Podiatrist · Specialist in Biomechanics · Founder of VOLKAN
"The tools do not make the body strong or weak. It is the work that the body stops doing or regains thanks to them."
"And what if my foot gets used to them later?"
I remember a patient who held his insoles in his hand while we talked.
He hadn't used them yet.
He looked at them with some distrust.
—Doctor… what if later my foot can’t live without them?
It was a completely understandable concern.
For years he had heard that insoles "fit" the foot, that they make the muscles work less and that, sooner or later, the body ends up depending on them.
Instead of answering directly, I asked him a question.
—If you wear glasses to read, does that mean your eyes become lazy?
He smiled.
He understood that the answer couldn't be that simple.
The body responds to demands
Throughout this book, we have repeated an idea many times.
The organism adapts to the work it performs.
A muscle that receives an adequate stimulus improves its capacity.
A tendon that bears progressive loads reorganizes its structure.
The nervous system learns when it participates.
But the opposite also happens.
When a function is not used for a long time, the organism stops investing so many resources in maintaining it.
Not because it is lazy.
Because biology is extraordinarily efficient.
It conserves what it needs.
It reduces what it no longer uses.
A aid is not a condemnation.
Imagine a person with an injured ankle.
For several weeks, they use a crutch.
The crutch reduces part of the load.
It allows walking with less pain.
It facilitates healing of the tissues.
Would we say that the crutch has weakened the leg?
No not exactly.
It has temporarily reduced the work that leg had to do because there was a reason for it.
The problem would arise if the person continued using the crutch many months after recovering, when there was no longer any need.
With orthotics, something similar happens.
The usefulness depends on the context.
And also on the moment.
Offloading is also part of the treatment.
There is a deeply rooted idea in our culture.
More effort always means more improvement.
However, the body does not work that way.
When a tissue is overloaded, continuing to demand the same rarely speeds up recovery.
Many times the opposite happens.
It needs a temporary reduction in demand to reorganize.
An orthotic can help precisely in that process.
Not because it replaces the foot.
But because it redistributes part of the work while the body regains capacity.
The discharge is not the enemy of adaptation.
In many cases, it is the first step for that adaptation to occur.
Regain protagonism
The objective of a good intervention should never be for the organism to depend indefinitely on assistance.
It should be to regain, whenever possible, the functions it can perform again.
Sometimes that means maintaining an insole for many years, because there is a structural pathology that justifies it.
Other times it means using it only during a specific stage while tissues regain load tolerance.
The decision never depends on the object.
It depends on the evolution of the person.
What does this have to do with barefoot?
A lot.
During the last chapters, we have seen that more flexible footwear allows the foot to participate more actively in movement.
That does not automatically make barefoot the best option for any moment.
In the same way, an insole can temporarily reduce part of the work of certain structures without that representing a problem.
The question remains the same.
What does this organism need now?
It is not about choosing between barefoot or insoles.
It is about understanding when to favor greater participation of the foot and when it is advisable to temporarily relieve a function to allow the organism to continue adapting.
Biomechanics does not confront tools.
It puts them at the service of people.
What I see every day in consultation
Often, the best results appear when the treatment evolves at the same pace as the patient.
There are people who start needing significant help.
Over time, that help may be reduced.
Or modified.
Or maintained because it continues to serve a function.
There is no single correct outcome.
What matters is that each decision has a clinical sense.
When the treatment is reviewed and adapted to the evolution of the organism, it ceases to be a rigid solution and becomes a living process.
And the body always responds better to living processes than to inflexible recipes.
What you can do starting today
If you use orthotics, ask yourself something different.
Not just:
"Do I need them?"
Also ask:
What function are they helping to perform?
And, every now and then, review that answer with the professional who prescribed them.
Because the organism changes.
And a treatment that was perfect five years ago may need adjustments today.
Not because it was wrong.
But because you are no longer exactly the same person.
🔬 In a sentence
An orthotic does not weaken the foot by itself. What changes the organism is the amount of work that its tissues perform while using it.
The most important idea
Orthotics do not strengthen or weaken the body simply by existing.
They are a tool to modify how loads are distributed and how certain structures participate during movement.
At times, reducing the workload of a tissue allows it to recover and resume its function with greater capacity.
In other cases, maintaining assistance remains the best option because the body's demands require it.
The key is never in the tool.
It is in understanding what function it is performing and whether that function is still necessary.
Because the goal of any treatment is not to create dependency.
It is to provide the body with the conditions to move with the greatest effectiveness, safety, and freedom possible.
A question to reflect on
Think of any support you have ever needed.
A pair of glasses.
A cane.
A splint.
A seatbelt in a car.
Was the problem using that aid… or stopping to ask yourself if it was still necessary when circumstances changed?
Perhaps with orthotics, the same thing happens.
In the next article…
After talking about the foot, footwear, orthotics, and movement, there is still a question that frequently arises in consultation.
What happens when the pain does not go away, even though the structure seems to be fine?
Many people live with persistent discomfort despite imaging tests showing few changes or even normal results.
In the next chapter we will return to one of the most fascinating ideas of pain neuroscience: the organism can continue to protect a tissue that has already healed.
We will discover why, at times, recovery is not about repairing the body further, but about helping the brain to trust it again.