By: Ellie Barziv, Senior Editor
For many older adults, mobility challenges often begin at the feet. A slight arch collapse, ankle instability, or joint pain may seem minor at first, but over time, they can impact everything from posture to independence. Fortunately, orthotics offer a highly effective and non-invasive solution. Whether it’s standing longer, walking farther, or simply regaining confidence on uneven ground, orthotics help seniors move better and feel better.
According to the CDC, nearly one in four adults aged 65 or older report falling each year, and over 800,000 of them are hospitalized due to injury, many of which are preventable with proper mobility support¹. For aging adults who want to maintain an active, independent lifestyle, addressing foot alignment and stability isn’t just smart, it’s essential.
As we age, the tendons and ligaments in our feet naturally weaken. This can lead to discomfort or instability, but the right orthotics can provide critical support, improve alignment, and reduce strain with every step.
What Are Orthotics and Who Needs Them?
Orthotics are supportive devices designed to enhance the body’s movement. They may be inserted into shoes (foot orthotics) or externally fitted around the ankle and leg (ankle foot orthoses, or AFOs). Orthotics work by correcting misalignment, improving balance, and relieving pain, especially in cases of arthritis, post-stroke weakness, neuropathy, or tendon degeneration.
“As we age, the tendons and ligaments in our feet naturally weaken,” says Bradley Sweatt, board-certified prosthetist and orthotist and founder of Prosthetic & Orthotic Associates of South Carolina. “That’s why we see more cases of pes planus, or flat foot, which occurs when the arch collapses.” Flat feet don’t just affect the foot; they can throw off your entire body’s alignment, leading to knee pain, hip strain, and even lower back issues. With a properly fitted custom orthotic, the arch is supported, the heel is aligned, and pressure is distributed more evenly across the foot. The result? Less pain, more movement, and better long-term joint health.
Custom vs. Over-the-Counter: Why Fit Matters
While drugstores offer a range of generic insoles, there’s a critical difference between over-the-counter inserts and custom orthotic solutions. “Over-the-counter orthotics are made to fit the average foot,” explains Bradley. “But very few people have an average foot. Custom orthotics are designed based on a full evaluation of your joint motion, strength, and biomechanics.”
During a fitting, a certified orthotist will assess how the foot and ankle move, measure range of motion, and evaluate muscle strength. For example, someone with weak dorsiflexion (the ability to lift the foot) may need a posterior leaf spring AFO to help clear their toes when walking. But if they also have weak plantarflexion (pushing down), a ground reaction AFO offers more control and energy return.
A study published in The Journal of Foot and Ankle Research found that custom orthotics significantly improve pain, function, and walking performance in older adults, particularly when compared to standard insoles. The more precise the fit, the more impact orthotics can have, not just on your feet, but on your whole mobility experience.
A Life-Changing Return to the Court
Orthotics are not just about walking comfortably, they’re about reclaiming the life you love. Bradley recalls one particularly moving case: a former pickleball enthusiast who suffered a stroke, resulting in left-sided hemiparesis (muscle weakness on one side of the body). “They couldn’t walk safely, much less play a sport,” Bradley said. “But their goal wasn’t just recovery. It was to get back on that court.” He fitted the patient with a custom AFO that stabilized the ankle, corrected the foot’s position, and provided a dynamic push-off with every step. Combined with physical and occupational therapy, the patient gradually returned to their active lifestyle and to the social life that came with it. “Pickleball wasn’t just exercise,” Bradley emphasized. “It was friendship. Purpose. Joy. The orthotic gave them the foundation to build all that back.”
Myth-Busting: Do Orthotics Weaken Muscles?
There’s a common myth that orthotics can make muscles weaker over time. In reality, it’s quite the opposite, properly designed orthotics support your muscles in a way that encourages natural movement, especially when alignment issues or joint degeneration are involved.
A study in Gait & Posture found that older adults using custom orthotics not only improved balance and walking speed, but also reported higher confidence and reduced fear of falling.“By offloading strain and encouraging proper movement, orthotics can enhance function and strengthen the right muscle groups,” Bradley explained. “It’s not about relying on a device, it’s about enabling the body to do more with less pain.”
Signs It Might Be Time to Consider Orthotics
You don’t have to be recovering from surgery or a major injury to benefit from orthotics. Most people who seek orthotic support are simply dealing with everyday mobility limitations they’ve learned to live with, but shouldn’t have to.
Common signs you may benefit from orthotic support include:
- Frequent tripping or unsteady gait
- Heel, ankle, or arch pain after light activity
- Difficulty walking long distances or standing for extended periods
- A history of stroke, neuropathy, or foot drop
- Joint pain in the knees or back related to alignment issues
If you’re nodding yes to one or more of these, it may be worth getting evaluated by a board-certified prosthetist or orthotist.
Your Next Steps
Getting fitted for orthotics is easier than you might think. While some patients are referred by their doctors or physical therapists, others reach out directly to a certified clinic. The process begins with a conversation, what hurts, what’s changed, and what matters most to you.
“Orthotics aren’t about limitations,” Bradley says. “They’re about possibility. We want people to feel strong, safe, and independent again, no matter their age or condition.” For older adults who want to stay active, stay social, and stay upright, orthotics may be the smartest step forward.
meet the expert
Bradley Sweatt is a board-certified prosthetist orthotist and the founder of Prosthetic & Orthotic Associates of South Carolina, based in Charleston. He holds a Bachelor of Science in Biochemistry from Charleston Southern University and a Master of Prosthetics & Orthotics from Northwestern University. Bradley is known for his expertise in developing innovative, patient-centered orthotic and prosthetic solutions that help individuals regain mobility and independence. His mission is to empower people to live full, active lives and to redefine what they believe is possible.
This article is for informational purposes only and does not replace professional medical advice. Consult a qualified healthcare provider with any health concerns.
