Why Feet Cause So Many Problems (and What Orthotics Actually Do): Dr. Zac Answers Your Top Questions

Hi — I’m Dr. Zac Cartun, Chief Medical Officer and Co-Founder of Stride Soles, and today I’m answering some of the most common orthotics questions I get through email.

These are questions people ask when they’re dealing with foot pain, thinking about custom orthotics, or simply trying to understand why something as “small” as the feet can cause such big problems.

Let’s jump in.

And as always: if you want to keep the conversation going, email us at team@stridesoles.com

Question 1: Why do feet cause so many problems in the first place?

This is a great question — and honestly, it’s not surprising once you understand what the foot is doing all day.

According to the American Medical Association, about 80% of adults experience quality-of-life-reducing foot pain at some point. Meaning: it’s not just annoying soreness — it’s bad enough that people actually change their daily habits. They stop walking as much. They skip activities. They stay in more. That’s a big deal.

And think about the downstream effects:

• lost work productivity

• fewer social plans

• exercise avoidance

• long-term deconditioning

• chronic compensation injuries

So why does it happen?

Because the foot is insanely complex.

The human foot contains:

• 26 bones

• 33 joints

• tons of ligaments, tendons, fascia, muscle layers

• and multiple interacting planes of tissue that have to coordinate perfectly

And the foot has one main job: support your entire body weight — repeatedly — all day — every day.

Now add the modern problem:

The ground is not forgiving.

We spend most of our time walking on concrete, asphalt, hardwood floors — surfaces that the human foot was never designed for.

So what did we do to fix that?

We invented highly cushioned shoes.

Which helps… but also creates new issues.

For example:
Cushioning lets people do heavy heel striking — slamming the heel into the ground with every step.

If you try that barefoot, your body would immediately say:

“Nope — absolutely not.”

But with thick cushioning, it feels okay in the short term… while quietly transmitting abnormal force up the body over time.

That constant impact doesn’t just stay in the heel — it moves up what we call the kinetic chain, meaning:

foot → ankle → knee → hip → pelvis → spine

That’s why foot issues can become body issues.

Question 2: Do flat feet or high arches automatically mean you need orthotics?

No — and this one matters.

Terms like:

• flat feet

• high arches

• pronation

• supination

…are descriptions, not diagnoses.

They classify what a clinician sees.

They do not automatically reflect what a patient feels.

Here’s the simple truth:

Orthotics are designed to reduce pain and prevent injury.

So if you’re not in pain, you don’t have an urgent need for orthotics.

That said — structure still matters.

If someone has flat feet or high arches, it often means:

• your gait may be less efficient

• you may be compensating without realizing it

• your risk of irritation/injury over time is higher

So even without pain, orthotics can still provide preventive benefit, especially if you’re athletic, on your feet all day, or already noticing wear patterns or asymmetry.

But if you are in pain?
Then I highly recommend changing something — not necessarily only orthotics, but also:

• physical therapy

• better footwear

• mobility and strengthening work

• activity modification while healing

Orthotics are powerful — but they’re part of a bigger system.

Question 3: Can orthotics actually change the way I walk?

Yes — and this is one of the most important concepts.

Orthotics can make gait more efficient, but not because they magically “transform” your foot overnight.

Instead, orthotics help by changing how forces are distributed.

Let’s take an example:

If you have severe heel pain…

You’re going to subconsciously avoid the heel.

That means you’ll start:

• shortening your stride

• landing on the forefoot/midfoot

• walking stiffly

• shifting weight asymmetrically

And now — you’ve created a new problem: compensation.

It’s extremely common for people to think they have “random hip pain” or “mysterious back tightness,” when the real issue is:

“I’ve been walking weird for months.”

A properly designed orthotic redistributes pressure away from painful zones — so you can regain a more normal heel-to-toe gait.

That’s why many people feel relief not only in the foot… but also in the hips and lower back.

Question 4: Do athletes actually get a performance boost from orthotics?

This answer is both yes and no.

The myth:

Orthotics will not suddenly make you:

• sprint faster

• jump higher

• dunk a basketball

• play soccer like Messi

• shoot a perfect round of golf

There’s a whole industry that sells “instant performance miracles.”

Be skeptical of that.

The reality:

Orthotics can improve performance over time because they:

• reduce fatigue

• improve movement efficiency

• reduce injury risk

• allow more training consistency

So it’s not “instant +20% athleticism.”

It’s “slightly better mechanics and fewer setbacks,” which compounds over weeks/months.

There’s also a reason many elite athletes use orthotics. If you look at NBA players’ footwear setups, orthotics are extremely common — because even tiny efficiency gains and injury prevention matter a lot at high levels.

Question 5: What’s the biggest misconception about custom orthotics?

This one might be my favorite question.

The biggest misconception is:

Orthotics only solve foot problems.

Yes, orthotics can help with:

• plantar fasciitis

• heel pain

• metatarsalgia

• Achilles tendonitis

• pain from flat feet/high arches

But the real story is bigger.

Foot pain creates chain reactions.

If the outside of your foot hurts, you’ll shift inward.

Then you stress the ankle.

That changes knee mechanics.

That alters hip alignment.

That shifts pelvic movement.

Then your spine compensates.

Suddenly you’re dealing with:

• knee pain

• hip pain

• lower back pain
  …and you think it’s unrelated.

A lot of people assume lower back pain is purely about sitting — and yes, sitting all day doesn’t help.

But many issues come from:

• heel striking

• asymmetry

• poor balance of stance

• repetitive inefficient mechanics

Orthotics can help realign the entire base of movement — which can have effects far beyond the feet.

Final Thoughts

Today’s episode was a short Q&A — just me — but I hope it clarified something important:

Your feet aren’t a minor part of your body.
They’re the foundation.

And if the foundation is misaligned or painful, the entire structure compensates.

If you want to ask follow-up questions or share your situation, email us at:
team@stridesoles.com

Thanks for listening — and I’ll see you next week.