Custom orthotics question

I've just received my first pair of custom orthotics, and I'm a little confused about breaking them in and using them.

The break-in instructions seem to be for people that will be wearing them all day. But I will use them primarily for running. They won't fit in my work dress shoes (well, maybe once it's boot weather), and not in open-toed shoes at all. I have supportive sandals and open-toed shoes for the summer.

So, the instructions say to increase the length of time a little each day until I can wear them comfortably for 8 hours, and then start using them for high-impact uses like running. But I'll never be wearing them for 8 hours anyway...

I guess I'm just wondering if anyone else has used these, especially for athletic activities, and how you went about breaking them in. My assumption is that the goal is just to use them gradually as you get used to them, so I did a few run/walk workouts last week that went okay.

My other question then is if I really shouldn't be running in them yet, should I be running without them? I have the doctor's okay to run in general, and I need to start a training plan this week.

I didn't pay attention to that - just started wearing them as much as I could. THey have made a big difference.

I'd think of them like a new pair of shoes. Sometimes you need to break them in; other times, you don't. As you begin working out in them, if they begin to cause pain you will either need to break them in (or, gradually accustom your body to the change since they may be correcting some sort of misalignment.) Sometimes you may need to take them back for an adjustment. Good running.

phyllis said:
I didn't pay attention to that - just started wearing them as much as I could. THey have made a big difference.

This

I found when I first started wearing them, because they change how I stand and my relationship with the ground, that my back and legs got sore. That is why they have you ease into them. I never ran in mine. I found them to be too hard and counterproductive to needing cushioning for my injury (Plantar Fasciitis). The PT supported that. In the end, I stopped wearing the orthotics all together as I solved my imbalances that caused the injury in the first place. Also, I didn't want to change how my running shoes fit. Finding shoes that work for running is hard enough!

@leealli it's funny you should say that, I've already been thinking that next time I'm due for shoes I should probably get fitted for a new pair with the orthotics in mind.

Were you running in custom ones, or not? I'm finding the custom are much more cushiony and comfortable than the out-of-the-box pair I tried first. They're also thinner so they fit better in the shoes.

TarheelsNJ, Where did you get your new orthotics? And, what are they made of?

I recently attempted to replace my old ones, but the new ones were so thick they are unwearable, even with my most generous shoes and light sox. I need thinner ones similar to my old ones.

Yes, in the future you will need to fit any new shoes with your orthotics in mind. Even though they are thinner, some shoes may be too tight.

krnl said:
TarheelsNJ, Where did you get your new orthotics? And, what are they made of?
I recently attempted to replace my old ones, but the new ones were so thick they are unwearable, even with my most generous shoes and light sox. I need thinner ones similar to my old ones.
Yes, in the future you will need to fit any new shoes with your orthotics in mind. Even though they are thinner, some shoes may be too tight.

I actually don't know what they're made of but I'm sure I have that info somewhere. I got them made through my podiatrist at APRC.

Tarheelsnj: my orthotics were custom made from APRC. My PT was less than happy with them and didn't like the method that APRC uses to have them made. Regardless, he supported and wanted me to use them. It was my own decision to stop trying to use them when my other foot started to hurt. I was a little disappointed by my appointment at APRC: the first thing they discussed was orthotics, the second was a cortisone injection. I see the cortisone as something to try way down the road after other methods have been tried. I was also prescribed some pain cream that came from a specialty pharmacy. It was really expensive and I found it to be a waste. After just a week, the pharmacy called wanted to refill it again. I had barely used any and at those prices, I wasn't interested. For that matter, the orthotics were very expensive too. My injury (different than yours) was about finding the cause -so PT was the way to go.

I had orthotics in the 80's - they were very different then - for a knee injury; and I used them in ALL my shoes - running and street. Of course, every new shoe I was thinking of purchasing, I had to make sure they worked with the orthotics.

That's really interesting. Fortunately my insurance covered the cost, but I do worry slightly that I don't have a "diagnosis" but I also can appreciate that I need arch support. I definitely think wearing cheap flip flops contributed or even caused my foot pains. I just hope the orthotics don't make it worse.

At the risk of sounding like a troll, I have a simple question. You went to a doc to have the orthotics made, and are now faced with breaking them in. You have questions about how to do it. And you come to MOL with those questions? Why not to your doc?

Dennis_Seelbach said:
At the risk of sounding like a troll, I have a simple question. You went to a doc to have the orthotics made, and are now faced with breaking them in. You have questions about how to do it. And you come to MOL with those questions? Why not to your doc?

I had a feeling someone would ask. The doctor didn't mention anything about breaking them in at all- just said go ahead and run, see how you feel and we'll follow up in a few weeks. The generic instructions were in the box with the orthotics. So I was a little surprised and I guess I'm just wondering about others' experiences with them.

Take it slow with the running. Run in the orthotics for half a mile. for a day or two. Then a mile. and so on. You don't want to end up with damage somewhere else. Your doctor should have been more forthcoming. My guess is he or she isn't a runner!

I got orthotics for a very high arch. They made my feet feel great but made my back start to spasm (again). I stopped wearing them. Interestingly, I don't have the foot pain I used to have. I just realized it when I read this thread...

Leealli said:
Take it slow with the running. Run in the orthotics for half a mile. for a day or two. Then a mile. and so on. You don't want to end up with damage somewhere else. Your doctor should have been more forthcoming. My guess is he or she isn't a runner!

That's what I've been doing, a run/walk workout easing into them gradually. So far so good.

But then that's kind of my confusion... if you're only running in them for half a mile, do you take out the orthotics and run without them? You know what I mean?

Yes. If you can run without pain. Just like when I am working in a new pair of running shoes. I run a few miles in them, and then switch. Granted, these tend to be treadmill runs. Maybe these orthotics are just right for you and will make everything okay and you won't need to build up quite so slowly.

Leealli said:
Yes. If you can run without pain. Just like when I am working in a new pair of running shoes. I run a few miles in them, and then switch. Granted, these tend to be treadmill runs. Maybe these orthotics are just right for you and will make everything okay and you won't need to build up quite so slowly.

Got it, I see. Yeah they feel pretty comfortable out of the gate. But I also wasn't in severe pain before either.

Disney half marathon here you come!

Leealli said:
Disney half marathon here you come!

One way or another... =) But yes, training officially starts this week. I'm easing into it with run/walk and we'll see how it goes!

Grrr, I just received my claim from Aetna and the orthotics were not covered. That is super frustrating!! APRC told me they would check my coverage before ordering. They didn't even have me pay anything when I picked up (I asked about this and they said if there was a charge it would have been included already).

I had no idea they would not be covered at all - and they're $600! I might not have had them made had I known it was that expensive. Stupid of me to not call and check myself.

APRC did the same to me. They said that they would call me to confirm before they ordered the orthotics that the insurance was covering. They never did. They just ordered the orthotics. (Fortunately, after my co-pay, they were covered ) Then, 12 months later, they sent me a letter telling me I should come back in to be fit for a new pair since the orthotics wear out. I didn't like how they handled this. As it was, the PT didn't like the way the orthotics were fit and would have done it differently. Since I never ended up wearing the orthotics for more than a few weeks, it was a bit of waste of money for me.

You are having quite a day, aren't you?

Right?! Ugh, not my day at all.

I guess I'm just waiting for APRC to bill me. Maybe they'll work something out with me, I don't know...

At this point I'm feeling pretty frustrated since I don't have any kind of diagnosis, have extremely expensive orthotics and still feel a pinch in my foot sometimes- which doesn't bother me except for the fear it will turn into A Thing.

I had my orthotics made by Dr. Jordan Steinberg in West Orange NJ. He took the time to explain all the different types and what best suited me. I now where them everywhere.

TarheelsInNj said:
Grrr, I just received my claim from Aetna and the orthotics were not covered. That is super frustrating!! APRC told me they would check my coverage before ordering. They didn't even have me pay anything when I picked up (I asked about this and they said if there was a charge it would have been included already).
I had no idea they would not be covered at all - and they're $600! I might not have had them made had I known it was that expensive. Stupid of me to not call and check myself.

Can't you try to dispute it?

You might have to ask the ordering podiatrist to give them a diagnosis code (even if he/she is unsure)

mjh said:

TarheelsInNj said:
Grrr, I just received my claim from Aetna and the orthotics were not covered. That is super frustrating!! APRC told me they would check my coverage before ordering. They didn't even have me pay anything when I picked up (I asked about this and they said if there was a charge it would have been included already).
I had no idea they would not be covered at all - and they're $600! I might not have had them made had I known it was that expensive. Stupid of me to not call and check myself.

Can't you try to dispute it?
You might have to ask the ordering podiatrist to give them a diagnosis code (even if he/she is unsure)

I definitely will. I haven't gotten a bill from APRC though, just the claim notification from Aetna. But in the remarks it says orthotics are not covered at all.

If you are still having pain, you should go see someone else. Or go to a PT and see what they think. You don't need a prescription in NJ to see one. Orthotics can be great but you need to actually find out the root of the problem and solve whatever that is - ESPECIALLY since you are a distance runner. Don't mess around with that.