Orthopedic, postural, and proprioceptive insoles

Types of insoles

Proprioceptive insoles

Postural proprioceptive insoles are orthopedic devices designed to improve balance and posture by stimulating the sensory receptors in the foot.

Their main role is to provide proprioceptive stimulation, i.e., to enable the body to perceive its position and movements in space via the elements located under the foot. Stimulation of the sensory receptors in the feet, called proprioceptors, is responsible for transmitting sensory information to the brain, thereby maintaining balance and posture.

When you wear your insoles, they exert pressure on specific points on the foot, which activates the proprioceptors. This improves the perception of the body’s position in space, corrects postural imbalances, and induces better muscle coordination.

These insoles are custom-made in the office, taking into account the anatomical characteristics and specific needs of each individual.

They are composed of different layers of flexible and resistant materials and customized to the patient’s needs, most of the time quite thin.

Thermoformed/sports insoles

Orthopedic insoles (or foot orthotics, in scientific jargon) can be thermoformed to the patient’s foot and, if necessary, to the sports shoe. They are made from technical materials suitable for sports shoes (which are more or less narrow) and the sport in question: resistance to moisture, cold, repeated friction (rubbing), etc.

A thermoformed insole for a mountain trail runner will not be designed and made from the same materials as those used for a cyclist’s cleats or a ballet dancer’s pointe shoes.

It is important to note that there is no such thing as an insole that is too “thick,” too “hard,” too “thin,” too “short,” etc. Each insole is designed according to the treatment required by the patient, their daily use, their sporting activities, their footwear, and their preferences!

The less restrictive the treatment, the more it will be worn and the more effective it will be. This is why it is essential that the podiatrist who examined the patient fits the insoles with them and monitors them if any adjustments are necessary.

Post-operative insoles

Specific post-operative orthopedic insoles are recommended after foot surgery when the pain is too severe to start walking again or delays the progress of rehabilitation. Your podiatrist can therefore manufacture and fit this type of insole for you, depending on your condition, your operation, and following a specific post-operative assessment.

They will obviously need to be modified as you recover (reduction in swelling, decrease in pain, return to sports, etc.) and will eventually become everyday or sports insoles that you can keep for a year or more.

They are recommended after an Achilles tendon rupture, hallux valgus surgery, and more. and many other conditions.

Pacific flip-flop insoles thermoformed to the foot

Heat, certain lifestyles, summer, islands… sometimes wearing shoes is greatly reduced or even completely interrupted due to lack of practicality. This means that insoles are worn less often… which can lead to a recurrence of pain.

To avoid this, and although flip-flops (or thongs in the West, savate in Tahiti) are not the most recommended type of footwear, we can manufacture your personal treatment directly on the soles of your flip-flops with the addition of simple straps.

All you have to do is not lend them to anyone or leave them on the beach… because they are specific to your treatment.

Adaptation, use, follow-up, and care

Adaptation

• First days of treatment: you may experience discomfort, particularly in your feet when they come into contact with new rough surfaces.

This will pass after the adaptation phase.

If the discomfort is too unsettling, you can gradually introduce the insoles into your daily routine: 1 hour on the first day, 2 hours on the second, and so on, until you are wearing them all the time.

• It may take two to three weeks to get used to wearing orthotics. Postural correction related to insoles can cause side effects such as unusual pain or soreness, muscle fatigue, a feeling of instability, etc. This is completely normal! However, if these new symptoms persist beyond 4 weeks of adjustment, we may reevaluate the treatment. Each bodily reaction is patient-dependent, and we will adjust the insoles based on any discomfort observed over time.
• Avoid strenuous exercise immediately after starting to wear the insoles: this could increase the undesirable effects associated with adaptation, particularly soreness and blisters. Wait until you are used to wearing them on a daily basis before climbing mountains!
• When doing household activities, it is important to wear the insoles in closed indoor shoes: choose machine-washable sneakers or ballet flats, for example.
• Choose good shoes in general (stabilizing, etc.) that are not worn out, as poor-quality shoes will alter the effect of the treatment.

Use

Sole care

• If you are undergoing treatment for fungal infections or perspiration, treat your shoes and soles as well.
• You can take them out of your shoes in the evening to air them, as well as after a workout.
• Be careful with pets who like to play with them and may not take the best care of them.
• Do not expose them to heat (radiators, fireplaces, sunlight, etc.).
• Wash them with a slightly damp sponge and soap, NEVER in the washing machine or by soaking them in water.

Lack of space in the shoe

• Remove the original insoles from the shoes if you need more space or for sports activities.
• For open shoes and ¾-size insoles, we can cut the insoles to fit the toes, but this may be restrictive: ask us for advice if necessary.
• In this case, you can place a self-adhesive “Velcro” strip under the heel, centered, and if necessary in front of the insole so that it does not slip out of the shoe.
• For sports, you can place the orthopedic insole under the original insole of the shoe for greater comfort. Even underneath, the treatment remains effective.

Therapeutic follow-up and sole control

At the end of the adaptation phase, you can consult your osteopath after 4 weeks if you feel the need, in order to resolve any remaining dysfunctions.

If we recommend exercise protocols to be done in parallel with wearing the insoles: 10 minutes per day is necessary

At 6 weeks after you start wearing the insoles, send an email to the office (podiatrylab35@gmail.com) to give us your feedback.

If you do not see a 50-60% improvement in your symptoms or if discomfort persists, we can readjust the insoles to make them more effective.

The length of time insoles are worn varies greatly:

Insoles can be made to relieve acute pain (after hallux valgus surgery, for example) and help you start walking again. The goal is to relieve pressure on the inflamed area. The same applies in the case of traumatic injury. They will therefore be very temporary, lasting only for the duration of your recovery.

Treatment with insoles may be longer when the pain is chronic, allowing time for the body to readjust to a better posture.

Some athletes prefer to wear sports insoles for prevention, comfort, and performance, with stabilizing elements.

In children, a specific assessment can be carried out to detect any abnormalities that could persist into adulthood.

If orthotics are necessary, follow-up should be carried out approximately every 6 months (depending on growth and changes in shoe size in particular) throughout the growth period with the aim of removing them once the disorder has been cured.

Finally, in a few fortunate cases, orthotics may need to be worn for life if there is significant deformity or an organic posture disorder (e.g., a large difference in leg length), and if pain recurs when the insoles are removed despite rehabilitation and associated lifestyle changes (footwear, sports, etc.).

It is necessary to have another posture check to ensure that the pain has disappeared before considering removing the insoles without risk, and to follow the associated advice (suitable shoes, recommended type of sport, exercises, etc.).

Coverage & reimbursement of consultations and orthopedic insoles

Postural, sports, and post-operative assessments are reimbursed by some supplementary insurance policies.

Orthopedic insoles are partially reimbursed by health insurance. Your supplemental insurance may cover the rest, in full or in part, depending on your policy.

The CPAM (French national health insurance) offers reimbursement:

• Once a year for adults
• Twice a year for children up to and including 15 years of age

In 2024, the CPAM reimbursement rate is 60% of the price of the insoles, based on a reimbursement of €28.86, meaning that €17.31 is covered by the French national health insurance system.

If you have a prescription from your doctor, please bring it with you. However, it is not required for reimbursement, as podiatrists are able to prescribe insoles if necessary (Ritz Law 2023).

For all consultations, FSE teletransmission will be used for insoles, and for all procedures performed at the practice, an invoice will be sent to you at the end of the consultation.