problems, I realized that I needed to find a better way to restore them to health. So from about 1985, I started developing better techniques to treat my patients and as a result, completely stopped using orthotics by 1992. I no longer advocate using orthotics to treat chronic musculoskeletal pain.


That being said, many physicians still treat their patients with orthotics and you may be one of them, so here are my answers to your questions:

Professor /Dr. Brian A. Rothbart Answers Your Questions About Orthotics

What are orthotics?

Orthotics are devices worn inside your shoes, underneath your feet. They can be soft, hard, different types of materials and can fit under part of your foot or your entire foot. The combinations and types are limitless.

My doctor tells me I need orthotics because my feet overpronate/hyperpronate/abnormally pronate. What does this mean?

All three terms are used interchangeably to mean that when you walk, your feet roll excessively inward. In many cases, this can flatten your arch and splay (widen) the front of your foot.


How do orthotics function?

Orthotics are based on an engineering model, which compares the stability of the human posture to the stability of the structure of a building (a weak foundation results in structural problems as a weak foot results in bad posture and chronic pain). With this concept in mind, orthotics are used to support the foot and prevent it from rolling inwards, which in theory results in better posture and a lessening or elimination of chronic pain.


What are orthotics used for?

Orthotics are generally used to address joint misalignments resulting from abnormal foot motion, that in time can lead to chronic pain. They’re also used to improve how your body moves, which is particularly important in sports, to help athletes improve their level of performance by improving their mechanics of motion.

Orthotics are not indicated for chronic pain coming from a primary neurological or muscular disease (e.g., Muscular Sclerosis), trauma-induced chronic pain (e.g., whiplash) or chronic pain resulting from a metabolic disease (e.g., Gut and Psychology Syndrome).


How do I know if I need orthotics?

In reality, you won’t know if you need orthotics  unless you consult with a healthcare provider who’s well versed in their use and dispenses them only after running the necessary tests to determine if your problem is within the framework of what his/her particular orthotics address.

For example; you may have chronic muscle and joint pain, but that doesn’t necessarily mean that you need orthotics. The reason being; there are many causes of muscle and joint pain and some of these causes (such as a Rothbarts Foot or PreClinical Clubfoot Deformity) do not respond to orthotic use. In fact, if you have either of these two abnormal foot structures, using orthotics can – and often does – make your pain worse.


Will Orthotics Get Me Better?

In theory, they should. But in recent years there’s been an escalating debate on whether orthotics should be used to treat chronic pain. More specifically, current research is questioning whether orthotics might actually over time increase chronic pain by destabilizing the foot’s stability.

I have personally researched this subject and on my research website I have photographically demonstrated the destabilizing impact that orthotics have on foot stability. Based on my research, I do not use, nor recommend the use of orthotics for treating chronic musculoskeletal pain.

If you have more questions about your orthotics, be sure to read Part Two and Part Three – ‘Do You Have Questions About Orthotics’?



I’d like to begin this article by stating that I do not use orthotics! Hmmm, you may be wondering; how can Professor Rothbart qualify to answer my questions on orthotics if he doesn’t use them?

The answer is that I was originally trained as a podiatric surgeon and used orthotic therapy for a number of years. But after using orthotics on hundreds of patients and watching these same patients return time and time again with the same

Do You Have Questions On Orthotics?  Part One