Last week I had a patient that I hadn’t seen for a few years come back in to the clinic with a sore knee. Her original injury was a torn meniscus on the same knee which we had rehabilitated fully and she had returned to high level netball quite happily for the last 2 years. Therefore, this flare up seemed unnecessary. After a full physical assessment and a large amount of questions I wondered about her footwear. As it turned out it was her orthotics that were causing all her problems.
It is very common at the start of the winter sports season for many of our patients to complain of shin splints, achilles tendonosis, patella tendonosis and other joint injuries as a result of getting back in to multidirectional sports suddenly. For many patients they have experienced these symptoms before and followed their rehabilitation road to purchasing orthotics many years ago.
So when is it time to get new orthotics? Or boots? Or trainers?
The purpose of orthotics is to align your foot in a more neutral position to make sure the forces from the ground are evenly distributed through your foot and up through your bones and muscles. When your feet are over-pronated, flat, supinated or you have a high arch, these forces can go directly into one structure causing painful overload and injury.
Once your footwear (including both your shoes and your orthotics) start wearing out, your foot may start to collapse again and the ground forces will start to aggravate the same spot again. At this time you have to decide if it is the footwear that is wearing out or your orthotics. Check your shoes or pop in to Back In Action Physio, or your local shoe shop, to get some quick advice on your footwear and the current state of your orthotics. We will have a look and see if they are keeping your foot in the desired neutral position or not.
Often we find it is in fact the footwear or boots that have worn out or it may be that your new sports shoes already have arch support so you do not need your orthotics for this 
season. As for my patient, it was definitely her orthotics that were the problem (after 7 years of wear and tear!) and we had her in a new pair the very next day.
BUT…. You must remember to wear in your new footwear and orthotics gradually over the next 5 days as advised by your sports shoe specialist or therapist. If not, you could get some big blisters like this photo which the same patient sent me the next week. No more knee pain, but some tender skin to look after!
Sarah