Help for painful feet

Odilo, what do you do as an orthopaedic shoemaker at Transa?
We are a team of four who work at the branches in Zurich Europaallee, Markthalle Bern and Lucerne. Customers are often directed to us by the sales advisors – they are qualified experts and recognise more serious problems straight away. Then we take a closer look. We consider the person’s entire body, not just their feet. How are the knees and hips positioned? What does everything up to the head look like? We want to find out why the customer’s shoes don’t fit or why they have pain in their feet or musculoskeletal system. Then we can target these problems with our insoles.

What are the most common problems that customers come to you with?
We get flat feet, fallen arches and splayed feet. Bunions develop when the arch of the forefoot sinks in. Most people come with forefoot problems because this area suffers from too much pressure. Heel spurs or Achilles tendon problems usually come from heel misalignment. Our job is to find a solution for every problem.

So your job only starts when someone has already decided on a shoe?
Customers often come to us with a couple of recommendations from the sales advisors. We then see whether anything can be improved by adding an insole. If necessary, we also discuss alternative models, because the shoe and insole have to go together. But we don’t just make insoles for our own shoes; we also make them for shoes bought elsewhere. We differentiate between standard insoles, orthopaedic insoles and proprioceptive insoles. Standard insoles are pre-shaped and are available off the shelf with three different arch elevations. These can often help if the customer has fallen arches, flat feet or splayed feet. We custom-make orthopaedic insoles for our customers. The idea here is to provide the best possible support for the foot and relieve pain points. The entire arch of the foot is supported and the pressure spread over as large an area as possible.

Do proprioceptive insoles have a different approach?
Yes, exactly: the aim of these insoles is to allow and actually encourage foot movement. The problem areas on the foot are corrected mechanically. This changes the tension in the muscles in a positive sense: if muscles are too weak, they have to work harder, and if they are too strong, they can relax. The aim is to create harmony. The muscle chain must adapt to these changes all the way to the top – this results in improved statics and dynamics.

How exactly does this work?
With proprioceptive insoles, the foot isn’t in contact with the insole over its entire area. We work very selectively with three to five points in the heel and forefoot area. The heel is the control centre of our foot, and we can often correct problems in the forefoot by aligning the heel. Then there are one or two other possible points of support in the forefoot. The midfoot, though, has complex muscles and joints whose movements we don’t want to restrict and tendon insertions that we don’t want to aggravate. So we don’t make any corrections in this area to avoid causing this aggravation.

That sounds uncomfortable…
It’s true that proprioceptive insoles aren’t that comfortable at first. The insoles take around two weeks to get used to if the customer wears them every day. But if you have the time and are prepared to really commit to the insoles, they provide sustainable correction and are a long-term solution to problems.

Are there cases where you simply can’t help?
Yes, we have those too. For example, if someone has a severe hip problem, I wouldn’t just go ahead and make just any correction. It’s extremely important to carry out a thorough assessment so that we can recognise these types of cases. We work closely with various therapists and refer customers with these kinds of serious pre-existing conditions to them.

What does an appointment with you involve?
At appointments arranged in advance online or by phone, we analyse your feet and gait. We will feel your foot, look for pain points and check your mobility manually. We then use a scan, a video recording and a pelvic test to analyse the structure and dynamics of your feet and your whole body. After this analysis, which takes about an hour, we discuss our recommendations with you. If you decide for insoles, we will custom-make them for you – this takes about one to two weeks. You can test the insoles on site for the first time at the second appointment. After another two to three weeks, we will arrange another appointment for a follow-up check. If your symptoms have not improved after the acclimatisation phase, you can come back to us and we will make further adjustments.

What does the orthopaedic service involve?
You’ll find all the shoe expertise you need in Markthalle. Our team of experts, made up of shoe consultants and the Orthobox team, is on hand to help find the best possible shoe for your needs. At a pre-arranged appointment, we can examine your feet in detail and analyse your gait. Based on this, we will then make the right insoles for you.

Can you help me if the soles on my hiking boots are worn out?
Yes, that’s often possible. The best thing to do is to bring your boots to our shop, where we will check whether it is possible to re-sole them.

How much do these insoles cost?
The consultation is always free for the customer. Standard insoles cost CHF 50 to 60, and if you need forefoot adjustments, you will need to pay another CHF 40. Orthopaedic and proprioceptive insoles both cost CHF 410 each. Often, however, the costs are covered by health insurance or supplementary insurance – customers should check this in advance. We are officially recognised by the health insurance companies, and most of them require a doctor’s prescription. We then issue a reimbursement voucher that the customer can submit to the health insurance company.

You seem to be a fan of proprioceptive insoles. Why is that?
I like the long-term and holistic approach of them. Ideally, having a proprioceptive insole means that the customer no longer needs an insole in the long term because the problems have been resolved and the body takes over the correction itself. But don’t get me wrong: the conventional orthopaedic insole absolutely has its place and there are cases where it is the better choice. At the end of the day, what counts is that the customer is free of pain and can walk freely, for example when hiking in the mountains.