By Jeff Stewart – Podiatrist (B.Pod La Trobe, M.A.Pod.A) | Manly Cove Podiatry
If you have been dealing with foot pain – whether it is heel pain from running along the Manly beachfront, arch pain from the Manly to Spit walk, or general foot ache from long shifts at work – someone has probably mentioned orthotics. And once you start looking, you quickly discover just how many options exist, from $20 insoles at the chemist to custom orthotics prescribed by a podiatrist on the Northern Beaches.
What most people do not realise is that orthotics are not a simple two-way choice. There are actually three distinct tiers, and understanding the difference between them is what helps you make the right call for your situation.
What Are Orthotics, Exactly?
Orthotics are inserts that sit inside your shoe and change the way your foot loads and moves. Depending on the type and design, they can redistribute pressure, support the arch, correct alignment, reduce strain on specific structures, and improve the mechanics of how you walk and run.
Foot orthotics are used to treat a wide range of conditions – plantar fasciitis, shin splints, Achilles tendinopathy, bunions, knee pain, and more. But not all orthotics do the same job, and that is where a lot of people get confused.
Tier 1: Pharmacy and Online Insoles
What They Are
These are the pre-made insoles you can pick up at the chemist, a sports store, or order online without seeing anyone. They come in standard sizes, are designed around a generic foot shape, and provide a basic level of cushioning and arch support.
When They Work – and Where They Fall Short
They have their place. If you need extra padding for a one-off long day on your feet, or want to try orthotics for the first time before committing to anything more, they are convenient and inexpensive. But because they are built for an average foot, they cannot account for your specific foot structure, gait, or the mechanics driving your pain. They also tend to flatten and lose their support fairly quickly.
A lot of patients come to me having spent months in pharmacy insoles without improvement, assuming orthotics just do not work for them. Usually the issue is not orthotics – it is that what they were using was never designed for their feet.
Tier 2: Practitioner-Supplied Prefabricated Orthotics on the Northern Beaches
The Middle Tier Most People Don’t Know Exists
This is an option that sits between the chemist shelf and a fully custom device, and it is one that does not get talked about enough. At Manly Cove Podiatry, we stock a range of practitioner-grade prefabricated orthotics – a step above what you find in a pharmacy, and supplied as part of a proper clinical assessment so the right device is selected for your specific needs.
Assessed, Selected, and Adjusted to Suit You
The key difference is not just the quality of the product – it is the process. We assess your foot structure, gait, and the mechanics driving your pain, then select and modify the device in-clinic to suit your individual requirements. That might mean adding extra heel cushioning, adjusting the arch height, or posting the device to correct a specific alignment issue – the kind of adjustments that make a real clinical difference.
For many patients across Manly, Balgowlah, Freshwater, and Seaforth, a practitioner-supplied prefab with the right modifications is the most appropriate solution. It provides genuine clinical benefit at a lower cost than a fully custom device, and we can fit and adjust it on the same day. It is a particularly good option for children whose feet are still growing, or for patients who need something quickly while a custom pair is being made.
Tier 3: Custom Orthotics Prescribed by a Manly Podiatrist
What Makes Them Different
Custom orthotics are prescription medical devices made specifically for your feet from the ground up. The process starts with a thorough biomechanical assessment – looking at your foot structure, joint range of motion, gait, calf flexibility, and the loading patterns contributing to your problem. We then take a 3D scan of your feet, and the orthotic is fabricated to match your exact contours and clinical requirements.
Who Needs Custom Orthotics?
The result is a device that addresses the specific mechanical issue driving your pain – not just generic arch support. Custom orthotics for plantar fasciitis, Achilles tendinopathy, and other biomechanical conditions are designed for different footwear types, can be made from materials suited to your activity level, and can be fine-tuned over time as needed.
Custom orthotics are significantly more durable than prefabricated options, and most private health funds provide a rebate toward the cost when prescribed by a podiatrist. Worth checking your extras cover before assuming it is fully out of pocket.
At a glance
| Pharmacy / online | Practitioner prefab | Custom prescribed | |
|---|---|---|---|
| Fit | Generic – average foot shapes | Prefab base, modified in-clinic for you | Made specifically for your feet |
| Lifespan | Months – varies by use | Longer than pharmacy – varies | Several years with normal wear |
| Addresses cause | No – generic cushioning only | Partially – with in-clinic modifications | Yes – designed around your biomechanics |
| Assessment | No – over the counter | Yes – practitioner supplied | Yes – biomechanical assessment + 3D scan |
| Health fund | Not covered | Check your extras cover | Yes – with podiatrist prescription. Check your extras cover |
| Best for | Mild, short-term relief | Moderate conditions, fast turnaround | Complex or ongoing conditions |
How Do You Know Which Orthotics You Need?
There is no universal rule – it depends on what is driving your pain, how long you have had it, and what you are asking of your feet day to day. A runner training for the Manly Triathlon has different needs to someone on their feet all shift at a Northern Beaches cafe, or a Dee Why or Brookvale office worker with plantar fasciitis. A few useful questions to ask yourself:
- Has the pain been going on for more than 6 to 8 weeks without improving?
- Have you already tried pharmacy insoles without lasting relief?
- Does the pain return every time you increase your activity?
- Have you been told you have flat feet, high arches, or a structural issue with your feet or lower limbs?
- Is the pain affecting how you walk, train, or get through a working day?
If you answered yes to any of the above, a proper orthotics assessment in Manly is worth it. Not because custom orthotics are automatically the answer – sometimes they are not the right solution at all, and there are better treatment options – but because you need to understand what is actually driving the problem before you can address it properly.
That is what the assessment is for. We look at the whole picture: foot structure, gait, footwear, activity levels, and history. If orthotics are appropriate, we prescribe exactly what your feet need. If something else will work better, we will tell you that too.
What About Private Health Insurance?
The rebate you can claim depends on your level of extras cover and the type of orthotic prescribed. Custom orthotics prescribed by a podiatrist generally attract the highest rebate. Practitioner-supplied prefabricated orthotics may also be covered depending on your fund and policy. It is worth calling your health fund before your appointment to check exactly what you are entitled to, and bring your card along so we can process it on the spot via HiCaps.
At Manly Cove Podiatry, we stock practitioner-grade prefabricated orthotics that we can modify and individualise in-clinic, as well as fully custom prescribed devices following a biomechanical assessment and 3D scan. We have been fitting orthotics on the Northern Beaches since 1994. We do not supply pharmacy or online orthotics – everything we fit is practitioner-grade. We will always recommend what is right for your situation, not just the most expensive option. If you are unsure where to start, book an assessment and we will work it out together.
Book a shin splints assessment at Manly Cove Podiatry
Book online: manlycovepodiatry.com
Call us: (02) 8966 9552
Saturday appointments available – no referral needed
