Choosing the Right Orthotics: From Off-the-Shelf to Fully Bespoke.

Foot or ankle pain is a common issue affecting people of all ages across the UK. Whether it’s caused by spending long days on your feet, an increase in sports activities in the population, injuries, an underlying condition or an ageing population, the right support (insoles) can make a big difference to your comfort and mobility.

In the UK, 268 million US dollars was the estimated market size of insoles and shoe inserts in 2023 with an estimated annual growth rate of 4.7% from 2024 to 2030 (1). An orthotic device can help relieve pain, improve alignment, and support your feet. There are various types available, ranging from simple off-the-shelf insoles to fully bespoke orthotics that are custom-made and prescribed by a healthcare professional specifically for your feet.

Understanding the differences between these options is important to ensure you choose the right one for your needs. A Podiatrist can assess your feet, discuss your lifestyle, comfort preferences, and budget, and recommend the most suitable orthotic solution for you.

Off-the-Shelf Orthotics: the initial Solution for Foot Fatigue or mild discomfort?

Are you dealing with mild foot pain or just general tiredness? off-the-shelf orthotics (also called prefabricated insoles or footbeds ) are often the first option people try. These prefabricated inserts can make a big difference in comfort, providing extra cushioning and light support without the need for a custom fitting.

You can easily find them online or in many shoe stores, often marketed for common problems such as plantar fasciitis or Morton’s neuroma. While they may not correct more complex biomechanical issues, they’re a great starting point for easing everyday discomfort and giving your feet some well-deserved relief.

However, if your pain persists or worsens, it’s best to seek a professional podiatry assessment. Sometimes what feels like a simple issue may be more complex, and your podiatrist can help determine whether a more tailored orthotic is needed.

Over-the-counter example: running absorption shock insoles from Enertor®
(https://enertor.com)

Semi-Bespoke Orthotics: A wise middle way

In some cases, semi-bespoke orthotics can be a great in-between option. They were developed and offered by a number of foot orthotics laboratories (2) and can be ordered through your podiatrist. They’re especially useful if you’re not yet sure how much orthotics will help, or if you’re hesitant to invest in a fully custom pair.

These devices allow for some personalisation — such as selecting:

materials and degrees control, heel raise (length leg discrepancy) for the rearfoot.
Absorption or boosting materials for the forefoot.
Adjusting top covers or shape depending on your shoes, or adding modifications based on your activity or sport.

They’re also ideal for temporary use, such as during recovery from injury on the side of your physiotherapy program. For children, they are a good option as they can be adjusted or replaced often due to rapid foot growth. They can help manage some children’s disorders such as heel pain caused by Sever’s disease (calcaneal apophysitis),

Typically, these orthotics last around one year before the materials start to compress or lose effectiveness, even sometimes less if used in high-impact sports activities. They can serve as a therapeutic trial, helping to confirm whether orthotic support is beneficial before moving to a longer-lasting bespoke solution.

Semi-bespoke Orthotics with Midfoot EVA Arch Support added.

Fully Bespoke Orthotics: The Gold Standard for Complex or Chronic Cases

When it comes to chronic pain, foot deformities, recurrent injuries, or complex children, fully bespoke orthotics may be your best choice. These are custom-made from a detailed assessment of your foot shape, gait, and biomechanics, ensuring precise support exactly where it’s needed.
Bespoke orthotics can address complex problems such as inflammatory diseases, postural imbalances, or ankle instability/proprioception loss, hypermobility spectrum disorder. They not only provide targeted relief but also help prevent further issues by improving alignment and evenly distributing pressure. For example, custom-made foot orthoses prove to be effective in reducing pain and improving foot function in patients with Psoriatic arthritis and rheumatoid arthritis (3). Depending on the need in each case, they are made from different materials such as polypropylene, EVA, carbon fibre or most recently 3D printed orthotics made with flexible TPU (thermoplastic Polyurethane) or Nylon.
While they require a higher initial investment (the cost is often not covered in your insurance policy), bespoke orthotics are built for long-term therapeutic benefit and durability, making them an excellent choice for those with chronic or/and structural foot conditions.
For bespoke orthotics fabrication, the accurate shape of your feet is captured either with a scanner attached to an iPad or with a traditional foam box mould, then sent to manufacture.

Bespoke Orthotics from laboratory: Polypropylene Device Without Top Cover and Adjacent EVA/Vinyl Options

Conclusion:

Consulting a podiatrist initially is highly recommended to ensure the correct choice alongside with other treatments such as a physiotherapy program, focused shock waves therapy, before buying an orthotics’ devices. A biomechanical assessment by an MSK podiatrist, to provide an accurate diagnosis, would be the first step before deciding if a semi-custom or a custom moulded is required. The podiatry appointment would be greatly useful and strongly recommended:

If you have chronic persistent foot or ankle pain.
Underlying conditions such as hypermobility spectrum disorder, inflammatory disease.
Addressing mechanical issues.

Still not sure:
For more information or to book a Musculoskeletal (MSK) podiatry appointment, please contact our clinic at 07714792424 or info@sonopodiatry.co.uk

References:

1-UK Shoe Insoles Market Size, Share | Industry Report, 2030 (no date) www.grandviewresearch.com. Available at: https://www.grandviewresearch.com/industry-analysis/uk-shoe-insoles-market-report.

2-Zifchock, R.A. and Davis, I. (2008) ‘A comparison of semi-custom and custom foot orthotic devices in high- and low-arched individuals during walking’, Clinical Biomechanics, 23(10), pp. 1287–1293. Available at: https://doi.org/10.1016/j.clinbiomech.2008.07.008.

3. Walha, R., Dagenais, P., Gaudreault, N. et al. (2022). The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial. Arthritis Res Ther 24, 124. https://doi.org/10.1186/s13075-022-02808-8