Sizes: Men’s 4 to 16.5, Women’s 6 to 14.5 | Arch Type: Neutral, low | Anti-Odor: Yes | Materials: EVA foam, silicone, fabric | Our Overall Rating: 4.2/5 Sizes: Men's 4.5 to 14.5, Women's 5.5 to 15.5 | Arch Type: High | Anti-Odor: Yes | Materials: Polyurethane foam, gel, plastic | Our Overall Rating: 4.8/5

The main objective of this review was to understand whether the amount of the angulation of the wedge influenced the EKAM and KAAI in patients with medial knee OA. It was our hypothesis that larger angulations would lead to a higher effect. However, the effect size of insoles with wedges ≤5° (SMD = − 0.22) and the effect size of insoles with wedges > 9° (SMD = − 0.30) are very similar for the first peak and for the second peak EKAM. For KAAI, because was retrieved only one study ( n = 18) [ 25] that studied insoles with a wedge greater than 9°, it is not possible to form any conclusion. An emerging problem that would require further analysis is related to the correct adjustment of the insoles to each patient. Apparently, there is no research investigating an optimal dose–response concerning the degree of lateral wedge insoles for each patient based on biomechanical factors. From our knowledge, only one study attempted to examine the effect of incrementally increasing lateral wedge amounts on EKAM [ 47]. However, a key limitation of that study was that the participants were healthy and young. The authors tested seven inclinations of lateral wedging (0°, 2°, 4°, 6°, 8°, 10°, 12°). Yet, it is curious that with an insole angled at 2°, the average reduction was surprisingly 6.4% in the first peak EKAM and 5.1% in the KAAI, values that are similar when compared to studies with participants with medial knee OA, where insoles with angles of 5° and 6° are typically applied [ 8, 13, 26]. Some studies have attempted to apply lateral wedge insoles in a customization way but based on other indicators such as subjective comfort, pain relief, or static pedometer evaluation [ 16, 19, 48, 49, 50]. Their conclusions seem more promising than traditional applications based only on one degree for all individuals. In the study by Barrios et al. [ 48], the authors observed an increased EKAM over time (1 year) in the control group but not in the intervention group and, within the intervention group, the mechanical effectiveness of the lateral wedging did not decrease over time. However, the extent of these effects remains ambiguous, with some authors suggesting that the effect size of the decrease in load on the medial compartment observed with lateral wedge insoles is too small to be clinically relevant such as reducing pain or symptoms [ 15, 27, 51]. On the other hand, other authors [ 22, 52] suggest that minor changes in knee load may have a positive effect on patients’ symptoms given the number of steps taken per day (about 6500) [ 51]. An interesting question that has not yet been answered is whether a difference of 1 or 2 degrees in the wedge could have an impact on the biomechanical parameters and, in particular, on the patient’s complaints over a long time, especially when referring to a chronic and evolutive disease with a great impact on patients’ health-related quality of life [ 53]. We know that the biomechanical response to insoles by patients with similar characteristics presents a considerable variability. Do these have to be worn under my current insole? Some of my shoes do not have enough room for two inserts.

Also worth noting: These insoles have earned the American Podiatric Medical Association's (APMA) Seal of Approval, meaning a group of podiatrists has determined that they help promote better foot health. An anti-odor coating prevents unpleasant smells from building up over time, keeping your shoes fresh. And we like that their slim, low-profile design allows them to fit in most shoes without any extra trimming. Searching for custom insoles that don't cost a fortune? We highly recommend Fulton's The Athletic Insoles. As you wear them, these durable cork and foam insoles mold to the shape of your feet to provide support exactly where you need it the most. We love that this feature makes them suitable for people with all arch types, whether yours are high, low, or neutral. Antimicrobial technology helps prevent odors from building up over time, while the four-way stretch fabric stops blisters before they start. And we love that these insoles are a solid value, at around a third of the cost of some of our other favorites. Lateral wedge insoles are traditionally used to reduce the adduction moment that crosses the knee during walking in people with medial knee osteoarthritis. However, the best degree to reduce knee joint load is not yet well established. Methods

If pain is on the inner side of the knee, on what side should the higher side of the wedge be placed? 2. What is the angle of the wedge- 5 degrees? Arnold JB, Wong DX, Jones RK, Hill CL, Thewlis D. Lateral wedge insoles for reducing biomechanical risk factors for medial knee osteoarthritis progression: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2016;68(7):936–51. Electronic databases were searched from their inception until May 2017. Included studies reported on the immediate biomechanical effects of different degrees of lateral wedge insoles during walking in people with knee osteoarthritis. The main measures of interest relating to the biomechanics were the first and second peak of external knee adduction moment and knee adduction angular impulse. For the comparison of the biomechanical effects of different degrees of insoles, the studies were divided in three subgroups: insoles with a degree higher than 0° and equal to or lower than 5°; insoles higher than 5° and equal to or lower than 9°; and insoles higher than 9°. Eligible studies were pooled using random-effects meta-analysis. Results For those dealing with plantar fasciitis, or painful irritation in your plantar fascia tissue, we recommend Walk-Hero's Comfort and Support Plantar Fasciitis Insoles. They helped revamp our old shoes, correcting overpronation while reducing the pain and pressure we felt in our arches. We also like the deep heel cup, which offers great stability. Iijima H, Fukutani N, Aoyama T, Fukumoto T, Uritani D, Kaneda E, et al. Clinical phenotype classifications based on static Varus alignment and Varus thrust in Japanese patients with medial knee osteoarthritis. Arthritis Rheumatol. 2015;67(9):2354–62.Hunt MA, Takacs J, Krowchuk NM, Hatfield GL, Hinman RS, Chang R. Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study. J Foot Ankle Res. 2017;10:20. Yes, two things to try. First, try two Lateral Sole Wedges in one shoe. If you're treating the left foot, take the right Lateral Sole Wedge and do a 180 with it, putting it in the left shoe (bottom side up). Then take the left Lateral Sole Wedge and put it on top of the right one. Now you have two Lateral Sole Wedges in one shoe, right? This will only work in tennis shoes or work boot in that they'd have enough room to fit both lateral sole wedges. Abdallah AA, Radwan AY. Biomechanical changes accompanying unilateral and bilateral use of laterally wedged insoles with medial arch supports in patients with medial knee osteoarthritis. Clin Biomech. 2011;26(7):783–9. We love that PowerStep's Original Insoles earned the APMA's Seal of Approval. However, the arch support was so high that it made the toe boxes of our shoes feel tight. Sasaki T, Yasuda K. Clinical evaluation of the treatment of osteoarthritic knees using a newly designed wedged insole. Clin Orthop Relat Res. 1987;221:181–7.