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Are custom inserts worth it?

2020 Camino Guides
Camino(s) past & future
Walked CF September/October 2015
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
 

C clearly

Veteran Member
Camino(s) past & future
Frances (2012, 2014, 2015, 2016), VDLP (2017), Mozarabe (2018), Vasco/Bayona (2019)
Good question, to which you won't know the answer until after you try!

Orthotics treat problems with your feet. Your knee problem may or may not have anything to do with it, but certainly a foot problem could aggravate a knee problem.

Years ago when I had some ongoing soreness, and since it would be covered under my health insurance, I went to a podiatrist who gave me custom orthotics. Eventually the soreness went away but I figured it likely would have gone away anyway. I wore the orthotics for all walking, and was happy.

Then I had a stress fracture for other reasons. After it healed a new set was made, but again I wasn't totally convinced they were doing anything.

In 2018 after my camino, I developed a mild but nagging soreness on the inside of my arch. Again I tried various rest periods, higher arch support and lower arch support (over the counter versions), no arch support, sandals, different shoes, etc. The soreness remained for almost a year and I was worried about what would happen on my next camino. Finally I went to the podiatrist who thought I needed new orthotics with different support. I was skeptical, especially when I saw what a tiny difference there was in the shape of the new arch support.

To end the story happily, within a few week the soreness went away for the most part (there is sometimes a hint, so that is probably a susceptible place on my foot). Who knows if the orthotic was the cure? It wasn't even a severe pain, but I am walking much more comfortably now.

So sometimes they help and sometimes they don't. They are expensive so, you need to guess if they are "worth" it. I do think it is worthwhile to consult with a podiatrist, as well as the knee doctor as @Kanga says.
 

J Willhaus

Veteran Member
Camino(s) past & future
2016 CF;
Hospitalera, Zamora 2017, Hospitalera Grañón 2018, Hospitalera Estella 2019
I don't know where you live, but here in the US you buy a good insole for about $50 called Superfeet.
 

henrythedog

Loved and fed by David
Camino(s) past & future
Frances 2017, 2018, 2019, Ingles 2018, (Madrid 2019 partial - retired hurt!) (more planned)
A good podiatrist would not recommend custom orthotics if they were not necessary. It would be helpful if you could get a personal recommendation rather than just googling the nearest.

Your experience may differ, but my podiatrist has helped to alleviate a great deal of pain.
 

martyseville

Active Member
Camino(s) past & future
a/a
Without a doubt, Super Feet are well worth it.

takes a few daysto get used to them. Didn’t take me a single day to realize they help.

never had feet/foot pain since been wearing them.

various colors are for different needs.

I wear green ones and orange ones. Booth fit and feel great in my hiking light weight shoes.
 

koilife

Veteran Member
Camino(s) past & future
CF w/ son #1 (2013); Logrono-Leon/Salvador/Primitivo w/ son #2 (2016); Portugues w/ son #3 (2020)
If other medical issues are ruled out, you might go to a running store. They can probably create custom, heat moldable inserts for around $60-100 USD per pair. The advantage over something like Superfeet is that this insert is specific to your exact foot, including any left/right differences (the arch on Superfeet is slightly off for my foot, which then feels like walking on a rock). The other advantage is your precise foot/insole interface means less likelihood of developing blisters.

I get mine at Road Runner, but I know other national chains and local stores do this as well.
 
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davebugg

Veteran Member
Camino(s) past & future
Frances(2017)
Frances(2018)
Ingles(2019)
Portuguese(2020)
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
There is another thread where the issue of orthotics became a topic. Below is what I had posted in that thread

----------------------------------------------

It depends. When I was doing a preceptorship with a Podiatrist who had specialized specifically in sports and athletics (part of my clinicals during university), she scoffed at how frequently orthotics are prescribed. Her take was that general specialty Podiatrists rely on referrals and prescriptions for orthotics too much as an income source.

That said, she was quite frank about how she goes about the process of carefully assessing and diagnosing who would benefit from orthotics. . AND under what conditions and types of activities a person is involved in. In her view, orthotics are actually needed less than 10% of the time that they are prescribed.

So that can be considered or set aside because no one here can say whether or not you actually need orthotics. What I can say, is that for sporting and recreational issues, I would make sure that the foot doctor specializes in athletes and athletics. General practice podiatrists may or may not have the same equivalent knowledge and training in that area.
 

kelleymac

Veteran Member
Camino(s) past & future
March/April 2015, Late April 2016, Sept/Oct 2017, April 2019.
I would go to a sports doctor. I found out my knee problems came from weakened core muscles and my femur was entering into my knee joint at the wrong angle. So exercising a completely different place helped my knees. :) -- Also, I had damaged my feet from a fall (rock climbing '89), and wasn't able to stand for very long without pain for decades. I went to a lot of specialists and nothing helped-- including orthotics. Then, right before my camino, my sports doctor told me my feet muscles had atrophied (probably right after the fall and initial damage, when I didn't walk on my heels for over a year). He gave me foot exercises, but what really helped was walking 500 miles across Spain. My feet are strong now! They are two sizes bigger than before I walked the Camino!
 

Peter Fransiscus

Be a Rainbow in someone else's cloud.
Camino(s) past & future
All that we are is the result of what we have thought.
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
Start with zig zag walking when you go up or down hill.
An older Austrian lady told me about 45years ago at the time that I walked for the first time in the Alpes.
Never had knee and ankle problems.
Wish you a pain free Camino 🙏
 

koilife

Veteran Member
Camino(s) past & future
CF w/ son #1 (2013); Logrono-Leon/Salvador/Primitivo w/ son #2 (2016); Portugues w/ son #3 (2020)
I can't echo the zigzags enough. My fit 16 year old son wouldn't listen to me about that, and decided to "put it to the old man" instead. He was hobbling in a week from tendinitis in his knee (and I had much of his pack weight in my pack while he recovered :eek:). Along with the zigzags, I recommend the "rest step" (www.active.com/outdoors/articles/hiking-technique-the-rest-step). Once you get the hang of it, you can climb even very steep hills under load without much issue for your knees.
 

kelleymac

Veteran Member
Camino(s) past & future
March/April 2015, Late April 2016, Sept/Oct 2017, April 2019.
Another thought on knee problems. Pack your pack with the weight in the middle, not on the top of the pack. Before you go-- wear your pack packed with some weight for a few hours at a time. I wear mine while cleaning house (emptying dishwasher, vacuuming, etc.).

Another thought on foot problems-- get shoes that are big enough! Your feet will swell after a few hours of walking-- so get a half size bigger. Also, take the insert out of your shoe and set it on the floor. Place your foot on it. If your foot overlaps the insert, get a larger and/or wider size.
 

peregrina2000

Moderator
Staff member
My own two cents, based only on my caminos — My knees are generally fine, except when it comes to killer descents (the descent from San Juan de la Peña on the Aragonés, and last year the descent to Errezil on the Vasco/Saiatz are the two I am thinking of). It had nothing to do with my feet, apparently it had to do with my quads and other muscles around the knee, who knew! Last year, while walking with this bad knee pain on the Vasco, I got good suggestions from a PT friend and immediately started doing stretches and some other exercises targeted at the muscles around the knee. Within four days or so, the pain had subsided and the other descents went fine, including some pretty big ones on the Olvidado. I have continued the exercises throughout the year as part of my regular routine, so I have fingers crossed.

I do wear silicone orthotics, for a foot problem, and though they are marvelous, my knee pains always occur while I am wearing them. I agree with everyone who says that it’s impossible to know what is causing the knee pain without a medical diagnosis. Since you knees probably don’t hurt now, I think it would be helpful to try to reconstruct the situations in which it flared up. That might give some clue to the person examining you now.

Good luck and buen camino, Laurie
 

efdavila

New Member
Camino(s) past & future
Camino de Santiago from Sarria (future)
I've tried various orthotics over the years. I really like the Powerstep Archmolds. These you place in the oven to heat then mold to your feet.
 

wayfarer

Moderator
Staff member
Camino(s) past & future
SJPP-Santiago-Finistera-Muxia. April/May 2012
Sarria-Santiago Sept. 2013
SJPP - Almost Orrison April 2014
My two cents worth. My brother had foot problems while walking, went to a podiatrist, paid €350 for inserts, they didn't work. Went to the local sports store, was put on a custom high tech walking machine, given inserts based on the readout, charged €50 and he is still using them without any foot problems.
 

trecile

Camino Addict
Camino(s) past & future
Francés (2016 & 2017), Norte (2018), Francés-Salvador-Norte (2019), Portuguese (2019)
I had never had knee problems before my Camino last year. I had sudden pain on the outside of my right knee coming down the hill into Zubiri. I managed to make it to Larrasoaña, where I had a reservation. While I was icing my knee on the patio of the albergue another peregrina asked me where my pain was. When I said the outside of my knee she said that sounded like IT Band Syndrome, and that there were exercises and stretches to improve it. I immediately Googled it, and did the stretches and exercises. Within a day or so the pain was totally gone.
So, don't just think that the cause of your pain is your feet - remember everything in your body is connected.
 
Camino(s) past & future
Camino Frances, 2015
I had a knee problem when walking my first camino. Finally I paid attention to how I walked. I noticed pronation due to my arch collapsing. I wadded up toilet paper and put it under the insole of my boot. That took care of the problem for another month of walking. I had to add to the paper as it got compressed. The paper is still there after four years.

I got some specialty insoles prescribed by a doctor and they worked well on training hikes with a new walking shoe. However after a couple days on my last camino I found my legs giving out on me where I would almost fall down onto my knees. I actually did once. This was a different problem from my first camino where my knee hurt but didn't cause problems. I thought it might be because of road walking or much further distances. I decided to use the toilet paper again even with the prescribed insoles. After a day I was fine. It did cause rubbing between the top of my foot and the shoe but a different lacing pattern solved that problem.
 

PGG

New Member
Camino(s) past & future
SJPP - Santiago - (2014)
Porto - Muxia - (2017)
SJPP - Finisterre - Invierno - (2018)
Hello,
I'm not a medic, so bear that in mind.

In my experience inserts/orthotics are certainly an important part of the answer to managing knee issues.

After a lifetime of running, tennis and a bit of contact sport and operations on both knees, I think I know where you're coming from.

What works for me is,

Being as fit as I can be
Carrying as light a load as possible
Using well fitted orthotics/inserts
Using walking poles
Having excellent fitted boots.

I'm not a flag bearer for any brands, but if you would like details, I am happy to share them.

Good luck and enjoy it.

Paul
 

RRat

Member
Camino(s) past & future
Planning 2017
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
Not a good idea to ask strangers if you should see a doctor.
 

jmcarp

Veteran Member
Camino(s) past & future
Camino Frances, 2013
Camino del Norte a Chimayó (USA), 2015
Camino Portugues, 2017
I don't know where you live, but here in the US you buy a good insole for about $50 called Superfeet.
I've tried both Superfeet and SOLE insoles. For me, the Superfeet are fine for wearing around town, but for hiking, and especially long-distance hiking, I prefer the SOLE brand. But that's just me -- as they say, different strokes for different folks. Either way, be sure to try them on in the store to get a proper fit for arch height and arch location. The label size may not be your size, and both brands can be trimmed to fit. A good sales person in the shoe department should be able to help with sizing. In addition, the SOLE inserts can be heated in an oven at low temperature to further custom-fit them to your feet.
 
Camino(s) past & future
June 2018
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
Well, as a podiatrist, I advise a thorough check, but don't be pressured into hard custom orthotics. You can buy good over the counter ones everywhere. (Vasyli are good, and read the murder story ....)

I really like the thick gel ones. Lots of people who pound hard city streets just ache because the Camiino is not a flat surface but an irregular stony path (Chinese parks have stoney paths for health), so the tendons and ligaments that are never used on flat streets are pulled and stretched on the irregular paths. The Gel insoles mitigate this. Gel (silicone)heel cups are excellent. I cover many Gel/Silicone inserts with leather to stop sweat and aid traction. Unlike hard orthotics, Gels do not need breaking in. You can cut them to shape. The thicker the Gel heel pad, the less stress on your knee. Think! Do you slam your heel down as you walk? Get someone to video your walking at foot level.....

I advise taking a roll of strapping tape, like duct tape, to strap your feet or someone else's, there's always someone who knows how to use it, and some chiropody felt, which you can cut and stick in shoes, and on your feet on any spots that rub. If you don't use it, you will find others who need it. (Ladies, panty liners do a nice job in a similar way).
 

davebugg

Veteran Member
Camino(s) past & future
Frances(2017)
Frances(2018)
Ingles(2019)
Portuguese(2020)
No! I’m referring to good intentions as not being an adequate replacement for competent advice. Ok😄
I've seen quite a bit of competent advice. It is the confirming of the good, from the other type, that's the challenge. This is sorta like a place to start in order to get an idea of where to begin. But once you have that input, it is important to go to the professionals.
 

David Tallan

Veteran Member
Camino(s) past & future
Frances (1989 and 2016), Portugues - from Porto (2018)
I wouldn't assume that orthotics are necessary to solve the knee problems that occurred on your last Camino. I had (what seemed to me to be) serious knee problems that emerged on my 2016 CF, which I started without real training although I generally tried to walk shorter days at the beginning. By the end of the first week, it was clear that I needed walking poles, knee braces and regular doses of ibuprofen to continue and, even at the end, all three were still necessary and I would quickly feel it if I tried to proceed without the knee braces or ibuprofen.

However, my knees were not an issue at all on my next camino a couple of years later. And I didn't need orthotics to accomplish that. I had a good amount of rest for my kneed and then trained fairly well leading up to my next camino. I was able to walk it without any pain, without any ibuprofen, and without any knee braces.

This is all just my experience and not medical advice. What is causing your knee problems may be different from what was causing mine and orthotics may be more appropriate or necessary. So, of course, check with a proper medical professional as to whether orthotics would be beneficial or necessary for you.
 

Moorwalker

Active Member
Camino(s) past & future
The Saint's Way, Cornwall
Hi everyone! I am planning my second Camino, and seeking to right some of the wrongs I made last time, for which my body paid the price. I had some pretty serious knee issues last time, and I’m thinking that an orthotic insert might help to mitigate some of that knee pain. (I’m also training more). My question is, is it worth it to see a podiatrist and have a custom orthotic made for me, or are the orthotics I could buy at the store of a good enough quality? Thanks in advance!
I would go to a sports physiotherapist rather than a podiatrist because they are highly skilled at analysing gait irregularities that are causing pain. If the physio thinks orthotics would help then that's great, but I'd want to get the wider picture first.

The wrong orthotics can make knee pain worse if you don't have them made with the whole structure being looked at, and sometimes it can be a compromise between several conflicting requirements.
 

trecile

Camino Addict
Camino(s) past & future
Francés (2016 & 2017), Norte (2018), Francés-Salvador-Norte (2019), Portuguese (2019)
I would go to a sports physiotherapist rather than a podiatrist because they are highly skilled at analysing gait irregularities that are causing pain. If the physio thinks orthotics would help then that's great, but I'd want to get the wider picture first.

The wrong orthotics can make knee pain worse if you don't have them made with the whole structure being looked at, and sometimes it can be a compromise between several conflicting requirements.
Great suggestion. Everything needs to be evaluated, not just the feet.
It's likely that if you go to a podiatrist they will look for a foot related solution when the problem may lie elsewhere.
 

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