Do You Need Orthotics? Orthotic Guide

By Dr Ken Nakamura+

Do you have feet pain?


Have you been to your physiotherapist or chiropractor and been told you need orthotics?


Have you wondered if you really need custom-made orthotics?


In this article I give you the essentials to determine if you need orthotics and what to look for when a health care practitioner examines you for orthotics.


I don’t want you to be passive. I want you to be informed and know whether your health practitioner is doing a good job or not. Knowing the key points will allow you ask pertinent questions, look for the key tests by your health practitioner  and determine if they are competent. This is how I want to empower you.


First lets figure out if you need orthotics.


Please answer yes or no to each of these questions.


  • Do you have a foot that rolls in or out while walking? Many people’s feet roll in and flatten out while walking.
  • Do you have painful feet like bunions, plantar fasciitis, heel spurs?
  • Do you get corns and calluses near your big toe and little toe?
  • Do you have one leg that is shorter than the other?


  • Do you have knock knees or bow legs?
  • Do your shoes wear out before they are 4 months old?
  • Does one shoe wear out in a different pattern compared to the other?
  • Are you feet turned in or out?
  • Do you have metatarsalgia, morton’s neuroma, claw or hammer toes?
  • Do you have shin splints?

Answering yes to these questions doesn’t  necessarily mean you need orthotics but if you answered yes to more than 2 increases the likelihood of needing orthotics increases.


What kind Of Foot Arch Do you Have?

  1. Get a some paint or water and put it in a container large enough so one foot will fit.
  2. Get some thick paper ready that is large enough for an imprint of your foot.
  3. Stick one foot in the paint or water and stand on the piece of paper.
  4. Look at the imprint your foot has made.

Do you need orthotics? Find out your arch type fist: Flat Arch, Normal Arch, High Arch: Toronto Downtown Chiropractor

Now look at the type of imprint your foot has made and compare them to the picture above. The picture shows a spectrum of feet from the very flattest feet to feet that have high arches.


The red imprint represents a foot that has a flat arch. If you have this type of foot arch you will be prone to plantar fasciitis, heel spurs, bunions, etc.


See Also: Keep The Bunion Surgeon Away


The orange imprint is a normal foot.


The yellow imprint represents a foot that has a high arch. If you have this type of foot your foot is rigid with poor shock absorption. Your foot would be prone to plantar fasciitis and shin splints to name a few foot problems.


If you are at either end of the spectrum, likely you will need orthotics.


Postural Assessment For Orthotics

Did your health provider assess your posture? Especially around the pelvis.


Why would a health provider assess your pelvic posture if you need orthotics. The kinetic chain. (Basically the bones are all connected affecting one another). Remember that song about “Dem Bone”

Do you need orthotics? Kinetic Chain or the Bone Chain: Toronto Downtown Chiropractor

  • The toe bones connected to the foot bone,
    The foot bones connected to the ankle bone,
    The ankle bones connected to the leg bone,
    The leg bones connected to the knee bone,
    The knee bones connected to the thigh bone,
    The thigh bones connected to the hip bone,
    The hip bones connected to the back bone,


With everything connected together when you move one part the other parts move.  So a flat foot can cause this chain reaction.

  • Flat feet >>leg rotates inward>>thigh bone rotates inward>> low back pain


The flat feet causes the legs to rotate inward which then makes your femur (thigh bone) rotate inward. This stretches ligaments, muscles and puts a rotary torque like the force you put when trying to open a jar of jam.  Done for long enough or with enough force, the rotary torque (rotation force) pulls on the hip and low back and causes lower back pain or hip pain.


Your pelvis can also can also cause a chain reaction causing flat feet.

  • Butt sticking out posture >> thighs rotate inward>>Leg rotates in >>flat feet

Posture Correct An Excessive Low Back Curve

With the pelvic related flat feet you start out with your butt sticking out. Sticking your butt causes your femur (thigh bone) to rotate inward which rotate your lower leg inward.


When your lower leg rotates in this put more pressure on the medial arch (arch at your in-step).  Give it enough time and you will get flat feet.  Flat feet can then cause heel spurs, plantar fasciitis, bunions and more.


Most health practitioners don’t check your posture so they wouldn’t know if your flat feet is coming from your hip or if you simply have fallen arches.


The treatments should be quite different. If the problem originates in the pelvis then you shouldn’t be getting orthotics. You should be getting your pelvis treated and correcting your posture.


See also:  Correct The Exaggerated Curve In Your Low Back


Flat feet that originate in the foot may be a good indication for custom-made orthotics.


Home Exercises

Whichever health practitioner you choose, after they have diagnosed the cause of your flat feet or pain they should give you the appropriate exercises.


If  you have flat feet related to your pelvis your chiropractor should give you the appropriate pelvic exercises. If you have feet problems that stem from the foot itself then the appropriate foot exercises are in order.


Ask your health practitioner for the exercises. If they can’t or won’t show the exercises move onto someone that will.


Be Wary Of “Custom Orthotics” At Trade Shows, Booths, Malls and Internet Sites


I have seen companies at trade shows with gait scans (scan for the feet to show the way you walk) which are very impressive. They offer great visual feedback and can show where there is more pressure on the foot.


Some of the gait scans used are actually technically good but the problem is that the orthotics offered at these trade shows in my experience have all been off the shelf. They are not custom made orthotics.


I have seen some Toronto based trade shows use a gait scan to get the size of your foot then take an off-the-shelf “orthotic” then use a grinding machine to score the bottom of the “orthotic” to make it custom.


I think this is great if you are paying $40-50. This is fraud if they are being passed off as custom orthotics. Most of these off the shelf orthotics are between $300-$500.


The worst part is that if you need any modifications down the road you have no way do this. Good luck on any returns.


Are Your Orthotics Custom Made?


  1. First take the orthotics and put it on a hard surface Using your thumb, push as hard as you can against the medial arch (that bump sticking out on one side). The arch should not give against the pressure of your thumb as the arch would not be strong enough to hold up your arch of your foot.


  1. Put your foot on the orthotic then go up on your tippy toes. This increase the arch height of your foot. If there is a gap between the orthotic and the foot chances are the orthotic is not custom-made to your foot. You should not be able to stick a finger between the orthotic and the foot.


If you find these tests to be positive ie. they don’t pass, then you likely have been duped.

Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.


Dr Ken Nakamura

3 Responses to Do You Need Orthotics? Orthotic Guide
  • Alice Carroll says:
    October 28, 2022 at 11:22 am

    Thanks for also talking about how I should be very meticulous about orthotics that are being marketed in certain ways. I’d like to get custom orthotics for my feet because I suffered from a heel injury months ago. My feet will surely need more support once I start getting back into running.

  • Marcelina says:
    July 22, 2015 at 6:59 am

    Hi there,
    I have a question. I have slightly bow legs. is it possible to fix it?

    thank you

    • Dr Ken Nakamura says:
      July 22, 2015 at 8:35 am

      Thanks for your question Marcelina. Usually most people with bowed legs actually have curved or bent leg bones. In that case only surgery will help. People with hips that are turned outward may be misdiagnosed as having bowed legs when they have externally rotated hips. In this case it is usually a matter of loosening up the hip external rotators or mainly the piriformis muscle.

      So the answer is it depends on what the actual problem is.

      You can try these exercises if the hip rotators are the actual problem.
      Any exercise can give you pain so should be supervised by a health practitioner.

      Hope that helps your legs. You don’t need orthotics for either problem.

Leave a Reply

Your email address will not be published. Required fields are marked *

Related Posts

© 2023 Dr. Ken Nakamura Downtown Toronto Chiropractor |Sports All rights reserved. Reproduction is prohibited without explicit Permission of
Dr. Kenji Nakamura. Use of this web site constitutes acceptance of the Terms of Use and Privacy Policy. The material appearing on is for educational use only. It should not be used as a substitute for professional medical advice, diagnosis or treatment. BodiEmpowerment is a registered trademark.

Bodi Empowerment is an online health magazine. We are dedicated to empowering people, by guiding their step-by-step self-treatment, in areas of rehabilitation and nutrition. We are headquartered in the financial district of downtown, Toronto.