First thing's first: What is the difference between inserts and orthotics? "All orthotics are inserts, but not all inserts are orthotics," explains Ragland. "An insert is any fabrication that is designed to go into a shoe to improve the shoe’s fit, function, or comfort — for example, heel grippers are inserts that adhere to the back heel part of the shoe, called the counter." Orthotics, on the other hand, are inserts that "lay on the floor of the shoe, called the insole," says Ragland. "Commonly, orthotics are prescribed to maintain arch support, but they can be customized to treat a litany of foot conditions such as metatarsalgia, hyper-pronation, hyper-supination, big-toe stiffness, and neuroma pain, among others."
According to Ragland, you likely won't be able to get one orthotic that's suitable for all your different types of shoes. "An orthotic for a sneaker and a dress shoe for the same person will be fashioned with completely different materials," she explains.
"The material used to produce an orthotic depends on what the orthotic is being designed to remedy," Ragland says. And on the synthetic end, she adds, you have plastics, cushion foams, and silicone gels.
Heel grippers aim to reduce friction on the back of your heel, says Ragland, like these Helloheel Fitter Grips heel liners. They're made from biodegradable rubber covered in soft suede, and they're a great option if your shoes often slip off or you get blisters at the backs of your ankles.
More natural options are available in the form of leather, cork, or wool, says Ragland. These SoxsolS wool flat insoles provide a thin layer of comfort and are especially useful when it comes to keeping your shoes sanitary. They absorb sweat and odors from flats, moccasins, heels, and other sockless shoes, and when they start to get smelly, you can just toss them in the washing machine and start over fresh.
According to Ragland, “Plantar fasciitis is the most common reason why orthotics are dispensed and worn. An orthotic helps to support the arch, establishing relief from plantar-fascial pain.”
Inflexible plastics are not the only option for plantar fasciitis. According to Ragland, “Leather was the original material used for arch support and continues to be used today for people who cannot tolerate a rigid, plastic device.”
Yet another problem that could be causing your foot pain: fat-pad atrophy. Ragland says this is "the degeneration of the natural, fatty cushion on the ball of the foot. Inserts for the ball of the foot provide cushioning to relieve fat-pad atrophy." Ballotte Ball of Foot cushions "offer a selection of complete foot gel cushions covered with friction-resistant material," she says, and since they're made from self-adhesive silicone, they're sanitary, shock-absorbing, and easy to apply. These are especially effective for heels, but can also be used on other styles of shoes that agitate the balls of your feet.
If you're not sure if you need insoles but suspect that you might, Ragland offers this advice: "Heel inserts or lifts are often dispensed by podiatrists before casting for custom-made orthotics because, if they relieve some pain, then a custom-fabricated insole will work. Lifts take pressure off the plantar fascia and can alleviate pain associated with plantar fasciitis."