Orthotics work like shock absorbers to remove pressure and stress from the foot and ankle alleviating chronic pain in those areas that can lead to back and neck pain. Foot orthotics help to correct improper foot alignment due to flatfoot or planus conditions and high arch or cavus foot. Orthotic shoe insterts can restore balance, improve sports performance and even alleviate pain in the knee, hip and lower back.

To explain how orthotic shoe inserts function, it is important to understand the mechanics of walking. With each step, the vertical axis of the heel ideally should land slightly inverted to the ground, with an inclination of only a few degrees toward the outside of the heel. From there, the foot begins to pronate (flatten) and then comes off the ground at the toes (resuppinates). So as you step your weight shifts from lateral or away from the midline, to medial or toward the midline, and back to lateral. Properly designed foot orthotics act to control how the foot strikes the ground, absorbs shock, and reduces stress in the foot along with back and neck pain or chronic pain.

This coordinated motion is a complex process in which many things can go wrong. If a structural problem is present, the foot can collapse under the body's weight. Over time, stress on the feet can result in deformities.

One of the foot's main functions is to absorb shock as the body's weight shifts with each step. It does this through a complex process in which the arch of the foot flattens slightly. This absorbs and distributes the weight throughout the entire foot. There are two major problems that can occur in this mechanism:

1. The first problem occurs when the arch does not flatten at all. This typically occurs in a person with a high arch and is called a cavus foot preventing proper shock absorption. Instead of spreading the weight throughout the entire foot, it falls only on the heel and the base of the toes. This increases stress on the foot, especially the heel. Furthermore, because the weight is not absorbed well in the foot, it radiates up the leg to other joints. Over time, this can cause pain in the knees, hips, and lower back. To correct this condition, an orthotic is used to adjust and even out the contact between the foot and the ground. This allows the entire foot to support the weight of the body. Also, extra cushioning can be built into the orthotic so that some of the force does not reach the foot.
2. A different problem results when the arch flattens too much. This is known as a planus or flatfoot. In this condition, the weight distribution on the foot is too far on the medial side. A flatfoot is unstable and cannot maintain a proper arch. Over time, the weight of the body on an unstable foot can cause the bones of the foot to become misaligned. This can lead to the development of bunions, hammertoes and other foot deformities, as well as knee and low back pain. To address this problem, an orthotic with an increased arch can be prescribed to distribute the weight laterally. Depending on shape of the foot, the heel of the orthotic can be slanted to shift the weight more toward the center of the heel.

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