The Hidden Cost of Orthotics: Why Long-Term Use May Be Weakening Your Feet
I was prescribed custom orthotics in grade school.
At the time, I was an active kid — involved in soccer, basketball and constantly on the move. I had knee pain that just wouldn’t go away, and orthotics were the fix. They felt like magic: slip them into my shoes, and I could keep playing, running, and jumping without discomfort (minus all the blisters I bore during the ‘break-in’ period).
So I wore them. And kept wearing them.
For over 20 years, every single pair of shoes I owned had a matching pair of orthotics — from sneakers and cleats to work shoes and hiking boots. I never questioned it. I just assumed that if I stopped wearing them, the pain would come back.
But as I began working as a physical therapist, especially with clients dealing with foot and ankle pain, I started to see a different picture. One that challenged the orthotic “solution” I had relied on for decades.
And now, 8 years after I stopped wearing orthotics completely, I’ve never felt stronger on my feet. My body moves better, and my knees don’t hurt like they used to. I feel more connected — literally — to the ground beneath me.
And a recent research study supports what I learned the hard way: long-term orthotic use may actually be weakening the very muscles we need to move well and stay pain-free.
Plantar Heel Pain and Orthotics: What’s the Connection?
Plantar heel pain (PHP), often referred to as plantar fasciitis, is one of the most common foot complaints. It presents as a sharp, stabbing pain under the heel, most intense during the first steps in the morning or after periods of rest.
Treatment often includes:
Calf and plantar fascia stretching
Night splints
Manual therapy
Foot orthoses (custom or over-the-counter inserts)
Orthotics often help manage PHP in the short term by supporting the arch and reducing stress on the plantar fascia. But this is a short-term solution — and recent research suggests long-term use may come with unintended consequences.
What the Research Says
A 2016 study by McClinton et al., published in the Journal of Orthopaedic & Sports Physical Therapy, examined this exact issue. The study compared people with plantar heel pain to a matched group without pain using two simple, clinic-friendly tests:
Rocker-Board Plantar Flexion Test (RBPFT): to assess ankle/calf (plantar flexor) endurance
Modified Paper Grip Test (mPGT): to measure toe flexor strength (big toe and lesser toes)
Key findings:
People with PHP performed worse on both tests than those without pain.
Longer duration of foot orthosis use was moderately associated with lower foot muscle performance.
In short, the more someone used orthotics, the weaker their foot and toe flexor muscles became.
How Could Orthotics Lead to Weakness?
It’s simple physiology: use it or lose it.
Our muscles grow and maintain strength when they’re challenged. But when we rely on external support — like orthotics — the muscles responsible for stabilizing and supporting the foot don’t have to work as hard. Over time, this leads to disuse and weakness.
Orthotics are designed to “offload” structures like the plantar fascia. While this may reduce symptoms, it can also reduce the activity of muscles like:
Tibialis posterior
Soleus and gastrocnemius
Intrinsic foot muscles (the small muscles within the foot)
With prolonged use, these underactive muscles can atrophy, leaving the foot less resilient, less adaptable, and ultimately more prone to pain and dysfunction.
My Story: From Supported to Strong
After more than 20 years of wearing orthotics, I began questioning the long-term effects — not just for myself, but for the clients I worked with.
I started weaning off.
At first, just around the house. Then short walks in minimalist shoes. Then longer walks. Eventually hiking, training, and running.
It wasn’t easy. I had to retrain my feet and ankles. My calves had to work harder. I felt muscles activate that had been dormant for years. But little by little, my foot strength improved — and so did my movement patterns, balance, and knee pain.
Now, 8 years later, I don’t use orthotics at all. My feet are stronger, more stable, and more connected to the ground. The best part? I haven’t had the knee pain that once ruled my life.
What This Means for You (and Your Clients)
If you use orthotics or recommend them in your clinical practice, this is not a condemnation — they can be helpful tools. But they should be viewed as part of a larger, more holistic strategy — not a permanent solution.
Orthotics ≠ strength.
They support, but they don’t train.
And that’s where the real healing — and resilience — comes from.
How to Shift Toward Strength
✅ 1. Incorporate Foot-Specific Strength Work
To support the foot’s natural arch and propulsion systems, train the muscles that support it:
Calf raises (progress to single-leg or loaded)
Short foot exercises (pulling the ball of the foot toward the heel)
Toe isolation movements
FDB training (flexor digitorum brevis)
Balance work in barefoot or minimal shoes
These exercises rebuild the strength and endurance of the plantar flexors and intrinsic foot muscles — the exact muscles shown to be weaker in those with PHP and long-term orthotic use.
✅ 2. Wean Off Orthotics Gradually
If you’ve been wearing orthotics for years (like I did), transitioning out of them safely is crucial:
Start barefoot at home for short intervals
Use minimalist shoes for light activity
Slowly increase time out of orthotics
Continue strength training as you transition
✅ 3. Reconsider the Long-Term Orthotic Plan
Ask yourself (or your clients):
Do I still need these every day?
Are my feet doing any of the work, or am I relying fully on support?
Have I built strength to back up the structure I’m asking of my body?
If the answer is no — it might be time to reintroduce load and build strength from the ground up.
Support vs. Strength: A Paradigm Shift
Foot orthoses can reduce pain. But they won’t rebuild strength. They won’t retrain balance. They won’t make you more resilient to life’s unpredictable loads.
In fact, long-term use may do the opposite — weaken the very muscles that are meant to support you.
Just like any other part of the body, your feet need to be trained — not just protected.
So if you’ve been in orthotics for years, consider this your nudge to begin rebuilding.
Ready to Build Strong, Pain-Free Feet?
If you’re tired of relying on orthotics and want a structured, expert-backed plan to:
Strengthen your feet
Improve your plantar flexor performance
Reduce plantar heel pain
Regain confidence in barefoot and unsupported movement
Check out my Plantar Fascia Protocol — a 6-week program designed to help you move better, feel better, and ditch pain at the source.
🦶 Let’s Reclaim Resilient Feet — Together
I’ve lived through decades of orthotic dependence. I’ve experienced the transformation that happens when you build strength instead of relying on support.
And now, I want to help others do the same.
Whether you're dealing with PHP, knee pain, or just want your feet to work with you instead of against you — remember: strength is always within reach. You just have to train for it.
Keep Moving Forward BBs!
xoxo
Lindz