Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis.

Researchers pulled together data from 12 randomized controlled trials involving over 5,000 runners to see whether foot orthoses (custom or off-the-shelf shoe inserts) actually reduce injury and pain. The evidence in this area has historically been weak, so this systematic review and meta-analysis aimed to get a clearer picture. What they found was a meaningful reduction in injury risk: runners using foot orthoses sustained injuries at about 40% lower rate than those without orthoses.

The injury rate in the control group was 37% compared to 24% in the orthoses group. The authors graded this as moderate-quality evidence, which means while the finding is encouraging, there's still room for stronger research. The takeaway is that foot orthoses may help runners stay injury-free, though this is not a guaranteed fix and individual results will likely vary.

A new analysis of 12 separate studies looked at whether shoe inserts help prevent running injuries. Researchers tracked over 5,000 runners and found that those who used foot orthoses (custom or store-bought inserts placed inside the shoe) had fewer injuries than runners who didn't use them.

Specifically, about 24 out of every 100 runners with orthoses got injured, compared to 37 out of 100 without them. That's a meaningful difference, but it's not perfect protection.

The evidence they found was moderate strength, which means it's worth paying attention to but also not the final word on the topic. Some runners may benefit more than others, and the type of orthosis and how well it fits likely matter, though the studies don't tell us exactly which runners benefit most.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This meta-analysis consolidates 12 RCTs and presents a relative risk reduction of 0.6 (95% CI 0.5-0.7) for lower limb injury in runners using foot orthoses compared to controls, representing a 40% absolute reduction in injury incidence. The evidence base included 2,983 participants and was rated as moderate quality with moderate heterogeneity (I2 = 54%), indicating fairly consistent but not uniform findings across trials.

The absolute numbers are useful to anchor against clinical reality: 24% injury rate versus 37% in controls translates to roughly one prevented injury for every six runners treated. The abstract does not detail mechanisms, optimal orthosis types, runner phenotypes most likely to benefit, or whether pain reduction paralleled injury prevention, leaving several clinical questions open.

The moderate-quality rating suggests the finding is worthy of consideration in injury prevention discussions, though clinicians should recognize uncertainty remains around individual prediction and optimal application. Future research clarifying which subgroups benefit most and exploring pain outcomes more thoroughly would strengthen clinical guidance.