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A Guide on Insoles

Many people believe that "insoles" or "orthotics" work by simply holding the arch up or aligning the skeleton. However, modern podiatry—led by experts like Dr. Kevin Kirby—focus on a different approach, called Tissue Stress Theory.This theory suggests that the goal of an insole is not just to "straighten" the foot, but to reduce the physical stress (forces) acting on injured tissues. By altering how the ground pushes back against your foot (Ground Reaction Force), we can relieve pain and allow healing to occur (Kirby, 2017).

Do I Need Expensive Custom Insoles?

Not necessarily.

There is a common misconception that you must spend hundreds of pounds on custom-moulded orthotics to get relief. For many patients, this is an unnecessary expense.Current biomechanical evidence suggests that a prefabricated (off-the-shelf) device—when professionally modified with specific features—can be just as effective as a custom device for many common foot problems. The most important factor is not whether the insole was moulded to your foot, but whether it has the correct features (stiffness and wedging) to alter the forces causing your pain (Kirby, 2000).

Our Approach: Modified Simple Insoles

We focus on using high-quality, medical-grade simple insoles that are customized in-clinic to your specific needs. By adding specific prescription features, we can create a device that functions like a custom orthotic without the high price tag or long waiting times.

Common Custom Features We Use

Here is a guide to the modifications we may make to your insoles based on Dr. Kevin Kirby’s design concepts:Arch Filler: This increases the contact area under the arch. It doesn't just "prop" the arch up; it spreads the load, ensuring that pressure is distributed evenly rather than focusing excessively on the heel or ball of the foot (Kirby, 2002).Rearfoot Wedging / Posting: This involves placing a wedge under the heel. If your foot rolls in too much (pronation), we place the thick part of the wedge on the inside (medial side). This shifts the ground reaction force, reducing the internal twisting force that strains the ankle and arch (Kirby, 1992).Midfoot Wedging / Posting: Similar to rearfoot wedging but placed under the arch area. This provides direct support to the mid-foot joints (such as the oblique midtarsal joint), which is particularly helpful for tired, aching arches (Kirby, 2002).Metatarsal Domes: A small, raised dome placed just behind the ball of the foot. It helps to separate the metatarsal bones and lift them slightly. This is excellent for relieving neuromas (trapped nerves) or burning pain in the ball of the foot.Metatarsal Cushioning: Soft padding added under the ball of the foot to replace the foot's natural fatty padding, which can thin out with age.Heel Raises: A lift added under the heel. This slightly points the foot downwards (plantarflexion), which takes the tension off the Achilles tendon and calf muscles. It is often essential for Achilles tendonitis or Sever’s disease (Kirby, 2002).First Ray Cutout: A specialized modification where the material under the big toe joint is removed or softened. This allows the big toe joint to drop down naturally.Why is this used? It facilitates the "Windlass Mechanism"—the natural tightening of the foot structures that creates a stable arch (Kirby, 2002). This is a powerful feature for managing conditions like Tibialis Posterior Dysfunction, as it helps the foot stabilize itself dynamically without forcing it into an unnatural position.

How to Get Your Customized Insoles

Book a Foot / Ankle / Leg Assessment (£40) so we can analyse your foot shape, walking and movement patterns and address any areas of excessive pressure. We will book you back in for an insole fitting appointment and a 2 week check up (£10 ea.) to make sure the insoles are helping and not causing any other issues.
We will then add custom features to a pair of insoles (£20-£30) (around 1 week) or order you some high quality KinetiX insoles (£95)(2-3 weeks).
Come in for your Insole Fitting where we can make sure the insoles fit well in your footwear and are comfortable to wear. Additional modifications can be made at the clinic if needed.
Try the Insoles for a few weeks, break them in slowly, wearing them for a few hours on Day 1 and gradually increase to see if they get more comfortable to wear. After 2 weeks come back in for an insole fitting to make any required adjustments.
Start Healing, use the insoles everyday to start relieving the extra strain on muscles and tendons. Soon you'll feel like you're walking on a cloud. Take this opportunity to strengthen weak muscles and prevent the pain from returning. Insoles are similar to reading glasses, they help reduce symptoms but will never correct the problem. Glasses help you see, but won't fix your eyes.

Book a Foot / Ankle / Leg Assessment

For advanced durability and specific medical-grade support, we supply Kinetix Insoles.These are Evidence-Based Foot Orthoses that are exclusively available from a medical professional. They bridge the gap between simple shop-bought insoles and expensive custom devices, offering superior structural integrity and scientifically designed contours to manage foot function effectively.

References

Kinetix. (n.d.). About Kinetix. Kinetix Insoles.Kirby, K. A. (1992). The medial heel skive technique: Improving pronation control in foot orthoses. Journal of the American Podiatric Medical Association, 82(4), 177-188. https://doi.org/10.7547/87507315-82-4-177Kirby, K. A. (2000). Foot and lower extremity biomechanics: A ten year collection of precision intricast newsletters. Precision Intricast.Kirby, K. A. (2002). Foot and lower extremity biomechanics II: Precision intricast newsletters, 1997-2002. Precision Intricast.Kirby, K. A. (2017). Tissue stress theory for the 21st century. Podiatry Today, 30(4), 36-42.

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