Custom Orthotics for Foot, Knee, Hip, and Back Pain: What Active Adults Should Know

Foot pain can affect more than your feet.

When your foot is irritated, stiff, poorly supported, or struggling to tolerate load, it can change how you walk, stand, run, lift, and move through your day. Over time, that may influence how the knees, hips, and lower back tolerate activity.

That does not mean every case of knee, hip, or back pain is “coming from the feet.” That would be too simplistic. Pain is rarely that linear. But foot mechanics, footwear, activity volume, previous injuries, strength, mobility, and tissue capacity can all contribute to how the body manages load.

This is where custom foot orthotics may be helpful for some patients.

Custom orthotics are not a magic fix. They do not automatically correct every movement problem or replace strength and rehab work. But when used appropriately, they may help improve support, comfort, and load distribution through the foot and lower limb.

At Dr. Harman Braich, Chiropractor, operating out of Creekwood Physiotherapy in Southwest Edmonton, custom orthotics are considered as one possible tool within a broader evidence-informed plan. The first step is not simply scanning the foot. The first step is understanding the person, the symptoms, the activity demands, and the goal.

What Are Custom Orthotics?

Custom foot orthotics are shoe inserts designed to support the foot based on an assessment of foot structure, movement, pressure, function, and symptoms.

They are different from general over-the-counter insoles. Store-bought insoles may provide cushioning or general arch support, while custom orthotics are made based on a more individualized assessment and manufacturing process.

That said, “custom” does not automatically mean “better for every person.” The right option depends on the condition, the goal, the footwear, the patient’s response, and the clinical reasoning behind the recommendation.

A good orthotics assessment should consider more than the foot shape alone. It may include:

• Current symptoms 
• Foot posture and mobility 
• Walking or gait mechanics 
• Footwear type 
• Work demands 
• Training volume 
• Lower-limb strength and control 
• Previous injuries 
• Comfort and patient preference 
• Whether orthotics are likely to meaningfully change symptoms or function 

This matters because orthotics are not just products. They are clinical tools.

Why Foot Mechanics Can Influence the Rest of the Body

The foot is the first point of contact with the ground during walking, running, and many standing activities. It helps absorb load, adapt to surfaces, and transfer force through the lower limb.

When the foot is painful or not tolerating load well, the body may compensate. Some people shorten their stride. Some shift weight away from the painful side. Some change how they push off. Others gradually reduce activity without realizing it.

These changes can affect how stress is distributed through the ankle, knee, hip, and back.

Research on foot orthoses and lower-limb biomechanics suggests that orthoses can influence movement patterns, but their effects are task-dependent and often more pronounced in the distal lower limb than farther up the chain. A 2022 review concluded that the biomechanical effects of foot orthoses vary by task and that more research is needed before broad clinical recommendations can be made. 

That is important because it keeps expectations realistic. Orthotics may change loading and comfort, but they are not a guaranteed solution for every knee, hip, or back problem.

When Custom Orthotics May Be Helpful

Custom orthotics may be considered when symptoms appear related to foot loading, footwear tolerance, prolonged standing, walking mechanics, or lower-limb alignment demands.

Common reasons patients ask about orthotics include:

• Plantar heel pain or plantar fasciitis 
• Arch pain 
• Foot fatigue with long standing or walking 
• Achilles tendon pain 
• Recurring ankle or lower-limb irritation 
• Knee pain that worsens with walking, stairs, or running 
• Hip discomfort associated with walking or standing tolerance 
• Low back pain that may be influenced by foot posture, leg length difference, or lower-limb loading 
• Work demands that require long hours on the feet 
• Athletic activity such as running, soccer, golf, gym training, or court sports 

The key word is “may.” Orthotics can be helpful in selected cases, but they are not required for every patient.

For plantar heel pain, a systematic review found very low-quality evidence that foot orthoses did not improve pain or function in the short term, but moderate-quality evidence that they were more effective than sham orthoses for reducing pain in the medium term. The review did not find a medium-term improvement in function. 

That means orthotics may be worth considering for some heel-pain patients, but they should be presented as one part of care rather than a guaranteed stand-alone solution.

Orthotics for Foot and Heel Pain

Foot and heel pain are some of the most common reasons people consider orthotics.

Plantar fasciitis, also described as plantar heel pain, often causes pain under the heel or arch, especially with the first steps in the morning or after periods of rest. Mayo Clinic describes plantar fasciitis as one of the most common causes of heel pain and notes that it involves the plantar fascia, a band of tissue connecting the heel bone to the toes. 

For plantar heel pain, best-practice recommendations generally emphasize a combination of education, load management, stretching, taping, and other treatments depending on the patient. A British Journal of Sports Medicine best-practice guide states that core treatment for plantar heel pain should include taping, stretching, and individualized education, with additional treatments considered when patients do not improve optimally. 

This is where orthotics may fit. They may help some patients reduce load on irritated tissues, improve comfort in footwear, and make walking more tolerable while the broader plan addresses strength, mobility, activity volume, and recovery.

But orthotics alone may not solve the problem if the patient continues to overload the foot too quickly or if other contributors are ignored.

Orthotics for Knee Pain

Orthotics may also be considered for certain types of knee pain, especially when symptoms are influenced by foot posture, walking or running mechanics, or increased lower-limb load.

Patellofemoral pain, often felt around or behind the kneecap, can be influenced by training volume, hip strength, quad capacity, foot mechanics, and activity demands. It is rarely about one single factor.

A 2024 best-practice guide for patellofemoral pain states that prefabricated foot orthoses may be prescribed to people who respond favourably to treatment-direction tests and can be customized for comfort by modifying density and geometry. 

That last part is important. It suggests orthotics should not be prescribed automatically to every person with knee pain. They may be more appropriate when a quick clinical test suggests the person responds well to that type of support.

An earlier BMJ randomized trial found prefabricated foot orthoses were superior to flat inserts in the short-term management of patellofemoral pain, but there was no added benefit when orthoses were combined with physiotherapy, and long-term improvements were seen across groups. 

For patients, the practical message is this: orthotics may help some knee-pain presentations in the short term, but strengthening, load management, and movement progression still matter.

Orthotics for Hip Pain

The relationship between orthotics and hip pain is less clear.

Some patients with hip symptoms may benefit from changes in footwear, support, or walking mechanics, especially if symptoms are aggravated by prolonged standing or walking. However, the research base is not as strong as it is for some foot and knee conditions.

A 2023 systematic review looked at foot orthoses and footwear interventions in people with hip-related pain, highlighting that this is an area of clinical interest but not one where broad claims should be made without careful patient selection. 

For hip pain, it is especially important not to assume the foot is the main driver. The hip itself may need assessment for joint sensitivity, tendon-related pain, strength deficits, range of motion, training errors, or referred pain from the spine.

Orthotics may be part of the plan for some patients, but they should not distract from the bigger clinical picture.

Orthotics for Low Back Pain

Low back pain is complex, and it is usually not caused by one isolated factor.

Foot posture, leg length difference, walking mechanics, and lower-limb loading may influence symptoms for some people, but orthotics should not be presented as a universal answer for back pain.

A 2025 systematic review reported low-quality evidence suggesting foot orthoses may improve pain and disability in people with low back pain, particularly in some subgroups such as people with pronated feet, flat feet, or leg length discrepancy. The authors also cautioned that the current evidence is insufficient to strongly support all orthotic types or long-term use. 

That fits with a cautious clinical approach.

For some patients, orthotics may help improve walking or standing tolerance. For others, the bigger priorities may be spinal assessment, hip strength, trunk endurance, sleep, workload, training progression, or a personalized rehab and exercise therapy plan.

In other words, orthotics may be useful when the assessment suggests they are relevant. They should not be sold as the missing answer for every case of back pain.

Why Assessment Matters Before Getting Orthotics

The biggest mistake with orthotics is treating them like a product first and a clinical decision second.

A good orthotics process should start with questions:

What problem are we trying to solve?

Is the pain likely related to foot loading or footwear?

Are there movement patterns that change with support?

Does the patient feel better during a support trial?

What shoes will the orthotics be used in?

Are there work, sport, or training demands to consider?

What rehab still needs to happen?

How will we measure whether the orthotics are helping?

This approach is more useful than simply assuming that flat feet, high arches, pronation, or pain automatically require orthotics.

Some people have flat feet and no pain. Some people have high arches and no pain. Some people pronate and function very well. Foot posture alone does not always tell the full story.

The better question is whether the person’s foot mechanics, symptoms, and activity demands suggest that orthotics are likely to improve comfort, tolerance, or function.

Orthotics Should Usually Be Paired With Rehab

Orthotics may help change the way load is distributed through the foot and lower limb, but they do not build strength by themselves.

That is why they often work best as part of a broader plan.

For example:

A runner with plantar heel pain may need orthotics for comfort, but also calf strengthening, walking-volume modification, and gradual return to running.

A person with knee pain may need temporary foot support, but also hip and quad strengthening.

A worker with foot fatigue may need orthotics, footwear changes, and a plan to improve tissue tolerance over long shifts.

A patient with back pain and suspected lower-limb contribution may need orthotics as an adjunct, but also spinal assessment, hip mobility, trunk endurance, and graded activity.

This fits the broader treatment philosophy at Dr. Harman Braich, Chiropractor: tools are helpful when they are used for the right reason, at the right time, for the right patient.

Custom Orthotics and Active Adults

Active adults often notice foot and lower-limb issues when demand increases.

This can happen when:

• Running volume increases too quickly 
• Summer walking or hiking increases 
• Soccer, golf, or court sports resume after time off 
• Gym training volume changes 
• Work shifts involve long standing 
• Footwear changes suddenly 
• A previous injury leaves one side less tolerant 
• Recovery is not keeping up with activity demands 

In these cases, pain is often not just about structure. It is about capacity.

Orthotics may help improve comfort and support while the person builds tolerance again. But the long-term goal should usually be better function, not permanent dependence on a device without a plan.

For some people, orthotics are a long-term tool. For others, they are one part of a transition back to activity. The right answer depends on the person.

What to Expect From a Custom Orthotics Appointment

A custom orthotics appointment should include more than a scan.

At Dr. Harman Braich, Chiropractor, custom foot orthotics include a biomechanical and orthopedic assessment, gait analysis, and 3D volumetric scan. The goal is to understand how the foot and lower limb are functioning, what symptoms are present, what activities matter, and whether orthotics are clinically appropriate.

The process may include discussion of:

• Foot pain or lower-limb symptoms 
• Walking, running, or work demands 
• Footwear habits 
• Previous injuries 
• Activity goals 
• Insurance requirements 
• Whether orthotics are being used for support, symptom reduction, activity tolerance, or work demands 

Patients should also understand that orthotics may require a break-in period. Some people adapt quickly, while others need a gradual transition. Comfort matters. If an orthotic is technically “correct” but not wearable, it is not clinically useful.

Who May Not Need Orthotics?

Not everyone needs custom orthotics.

A patient may not need orthotics if symptoms are primarily driven by a short-term training spike, footwear that can be changed easily, weakness that responds well to rehab, a mobility issue, or a condition that is not meaningfully influenced by foot support.

Some patients may do well with a footwear change, temporary taping, strengthening, mobility work, or a lower-cost prefabricated insert.

This is why honest assessment matters. The goal should be to recommend orthotics when they are likely to add value, not simply because they are available.

Localized Care for Southwest Edmonton Residents

Dr. Harman Braich, Chiropractor provides chiropractic care, rehab-focused treatment, and custom foot orthotics for patients in Southwest Edmonton while operating out of Creekwood Physiotherapy. This includes residents from Creekwood Chappelle, Chappelle Gardens, Chappelle, Ambleside, Keswick, Windermere, Glenridding Heights, Glenridding Ravine, Heritage Valley, Paisley, Desrochers, Jagare Ridge, Rutherford, Callaghan, Allard, Cavanagh, Blackmud Creek, Richford, Macewan, and Blackburne.

For local patients, convenience can make consistency easier. Foot, knee, hip, and back pain often require more than one decision. Patients may need assessment, orthotics, footwear advice, rehab progression, and follow-up to make sure the plan is actually helping.

Being close to home, work, school drop-off, or your usual commute can make it easier to follow through.

When to Book an Orthotics Assessment

Consider booking an assessment if you are dealing with recurring foot pain, heel pain, arch pain, knee discomfort with walking or running, hip irritation with prolonged standing, or back pain that seems influenced by walking, standing, or lower-limb mechanics.

You may also benefit from an assessment if your job requires long hours on your feet, if you are increasing your walking or running volume, or if you are unsure whether your footwear is helping or making symptoms worse.

The goal is not to convince every patient they need orthotics. The goal is to determine whether custom orthotics are appropriate for your situation and how they fit into a broader plan.

Final Thoughts

Custom orthotics may help some patients with foot, knee, hip, or back pain, especially when symptoms are influenced by foot loading, footwear, walking mechanics, or prolonged standing demands.

But they should not be treated as a universal fix.

The best results usually come from matching the tool to the patient. That means proper assessment, clear reasoning, realistic expectations, and a plan that may also include rehab exercise, footwear advice, strength work, and gradual return to activity.

At Dr. Harman Braich, Chiropractor, custom orthotics are used as part of an evidence-informed approach focused on movement quality, load tolerance, and long-term function.

Call today or visit braichchiro.com to schedule your chiropractic assessment with Dr. Harman Braich.

About the Author

Dr. Harman Braich, Chiropractor is a chiropractor in Southwest Edmonton operating out of Creekwood Physiotherapy. His approach emphasizes evidence-informed assessment, patient education, rehab exercise therapy, manual therapy when appropriate, and long-term movement capacity. His clinical focus is helping patients understand their pain, improve movement quality, and build resilience for work, sport, training, and daily life.

Research & References

Whittaker et al. (2018). Foot orthoses for plantar heel pain: a systematic review and meta-analysis. This review found moderate-quality evidence that foot orthoses were more effective than sham orthoses for reducing plantar heel pain in the medium term, but did not find a medium-term improvement in function. 

Morrissey et al. (2021). Management of plantar heel pain: a best practice guide. This BJSM guide recommends core treatment including taping, stretching, and individualized education, with additional treatments considered when patients do not improve optimally. 

Mayo Clinic. Plantar fasciitis: symptoms and causes. Mayo Clinic describes plantar fasciitis as one of the most common causes of heel pain and explains the role of the plantar fascia. 

Moisan et al. (2022). Effects of foot orthoses on lower-limb biomechanics. This review found that foot orthoses’ effects on biomechanics are task-dependent and more pronounced in distal lower-limb segments. 

Neal et al. (2024). Best practice guide for patellofemoral pain. This BJSM guide states that prefabricated foot orthoses may be prescribed for people who respond favourably to treatment-direction tests and can be customized for comfort. 

Collins et al. (2008). Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome. This BMJ randomized trial found prefabricated orthoses were superior to flat inserts in the short term, but did not show additional benefit when added to physiotherapy. 

Lin et al. (2025). Effect of foot orthoses on pain and disability in patients with low back pain. This systematic review reported low-quality evidence that foot orthoses may improve pain and disability in some low back pain patients, especially selected subgroups, while cautioning that evidence remains limited. 

Kinsella et al. (2023). Effects of foot orthoses and footwear interventions on outcomes in people with hip-related pain. This systematic review highlights the need for careful interpretation and patient selection when considering orthoses or footwear for hip-related pain.