Do I need orthotics? What a 3D foot scan shows

What orthotics are

Orthotics are insoles that sit inside your shoes to change how your feet are supported and loaded as you stand, walk and run. They range from simple off-the-shelf cushioned insoles to fully custom devices made to the shape and loading pattern of your own feet. The aim is not to "correct" your feet — most foot shapes are normal variations — but to redistribute load away from tissues that are being overworked, so that they have a better chance to settle.

Who may benefit

Orthotics are usually considered when a foot-related loading pattern seems to be contributing to pain, and simpler measures such as footwear changes and exercise have not been enough. Situations where they may help include:

• Plantar fasciitis — heel pain that lingers despite stretching, strengthening and supportive shoes.
• Flat feet that are painful, or where the arch collapses noticeably and the ankle rolls in, with pain in the foot, shin or knee.
• Very high arches, where load concentrates on the heel and ball of the foot.
• Bunion pain and metatarsalgia — pain under the ball of the foot, where offloading the painful area may help.
• Recurring lower-limb overload, such as shin splints or Achilles tendinopathy in runners, where foot mechanics appear to be part of the picture.
• Leg-length difference or knee alignment that seems to be loading one side more.
• People who stand for long hours at work and have persistent foot or heel ache.

Research on orthotics is mixed: they seem to help some people and some conditions more than others, and they tend to work better alongside exercise and sensible footwear than on their own. Outcomes vary from person to person.

Who probably does not need them

• Flat feet or high arches that do not hurt. A foot shape on its own is not a reason for orthotics.
• Pain that has only been there a short time and is already improving with rest and footwear changes.
• Pain whose cause lies elsewhere — for example in the lower back or hip — which orthotics would not address.
• Children with flexible flat feet and no pain, which usually develop normally.

Part of a good assessment is telling you when you do not need orthotics.

What a 3D foot scan shows

Our clinic uses a 3D foot scanner to capture the shape and loading of your feet. You stand on the scanning plate for a few seconds, and the system records:

• the height and shape of each arch
• how your weight is distributed across the heel, the outer edge and the ball of the foot
• whether the heel and big toe are aligned or angled inwards or outwards
• any difference between the left and right foot
• how your foot position relates to knee alignment

The scan is quick, painless and radiation-free, and gives both you and your clinician a clear picture to discuss. It is a measuring tool, not a diagnosis: your clinician combines it with a hands-on examination, watching you walk, and your history to decide whether foot loading matters for your symptoms.

How custom orthotics are made

If orthotics are recommended, your scan data and the clinician's prescription — which areas need support, cushioning or offloading, and how firm the device should be — are sent to a specialist UK manufacturing laboratory, which produces a fully custom pair for your feet. Your clinician will tell you the expected delivery time when you order. At the fitting we check comfort in your usual shoes and explain how to break them in: most people start with an hour or two a day and build up over one to two weeks, as the feet and legs get used to the change.

How long custom orthotics last depends on use and activity; your clinician can advise when they need checking or replacing. We review how they are working as part of your wider plan, which typically also includes calf and foot strengthening, footwear advice and, for stubborn heel pain, focused shockwave may be discussed. Prices for the scan and custom orthotics are on our fees page.

When to book

If you have persistent heel, arch or forefoot pain, or recurring shin, Achilles or knee problems with running, and you are wondering whether your feet are part of the cause, an initial assessment at our Bloomsbury clinic is a sensible next step. We will examine your feet and how you walk, scan them where it is useful, and tell you honestly whether orthotics are likely to help — or whether something else should come first.