Some people still believe that wearing an orthotic can lead to muscle weakness but the opposite is true, said Jonathan Leach, PAL Health Technologies orthotist.

“The only way to lose muscle mass is to immobilize that muscle – to not use that muscle,” Leach said. “So the muscle begins to atrophy.

“A custom orthotic is not intended to immobilize,” Leach said. “It’s intended to address the structure and mechanics that would allow you to increase your activity level. So, you can gain muscle strength safely and efficiently by using custom orthoses.”

“Custom orthoses allow you to increase your activity and, if you do that, you’ll gain strength,” Leach said. “But putting on an orthotic will not make you an athlete. That comes with hard work.”

The misconception that wearing an orthotic can lead to muscle loss, for some, is because they feel self-conscious wearing a brace, special footwear or custom orthoses. “Custom orthoses are not seen as preventative health care but a consequence of injury or pain associated with their feet,” Leach said. Orthoses aren’t “cute” and some people view them as a sign of weakness.

In fact, functional foot orthoses should be viewed as a sign of strength because they allow people to compete at a higher level with less risk of developing symptoms commonly associated with structural deficiency.

Some people, even some medical professionals, believe that orthoses aren’t needed because, through therapy, the body can heal itself, Leach said. What that argument lacks to consider is the root cause of a patient’s pathology -- that the bony structure will determine how muscles perform.

Orthoses frequently are prescribed for a structural bio-mechanical deformity rather than a temporary muscular deficiency, Leach said.

“Custom orthoses are designed and hand-fabricated to account for bony structure that causes the mechanics of the muscular-skeletal system to be less efficient with physical forces,” Leach said. “Over time, these physical forces cause increased tensile force on bone and soft tissue that can or often lead to symptoms. Use of custom orthoses does not come at a cost to muscles. Instead, they account for deficits that could lead to injury or undesirable pathology.”

Custom orthoses can compensate for structural inefficiencies because of genetics or post-operative anatomical misalignment. When the foot is brought into alignment, wear and tear on the foot is decreased over time.

The misconception that wearing an orthotic can lead to muscle loss comes, for some, from the minimalist running movement of several years ago, Leach said.

That movement believed that running and walking could be done more naturally by going barefoot or wearing shoes that offer minimal support.
“Whether you are able to run barefoot with no consequence is absolutely dependent on genetic structure and environmental surface condition,” Leach said.

A person’s bony structure will determine whether physical forces they endure are too much for their soft tissues, such as tendons, muscles, ligaments and connective fascia, he said. “Some connective tissues can withstand it. Others are less elastic,” meaning they could undergo injury or tear.

“If you didn’t win the genetic lottery, you will experience increased wear and tear and, when you injure yourself, it is common to gain weight,” Leach said.
Environment also matters. Barefoot or minimalist running work better on soft dirt than rocky soil, hot sand and pavement.

“Not everyone should run barefoot,” Leach said. “Nor are they intended too.”
Minimalist running shoes are soft and may not hold up to the forces generated due to the person’s height, weight and activity level.
“If you’re 235 pounds and running in those, those materials are not going to hold up,” Leach said.

People considering minimalist walking or running may benefit from checking first with a podiatrist or orthotist, Leach said.

“I tell people “Dress your feet according to your activity level,’” Leach said.

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Paul Swiech is vice president of communications with PAL Health Technologies. Before he joined PAL, he was a newspaper reporter for 37 years. In his free time, he enjoys spending time with family and exercising.