1 in 3 adults over 65 falls each year
Falls can cause injury, limit independence, and affect quality of life. The good news: most falls are preventable.
Custom foot orthoses can help!
Balance & falls (older adults, neuropathy)
Footwear + orthoses that fit properly and stabilize the foot improve balance metrics and, in multifaceted programs, reduce falls in community-dwelling older adults. Suprasensory/textured/vibrating insoles acutely improve postural sway and gait quality in diabetic peripheral neuropathy (DPN).
Well-fitted footwear + orthoses improve balance in seniors and neuropathy populations, and - in comprehensive programs - reduce falls over 12 months.
Research resources:
- Enhancing Footwear Safety for Fall Prevention in Older Adults: A Comprehensive Review of Design Features
- Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial
- Acute Effects of Vibrating Insoles on Dynamic Balance and Gait Quality in Individuals With Diabetic Peripheral Neuropathy: A Randomized Crossover Study
- The effects of vibrating shoe insoles on standing balance, walking, and ankle-foot muscle activity in adults with diabetic peripheral neuropathy
- Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial
Running & sport injury
Across 12 trials (n≈5,300 runners), foot orthoses were associated with ~40% lower risk of lower-extremity injury (RR ~0.60) with moderate heterogeneity; prophylaxis signal is strongest for bone stress injury. Individual RCTs also show comfort gains (and sometimes faster times), which correlates with adherence.
In recreational runners, orthoses show a moderate protective signal - especially for bone stress injury - and consistently improve comfort, which drives continued use.
Research resources
- Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis
- The Role of Footwear, Foot Orthosis, and Training-Related Strategies in the Prevention of Bone Stress Injuries: A Systematic Review and Meta-Analysis
- A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies
Occupational standing/industrial settings
Customized insoles reduce plantar pressures and lower-limb/back discomfort in people who stand for long periods (assembly lines, police, factory).
For people on their feet all shift, customized insoles improve comfort and reduce symptoms, supported by pressure redistribution data.
Research resources
- Comparison of Two Types of Insoles on Musculoskeletal Symptoms and Plantar Pressure Distribution in a Work Environment: A Randomized Clinical Trial
- Investigating the effect of custom-made insoles and exercises on lower limb and back discomfort in assembly-line workers in a rubber tire factory: A randomized controlled trial
Diabetes (ulcer risk + stability)
Pressure-optimized/digital insoles reduce ulcer recurrence in high-risk feet (core cost-savings story), and vibrating/textured insoles improve gait/balance in DPN - mechanistically aligned with fall-risk reduction in this cohort.
Well-fitted footwear + orthoses improve balance and, when delivered as part of a multifaceted podiatry program, reduce falls in older adults. In neuropathy, vibrating/textured insoles measurably improve sway and gait.
Why orthotics work
Orthoses increase contact area and reduce peak plantar pressures, improving comfort and off-loading hotspots; suprasensory/textured surfaces amplify plantar feedback, which supports postural control - especially where sensation is impaired (DPN) or where alignment is suboptimal (flatfoot).
Final thoughts
Balance improvements are strongest in older adults with foot pain and in DPN; fall-rate reduction evidence is tied to multicomponent interventions (orthoses + footwear optimization + exercise + foot care), not orthoses alone.
Runner prophylaxis evidence is promising but heterogeneous; emphasize bone stress injury and comfort/adherence rather than universal prevention.
For medial knee OA, lateral wedges show no clinical benefit.
1 in 3 adults over 65 falls each year
Falls can cause injury, limit independence, and affect quality of life. The good news: most falls are preventable.
Custom foot orthoses can help!
Balance & falls (older adults, neuropathy)
Footwear + orthoses that fit properly and stabilize the foot improve balance metrics and, in multifaceted programs, reduce falls in community-dwelling older adults. Suprasensory/textured/vibrating insoles acutely improve postural sway and gait quality in diabetic peripheral neuropathy (DPN).
Well-fitted footwear + orthoses improve balance in seniors and neuropathy populations, and - in comprehensive programs - reduce falls over 12 months.
Research resources:
- Enhancing Footwear Safety for Fall Prevention in Older Adults: A Comprehensive Review of Design Features
- Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial
- Acute Effects of Vibrating Insoles on Dynamic Balance and Gait Quality in Individuals With Diabetic Peripheral Neuropathy: A Randomized Crossover Study
- The effects of vibrating shoe insoles on standing balance, walking, and ankle-foot muscle activity in adults with diabetic peripheral neuropathy
- Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial
Running & sport injury
Across 12 trials (n≈5,300 runners), foot orthoses were associated with ~40% lower risk of lower-extremity injury (RR ~0.60) with moderate heterogeneity; prophylaxis signal is strongest for bone stress injury. Individual RCTs also show comfort gains (and sometimes faster times), which correlates with adherence.
In recreational runners, orthoses show a moderate protective signal - especially for bone stress injury - and consistently improve comfort, which drives continued use.
Research resources
- Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis
- The Role of Footwear, Foot Orthosis, and Training-Related Strategies in the Prevention of Bone Stress Injuries: A Systematic Review and Meta-Analysis
- A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies
Occupational standing/industrial settings
Customized insoles reduce plantar pressures and lower-limb/back discomfort in people who stand for long periods (assembly lines, police, factory).
For people on their feet all shift, customized insoles improve comfort and reduce symptoms, supported by pressure redistribution data.
Research resources
- Comparison of Two Types of Insoles on Musculoskeletal Symptoms and Plantar Pressure Distribution in a Work Environment: A Randomized Clinical Trial
- Investigating the effect of custom-made insoles and exercises on lower limb and back discomfort in assembly-line workers in a rubber tire factory: A randomized controlled trial
Diabetes (ulcer risk + stability)
Pressure-optimized/digital insoles reduce ulcer recurrence in high-risk feet (core cost-savings story), and vibrating/textured insoles improve gait/balance in DPN - mechanistically aligned with fall-risk reduction in this cohort.
Well-fitted footwear + orthoses improve balance and, when delivered as part of a multifaceted podiatry program, reduce falls in older adults. In neuropathy, vibrating/textured insoles measurably improve sway and gait.
Why orthotics work
Orthoses increase contact area and reduce peak plantar pressures, improving comfort and off-loading hotspots; suprasensory/textured surfaces amplify plantar feedback, which supports postural control - especially where sensation is impaired (DPN) or where alignment is suboptimal (flatfoot).
Why orthotics work
Orthoses increase contact area and reduce peak plantar pressures, improving comfort and off-loading hotspots; suprasensory/textured surfaces amplify plantar feedback, which supports postural control - especially where sensation is impaired (DPN) or where alignment is suboptimal (flatfoot).
1 in 3 adults over 65 falls each year
Falls can cause injury, limit independence, and affect quality of life. The good news: most falls are preventable.
Custom foot orthoses can help!
Balance & falls (older adults, neuropathy)
Footwear + orthoses that fit properly and stabilize the foot improve balance metrics and, in multifaceted programs, reduce falls in community-dwelling older adults. Suprasensory/textured/vibrating insoles acutely improve postural sway and gait quality in diabetic peripheral neuropathy (DPN).
Well-fitted footwear + orthoses improve balance in seniors and neuropathy populations, and - in comprehensive programs - reduce falls over 12 months.
Research resources:
- Enhancing Footwear Safety for Fall Prevention in Older Adults: A Comprehensive Review of Design Features
- Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial
- Acute Effects of Vibrating Insoles on Dynamic Balance and Gait Quality in Individuals With Diabetic Peripheral Neuropathy: A Randomized Crossover Study
- The effects of vibrating shoe insoles on standing balance, walking, and ankle-foot muscle activity in adults with diabetic peripheral neuropathy
- Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial
Running & sport injury
Across 12 trials (n≈5,300 runners), foot orthoses were associated with ~40% lower risk of lower-extremity injury (RR ~0.60) with moderate heterogeneity; prophylaxis signal is strongest for bone stress injury. Individual RCTs also show comfort gains (and sometimes faster times), which correlates with adherence.
In recreational runners, orthoses show a moderate protective signal - especially for bone stress injury - and consistently improve comfort, which drives continued use.
Research resources
- Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis
- The Role of Footwear, Foot Orthosis, and Training-Related Strategies in the Prevention of Bone Stress Injuries: A Systematic Review and Meta-Analysis
- A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies
Occupational standing/industrial settings
Customized insoles reduce plantar pressures and lower-limb/back discomfort in people who stand for long periods (assembly lines, police, factory).
For people on their feet all shift, customized insoles improve comfort and reduce symptoms, supported by pressure redistribution data.
Research resources
- Comparison of Two Types of Insoles on Musculoskeletal Symptoms and Plantar Pressure Distribution in a Work Environment: A Randomized Clinical Trial
- Investigating the effect of custom-made insoles and exercises on lower limb and back discomfort in assembly-line workers in a rubber tire factory: A randomized controlled trial
Diabetes (ulcer risk + stability)
Pressure-optimized/digital insoles reduce ulcer recurrence in high-risk feet (core cost-savings story), and vibrating/textured insoles improve gait/balance in DPN - mechanistically aligned with fall-risk reduction in this cohort.
Well-fitted footwear + orthoses improve balance and, when delivered as part of a multifaceted podiatry program, reduce falls in older adults. In neuropathy, vibrating/textured insoles measurably improve sway and gait.
Research resources
Why orthotics work
Orthoses increase contact area and reduce peak plantar pressures, improving comfort and off-loading hotspots; suprasensory/textured surfaces amplify plantar feedback, which supports postural control - especially where sensation is impaired (DPN) or where alignment is suboptimal (flatfoot).
Final thoughts
Balance improvements are strongest in older adults with foot pain and in DPN; fall-rate reduction evidence is tied to multicomponent interventions (orthoses + footwear optimization + exercise + foot care), not orthoses alone.
Runner prophylaxis evidence is promising but heterogeneous; emphasize bone stress injury and comfort/adherence rather than universal prevention.
For medial knee OA, lateral wedges show no clinical benefit.
Refferences
Balance & Falls
- Guidance & scoping synthesis (older adults): Proper fit, secure fixation, low heels, appropriate collar/heel height, and matched sole/insole hardness are fall-prevention contributors; ill-fitting shoes raise risk. (2024 scoping review/Karger; 2024 narrative review, open access). SOURCE 1 SOURCE 2
- Multifaceted podiatry RCT (Australia; BMJ 2011): Older adults with disabling foot pain (n=305) randomized to custom foot orthoses + footwear advice/provision + exercises + care of lesions vs usual care → significant fall-rate reduction over 12 months (pragmatic design). This is the strongest “real-world falls” trial. SOURCE
- UK REFORM program (2017 NIHR HTA): Multicentre cohort-RCT evaluating clinical and cost-effectiveness of podiatry+orthoses to prevent falls. The report details implementation/adherence economics—useful for HealthHUB/MinuteClinic operationalization. SOURCE
- Flatfoot balance meta-analysis (2024): Systematic review/meta-analysis shows foot orthoses improve balance in individuals with flatfoot—mechanism via plantar mechanoreceptor stimulation and alignment. (Useful for “balance” claim beyond seniors.) SOURCE
-
Neuropathy—acute balance/gait improvement (2024–2025):
• Diabetes Care 2024: Suprasensory vibrating insoles → better gait quality and postural balance in DPN (first controlled evidence in this space). SOURCE
• Gait & Posture 2024 / 2025: Vibrating or textured insoles reduce CoP sway and suggest greater stability in DPN. (Short-term lab outcomes; aligns with mechanism.) SOURCE
• BMJ Open 2019: 4-week textured insoles improved balance performance in adults with DPN. SOURCE
Injury Reduction (Runners / Sport)
- Runners meta-analysis (2022): 12 studies, N=5,321—foot orthoses reduced lower-extremity injury risk (RR 0.60, 95% CI 0.50–0.70; moderate-quality; I²=54%). Good for population-level retail claims with caveat of heterogeneity. SOURCE
- Bone stress injury signal (2023 synthesis): Review notes RR ~0.47 for bone stress injuries with orthoses—useful for active consumers and employer wellness groups. SOURCE
- Runner RCT (2023): Aetrex L700 orthoses vs no orthoses → significant comfort increase; trends to lower injury and faster times but not all outcomes significant (still helpful for adherence story). SOURCE
Occupational Pain & Load Management
- Assembly-line workers (Brazil; 2016): Customized insoles redistributed plantar pressure and reduced musculoskeletal symptoms after weeks of use; pressure mapping supports mechanism. SOURCE
- Industrial workers (Iran; RCT 2019): Custom insoles + exercise lowered lower-limb and low-back discomfort vs control over follow-up—applicable to employer/warehouse settings. SOURCE
- Police during prolonged standing/walking (NYC): Early cohort shows reduced post-work discomfort with customized insoles (pragmatic, non-randomized; still useful for “standing all day” use-case). SOURCE
Diabetes—Falls-Adjacent & Cost-Avoidance
- Neuropathy balance: Vibrating/textured insoles improve sway/gait (short-term). SOURCE