The foot is the base of everything above it. When it doesn't distribute load well or absorb impact properly, the problem doesn't always appear in the foot: it can show up in the knee, the hip or the lower back. A gait analysis helps find out whether that is where it starts.
What is analysed
A complete analysis isn't just standing on a platform and looking at colours on a screen. It has several parts, and each provides different information.
Examination on the treatment couch
Ankle, knee and hip mobility, leg length, big toe flexibility, condition of the Achilles tendon and the muscle. This is where we detect whether a joint restriction is affecting your gait.
Static analysis
With the patient standing, we assess heel alignment, arch height and how pressure is distributed at rest.
Dynamic analysis on a pressure platform
Walking and, if the patient runs, running too. It shows at which point in the stride excess pressure appears and which areas of the foot are bearing more than they should.
Video recording
In slow motion and from several angles, to see how the heel moves on contact and how the knee behaves during stance. Many problems can only be seen here.
Footwear check
Wear on your trainers is a free X-ray of your gait. Bringing your everyday and sports shoes is very useful.
Overpronator, supinator and why the label isn't enough
Pronation is a normal and necessary movement: the foot has to pronate to absorb impact. The problem appears when it pronates too much, or at the wrong moment of the gait cycle.
That is why labelling someone an "overpronator" says little. What matters is how much, at what phase of the stride, whether it is compensating for something else and whether it is causing symptoms. Some pronating feet need no intervention at all.
When an insole does make sense
Pain that keeps recurring in the same place
Plantar fasciitis, metatarsalgia, heel pain, shin splints, knee pain when running.
Structural foot problems
Symptomatic flat or high-arched feet, developing bunions, claw toes, excess pressure in a specific area.
Leg length difference
When it is significant and is causing compensations in the pelvis or back.
Diabetic or at-risk foot
Here the insole is for offloading and preventing ulcers, not for correction: the goal changes completely.
Athletes with high training loads
When the number of impacts is very high, a small imbalance repeated thousands of times eventually shows up.
When they are not needed
If your gait varies within normal limits, there is no pain and no recurring injuries, there is nothing to correct. In those cases the recommendation is usually something else: adjusting footwear, reviewing training load progression or working on foot and hip strength.
Custom doesn't mean made from a generic mould
A custom insole is designed with the data from your analysis: the material is chosen according to your weight and activity, the thickness and stiffness of each area are decided, and only the corrections the analysis justifies are included. It isn't the same insole for a distance runner as for someone with a diabetic foot, even if both have the same type of arch.
After delivery
Getting used to them takes a few days and it is normal to notice them at first. A review after a few weeks is advisable to check that foot support has changed as expected and make adjustments if needed. Children's insoles need reviewing more often, because the foot is still growing.
