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If you’re suffering from foot, leg or back pain, perhaps you have tried over-the-counter (OTC) retail insoles (also called prefabricated insoles) to ease your discomfort. Maybe you have even tried custom medical orthotics that were prescribed for specific ailments. In either case, both options have pros and cons which we will help explain.

The Quick Fix - OTC Insoles

If you’re in overall good health, there’s no harm in trying OTC insoles. Studies show that the nonprescription variety can be as helpful as custom versions for certain conditions (Berkeley Wellness). For instance, in a 2014 study in Musculoskeletal Care, people with plantar heel pain who wore prefabricated insoles for eight weeks had the same reductions in pain and disability as their counterparts who wore custom orthotics—at considerably lower cost. Though OTC insoles can be 1/10th the cost of custom medical orthotics ($15 - $50), there are often tradeoffs in terms of support, firmness, durability, and comfort.

OTC insoles fall into 3 categories:

  1. Foam insoles. When first inserted in shoes, foam insoles usually provide some level of comfort. However, due to lack of firmness, they offer minimal arch support. In addition, foam inserts tend to degrade very quickly and have a wearable life of less than 2 weeks.
  2. Gel insoles. Gel typically provides more support than foam but, because they offer no firmness, gel inserts are not considered a viable solution for long-term ailments.
  3. Rigid inserts. Rigid inserts are usually a piece of hard molded plastic placed under the heel or arch. Although they do provide support for those areas and are typically the least expensive OTC option, most people aren’t comfortable with this level of rigidity.

The Costly RX – Custom Medical Orthotics

If you have a serious foot, knee, hip, or back problem, it is well advised to see a doctor first, preferably a Podiatrist, Certified Pedorthist or Orthotist. Custom medical orthotics require a physical exam and digital foot mapping. Given this fundamental difference, custom medical orthotics can bio-mechanically correct / address the way you personally experience knee, heel or arch pain, and some lower back issues (Podiatry Today). They may also be recommended for specific biomechanics issues or health conditions.

Custom medical orthotics have the obvious benefit of being crafted to treat specific ailments for individual feet, but they also offer a longer wearable life (3-5 years is suggested) (Pain Science). However, their extended useful life is due to a higher level of rigidity than most OTC insoles. Though they may treat or provide support to specific areas of the foot, the rigidity may also cause additional discomfort and can become an issue if a foot or ailment profile has changed over time.

The biggest deterrent people face when considering custom medical orthotics is cost. Typically, they range between $400-$600, which amounts to more than 10x the cost of prefabricated insoles. Thus, if a less-costly OTC solution will ease a foot or lower body extremity ailment, most consumers are apt to go in that direction.

The Best of Both Worlds – Adjustable Arch Control Insoles

OTC insoles are accessible to everyone at retailers and pharmacies everywhere for reasonably low prices. However, they don’t always provide enough support due to the nature of the materials and one-size fits all mass manufacturing. On the other hand, custom medical orthotics may make a difference when OTC remedies fall short, but they can also be cost prohibitive as well as too rigid, causing discomfort and other issues.

Luckily, there is a new solution that provides customizable comfort, dynamic support and longer-lasting durability at near OTC prices.

SelectFlex arch control insoles are the best of both worlds. Uniquely, the patented SelectFlex PowerLIFT Arch™ (PLA) is the only insole technology that lifts the arch into correct anatomic alignment, simultaneously providing therapeutic benefits and comfort (ISHN April 2020). With the turn of a key, the SelectFlex PLA is easily customizable to 3 stiffness levels that conform to each individual’s arch and can be adjusted for either foot or type of activity. The chart below clearly illustrates the many enhanced benefits of SelectFlex in comparison to OTC retail insoles and custom medical orthotics.

The ultimate benefit of SelectFlex insoles are felt at day’s end, when dynamic alignment, arch support and energy return leave feet feeling comfortable and refreshed, even after walking miles. Studies show the SelectFlex PLA achieves 52% more arch support with each step in the gait cycle, and the PowerCup™ Heel provides 50% more ankle stability. When combined with the cushioning and moisture wicking PowerBed™, premium engineering and materials, SelectFlex insoles deliver maximum comfort and long-lasting durability at 1/4 the cost of medical orthotics.




 May is Military Appreciation Month and May 16th is National Armed Forces Day. SelectFlex dedicates this Blog Article to all active and retired military personnel who have protected us and made our country great. 

PROBLEM – Soldier Injuries Caused by Carrying Excessive Rucksack Loads

When Soldiers and other Service Members are deployed, they not only risk injury and death from combat, but are also exposed to a range of other health threats that may have a negative impact on the mission performance and readiness. (WRAIR: Soldier Health)

Soldiers and Marines in Iraq and Afghanistan routinely carry between 60 and 100 pounds of gear including body armor, weapons and batteries. The heavy loads shouldered over months of duty contribute to the chronic pain soldiers suffer. Muscle strain is a short-term condition that has always been prevalent among soldiers but, after years of war, the number of acute injuries that have progressed to the level of chronic pain has grown significantly.
(NPR: The Weight of War)

A regular rucksack may look similar to a tactical rucksack but they serve two very distinct purposes. The daily rucksack may carry anything from 50 pounds of rocks on a hike to clothes and camping equipment for survival training drills. On the other extreme, tactical backpacks used in combat or simulation exercises average roughly 100 pounds and can get as heavy as 175 pounds. Because the excessive weight compresses or stretches the nerves to the arm, backpack palsy is an increasing problem among military soldiers, who report numbness, weakness, and even paralysis.

Soldiers Foot Related Over-Use Problems Decrease Combat Readiness

  • 80% of soldiers feet roll inward or pronate, creating painful misalignment and overuse injuries overtime, exacerbated by Rucksack loading.
  • Varying and excessive pack-weight loads cause substantial pain and impair function, reducing mobility and survivability while in combat1.
  • Load related injuries and chronic conditions of the lower extremities (feet /ankles / lower back) hinder mission effectiveness for recruits during basic training and soldiers in infantry units.
  • Supporting Variable Rucksack loads puts enormous strain on the arch of the foot and plantar fascia tendon group, that must unload and absorb compressive pack-weight loads, negatively affecting gait and diminishing mission readiness.
  • Acute and chronic injuries to feet, knees, hips and lower back occur due to the imbalance and misalignment of the musculoskeletal structure, when the foot arch fails to support lower extremities, especially under excessive load.
OBJECTIVE – Reduce Long Term Injuries and Increase Combat Readiness


There is an African proverb that states, “It takes a village ...” This maxim also holds true for the holistic approach required for soldiers who are ready, lethal and able to meet the Army’s needs. (AUSA – Health Soldier, Ready Soldier)

There is an African proverb that states, “It takes a village ...” This maxim also holds true for the holistic approach required for soldiers who are ready, lethal and able to meet the Army’s needs.
(AUSA – Health Soldier, Ready Soldier)

Soldiers feet and lower extremities endure significant hardship due to excessive pack weight carried in the field. Alliance Design & Development Group (ADDG), the designers of SelectFlex, have undertaken the challenge of building a Military-grade insole to support the unique requirements of soldiers. Our patented Variable Resistance Beam (VRB) technology provides selectable levels of suspension to augment and support natural body movement, particularly under load.

The SelectFlex Military version will maintain up to 25 pounds per step, or up to 50,000 pounds per mile of vertical lifting arch support. To put that into perspective, our SelectFlex retail insole provides 3 selectable support settings, with a range of 11 to 17 pounds per step, or 20,000 to 30,0000 pounds of arch lifting support per mile. For the average person, this amount of arch support surpasses the needs of the daily grind of civilian life.

The strain and stress of extreme loads can cause acute and chronic foot injuries, which ultimately leads to diminished combat readiness. Promoting proper pronation and arch deformation control improves balance, ankle stability, and proprioception in the lower extremities under load, regardless of terrain, environment or variable pack weights.

The SelectFlex Military-grade insole will be the only fully adjustable, customizable on demand in-field, all terrain orthotic that’s built for soldier’s boots. They will preserve energy consumption, optimize effectiveness, and help keep warriors in the highest state of readiness.

SOLUTION – Protecting Soldier’s Feet Under Heavy Pack Weight Load

SelectFlex is engineered to provide adjustable dynamic support to meet the variable compressive pack weight load demands on the foot arch of the modern soldier, where the vast majority of injuries originate. It can also provide the warfighter selectable suspension technology to customize and dynamically correct imbalances of the foot and ankle on the move in theater.

The SelectFlex arch suspension system for civilian retail is currently marketed as the PowerLift Arch™, but the same principal applies to military use. Studies have shown that SelectFlex delivers up to 52% increased arch support to help protect feet under heavy pack weight loads. Additional insole benefits for personnel include:

  • Lifts the foot into correct comforting alignment with 3 Selectable Arch Deformation Control Settings providing continuous, Anti-Pronating, Dynamic Alignment and Energy Return to the lower extremities under load
  • Allows for dynamic proportional support to the variable loads placed upon the foot arch throughout the entire gait cycle, custom conforming to each unique arch shape
  • Reduces pronation, aversion and knee deviation under load
  • Improves balance and proprioception in the lower extremities
  • Provides optimal mobility by improving gait under load

ADDG is looking forward to introducing its military version of SelectFlex, which will provide soldiers with dynamic arch support to help relieve the pressures of variable compressive pack weights and alleviate over-use injuries. Our mission is to support our soldiers and keep them battlefield ready.

  1. Dean C. The Modern Warriors Combat Load, Washington D.C. Department of the Army, Army Center for Lessons Learned, 2003
  2. George SZ Childs JD, Teyhen DS, et al. Rationale, design and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009) BMC Musculoskeletal, 2007)
  3. Quinnipiac Motion Analysis Lab Study Phase 1 completed in Jan 2020







SelectFlex is dedicating this Blog Article to the Nurses who take care of us all when we are sick and in need. Today is the start of National Nurse’s Week, which culminates on Florence Nightingale’s birthday, the founder of modern nursing.



Under normal circumstances, Nursing is a demanding profession but, lately it’s become even more stressful. Nurses are known for taking care of others at the cost of their own well-being. Lack of self-care can lead to excessive fatigue and personal health issues. When a nurse takes the time to care for themselves, not only do they feel better, but colleagues and patients benefit as well. However, it’s not as easy as it sounds to create a work-life balance in addition to being a nurse role model.

Nurses especially, but also teachers, construction workers, hospitality workers and anyone else who spends a great deal of time on their feet, know the toll standing for long periods can take on the body. If the job requires standing for lengthy periods without rest, it can cause a wide variety of problems, particularly if combined with poor posture or shoes that don’t provide adequate support. These issues, over time, go far beyond tired feet and can develop into chronic foot pain and other ailments like plantar fasciitis.

1. Prioritize Foot Care

When standing, the same foot muscles strain repeatedly, as pressure remains constant. However, when walking about, the pressure shifts to and from different areas of the foot because the same muscles aren’t working all the time. Tired, achy feet are normal after standing all day but if feet hurt in one particular area after a long shift, it may indicate a need for more foot support.

Foot and leg swelling is a common consequence of working on the feet all day Foot care specialist Tamika Saunders, owner of Priority Feet in Grayson, Georgia, suggests nurses also take time after work to soak their feet in warm water with Epsom salt for about 10 to 15 minutes to loosen tight muscles, which can decrease inflammation and soreness. Although spending time and money on proper foot care may seem like a low priority compared to other daily demands, nurses like Saunders have seen the ramifications of neglecting this part of the body. “We learn to take care of our eyes, our teeth, our hypertension, but we rarely take care of our feet until something serious develops,” she said. “If nurses start focusing more on foot care, there are ways to alleviate pain that we have become accustomed to living with on a daily basis.”

2. Keep Blood Flowing

According to the Canadian Center for Occupational Health and Safety (CCOHS), working in a standing position on a regular basis can lead not only to fatigue and lower back pain but can also cause other health problems such as sore feet, swollen legs and varicose veins. These are common complaints among Nurses whose jobs require them to stand for long periods during a shift and can often be remedied with enhanced blood flow.

A good starting point to increase blood flow and alleviate these problems is to wear knee-high compression socks. The compression of the socks pushes on the veins and in turn produces more blood flow. Nurses often use socks that are 15-20 mmHG (millimeters of Mercury). Higher levels of pressure may be uncomfortable and lower levels may not prevent swelling. For comparative context, the average pair of panty hose that women wear carry an 8-10 mmHG rating. Nurses who wear compression socks will feel better at the end of the day and will reduce the swelling in their lower extremities as well as decrease their risk of acquiring varicose veins (

Once a shift is over, put your feet up and let the body relax. Like compression socks, elevating feet at the end of a shift (or whenever possible) helps recirculate blood that has pooled in the lower legs and return it to the heart and throughout the body.

3. Focus on Footwear

Of all the things nurses can do to care for their feet, wearing high-quality, comfortable shoes is the most important important (Pain Resource). Grueling 12-hour shifts seem to go by in a snap when you’re wearing the right shoes. You may be surprised to learn that supportive footwear does more than just help keep your feet from getting tired and sore. It also supports the rest of the body, especially lower back, knees, and ankles.

Wearing the wrong shoes while at work can either aggravate existing ailments or cause new ones (i.e. fatigue, foot pain, back pain). Shoes that do not provide adequate support can harm foot arches and, in turn, affect the back. Often a well-designed orthotic shoe insert that supports proper alignment can help prevent back pain.

4. Take Proactive Steps

Nurses should be fitted for new shoes or orthopedic insoles every year and two pairs are a must, so they can be rotated between shifts. Because a nurse’s shoes and insoles are subjected to so much wear and tear, they’ll need replacing every 3-6 months. (EveryNurse.Org) 

The best orthotics for foot pain provide cushioning to relieve walking and standing pressures, as well as arch support that lifts the foot into proper alignment with ankles, knees, hips, and back. Also look for cushioned arch support insoles that will return energy to feet with each step you take throughout a shift, no matter how long it is.

When nurses are suffering from pain and fatigue, they may be less energetic and productive. Not only does morale take a hit but, it may also lead to lost-time injuries. Thankfully, solutions exist today that can reduce the impact of a tough work environment on nurses' feet. A high-quality insole foot-bed is the answer to reducing pressure and discomfort, and can make a world of difference in how feet feel.

Adjustable Arch Lifting Support

Proper foot alignment is critical to relieving foot and joint pain, as well as preventing future issues for nurses on their feet all day. That’s why we created SelectFlex insoles with the first truly adjustable arch that molds to each individual foot shape. No two feet are alike yet, most over-the-counter insoles are “one size fits all.” A key benefit of SelectFlex insoles is they provide three adjustable arch height and comfort settings to dynamically realign feet, ankles, knees, hips, and lower back into optimal position for maximum comfort and support all day long. (EHS Daily Advisor).

These 4 tips offer an arsenal of pain-fighting, energy rejuvenating tools for healthier feet. When feet feel fine, it’s much easier to keep up with call-lights, doctor’s orders, tests or emergencies, and get through long days on the job. Nurses—take care of your feet and your feet will take care of you—so you can care for everyone else.