Effects of foot orthoses on running kinetics and kinematics: A systematic review and meta-analysis.

A team of researchers pulled together evidence from 35 studies to see what actually happens when runners wear foot orthoses—those custom or off-the-shelf shoe inserts designed to support the arch and heel. They wanted to know whether different types of inserts change the way people's feet, ankles, and legs move and load during running. The good news: most inserts did reduce pressure under the heel and forefoot.

The less clear news: custom inserts made running feel harder and more effortful, even though they were more comfortable to wear. The authors found scattered benefits across different designs, but they were honest that the evidence doesn't yet show orthoses reliably improve running performance or clearly prevent injury in healthy runners without existing foot problems.

If you've been thinking about getting a foot insert for running, this research offers a mixed picture. Orthoses—whether custom-made ones tailored to your feet or standard off-the-shelf versions—do reduce the amount of pressure pushing through your heel and the ball of your foot while you run.

Custom inserts tend to feel more comfortable when you're wearing them. On the flip side, some runners found that custom inserts made their legs work a bit harder during running and made exertion feel more noticeable, even if they were more pleasant to have in their shoes.

The research looked at healthy runners without foot injuries, so if you already have a foot or ankle problem, the picture might be different. Right now, there's enough evidence to say orthoses can change how your foot moves, but there's not yet clear proof that they'll make you run faster, farther, or injury-free.

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

This meta-analysis of 35 trials offers some biomechanical clarity around orthotic prescription, though clinicians should recognize the limitations. Both custom and off-the-shelf arch-support designs consistently reduced plantar pressure at the heel and medial forefoot with small to moderate effect sizes, though interestingly they increased midfoot pressure.

Custom orthoses showed a small advantage in comfort perception compared with controls. More specific interventions emerged: a raised heel cup combined with arch support produced a modest reduction in ankle inversion at initial contact, and a medial post with arch support reduced both ankle and tibial internal rotation more substantially.

However, custom orthoses appeared to have an unfavorable effect on running economy and perceived exertion, a finding that deserves attention when prescribing to endurance athletes. The authors appropriately cautioned that their analysis was restricted to healthy adults without existing musculoskeletal complaints, so the findings may not generalize to runners with pathology, and they noted that evidence for injury prevention and performance enhancement remains lacking.