones of the midfoot, the metatarsals
  • heel support through a wedge in the heel, which can help reduce the strain on the calf muscle - Achilles tendon unit
What do I think think about orthotics?

I think it is not the right solution for these problems. It is a lazy approach. It is a temporary artificial support, instead of development of one's own body and one's own skills of movement, the athlete is given a cane as an invalid, which eventually lead to more weaknesses and problems.

Why they don't work?

Orthotics don't work, because they deprive muscles from performing their specific functions by substituting for their work. Orthotics do not teach us to move proper and they deteriorate our perception of movement.

Why people should stop wearing them when starting with Pose?

When starting with Pose people start relying on the proper development of their body, muscles and perception, where any artificial devices would interfere with their process of learning the proper movement.

Next week we'll continue on this subject: Orthotics: How to stop wearing them and make a smooth transition to better running?



Joe D,
Your numbness is coming from pinching nerve and blocking blood flow. Probably your orthodics are doing that.

For reason unknown for me your second metatarsalís muscles and ligaments are off their functions. You have to restore their functions first and together with that work on changing your walking and running gate.

Posted by: DrRomanov at November 23, 2006 02:51 AM

I have a dropped 2nd metatarsal. Is this something that can be dealt with through a change in gait. I have not had any success with orthotics inteh past and am reluctant to try them again but cant tolerate feeling that bone hit the bottom of my shoe anymore.

Posted by: AJ at November 23, 2006 01:34 AM

My feet burn after running about a mile. I wear orthodics which were fitted by a podiatrist. Still they burn and the front of my left foot goes numb.

What can I do?

Posted by: Joe D at October 29, 2006 11:22 PM


you should've never gotten the orthotics, it is not surprising to read that your running felt weird... why on earth would it be normal when you're running wearing "platforms".

To answer your question - check your technique, that is the source of all aches.
I also recommend you read the articles in this section about running barefoot, strengthening your feet, etc
Read this one in particular - FEET WORK IN RUNNING

Good luck! I hope my advice helps you.

Posted by: Lana at October 24, 2006 06:07 PM

I have been running for about three years. I've run in many races, from 5ks on up. Just completed my third marathon. I average about 50 miles a week. Two years ago, I began experiencing pain in my left forefoot. I put a metatarsal pad in my shoe and that seemed to minimize the pain, although a dull, manageable pain sort of hung around. In August of this year, that manageable pain became sharp, causing me to change my gait when running, rolling pretty severely to the outside. I saw a podiatrist and he thought I had bruised the second metatarsal head. He put me in rigid orthotics. I have pretty low arches and Morton's toe. The orthotics have a metatarsal lift and a soft channel under the second metatarsal joint. I have now had these orthotics in my work and running shoes for a month exactly. I did not run much prior to the 10/01/06 marathon to let the joint heal. This didn't bother me too much because it was taper time anyway. I was worried about running the marathon in untested orthotics. The few pre-race runs I did felt very odd and inefficient. My heart rate was higher and I felt like I was working harder to keep a pace. The rigid rear portion of the orthotics seemed to be rolling me to the outside to address my pronation. The forefoot pain was mostly in check, but would certainly be a factor in the race. I went ahead with the race and experienced absolutely dead legs from about mile 19 to the finish. I missed my goal by 11 minutes and had a much tougher marathon than I would have predicted. My post marathon runs have also been marked by a feeling of great inefficiency, leg fatigue and elevated heart rate. For a time I began to believe I was suffering from overtraining syndrome, until this morning, when I put my old insoles in my shoes and went for a run. It was the best run I have had in a month. I did have the forefoot pain but the inefficiency and fatigue were not there. Even the heart rate was down where I would expect it. Long way of getting to a question: what do I do about the forefoot pain?

Posted by: Doug at October 18, 2006 10:08 PM

Regarding the leg length discrepancy and whether or not to use orthotics... After getting serious about running about 9 or 10 years ago, I soon developed severe plantar fasciatis, shin splints and back problems. I limped into the chiropractor who measured my legs, nicknamed me "Quasimoto" (a kind joke but I really was limping similarly) and informed me that I had really high arches and a 1/2" leg length discrepancy. He then sent me to the podiatrist for orthotics. Using them, chiropractic care, lots of ice and two cortisone injections in the foot, I recovered fully in about a year. Shortly thereafter I read about the Pose running method and tried it with great success. It's been about 8 years since then and I have had no recurring issues and run about 35-40 miles a week in the Pose style. Not only am I running pain free, I run much faster due to the efficiency of the technique (no heel braking). My theory is that my body is either compensating for the leg length discrepancy by dropping the heel lower on the side of the long leg during the foot strike OR it's just not irritating me as much as before because there's less pounding versus a heel strike running style. Either way, it's working for me. So, long story short, I agree with Dr. R and say ditch the orthotics as soon as you're feeling healthy and injury free.

Posted by: Brian at September 6, 2006 09:24 PM

Nothing is for sure in our life except the end of life. You are asking me, are the orthopedic soles 100% useless? If you want to develop your own muscles system and ability to move, then you have to give up them on some stage. If it is about just avoiding the pain, then you can stay with them. So it is about your choice between to move with your own ability or with the cane. It will not happen over night, it will take lots of efforts and time to learn how to move. There are no short cuts, but lots of smart work. I hope you can use my advice.

Posted by: drromanov at August 9, 2006 01:11 PM

I have this typical syndrome: serious practicing sports enthousiast, I gained weight after an accident, I have now fallen arches, and had recurrent knee injuries, so I decided to look at what I was doing wrong. Obviously I need to work out the muscles around my feet and core muscles. I try to exercise regularly; I wear MBTs at work and FiveFingers else as much as possible, however, in my MBTs if I don't have my supporting soles, within a couple of days I can no longer take the stairs, even for half a floor. Are you sure the orthopedic soles are 100% useless?



Posted by: cft at August 8, 2006 10:51 AM

what you mean by "would you still correct for a leg length discrepancy?"

Posted by: DrRomanov at July 13, 2006 05:46 PM

So, if you don't wear the orthotics, would you still correct for a leg length discrepancy?

Posted by: Some_guy at April 29, 2006 10:55 AM

This is an interesting idea. I will test this out for myself.

I went to see a podiatrist about shin splints, and his prognosis was "you need orthotics". It seemed that he was going to say this before I even walked through the door. If running gait is imperfect, I thought it was odd that he didn't suggest any exercises to help correct it.

He showed me a pair of old-fashioned rock-hard orthotics, saying "these would injure you, but they're made from gel now", and I thought to myself "hang on, a few years ago you would have recommend them to me, so why should I trust you now?"

Posted by: Mr D at April 25, 2006 09:56 AM

I am a testimony of what Dr Romanov is saying. The podiatrist wanted to fit me for orthotics as I was complaining about achilles pain. Instead of fitting for orthotics I decided to pursue running technique hoping for a solution to my pain. After learning Pose Method I no longer have achilles pain (and the hip pain from heel striking is gone too!). Thus, orthotics was not the answer for my problem! Proper technique was the correct solution.

Posted by: Clyde_in_Tex at November 16, 2005 03:11 PM
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