Sprains and Shoe Inserts: Do Orthotics Prevent Ankle Injuries and Speed Recovery?

Aug, 27 2025

Ankle sprains top the injury charts, whether you run, play five-a-side, or just missed a step rushing to the bus. Ads make big promises about insoles. The real question is simple: can they actually stop sprains or help you heal faster? Short answer: they can help, but they’re not a magic fix. Your feet, your shoes, and your rehab plan all matter.

• TL;DR: shoe inserts can reduce strain and improve alignment for some people, but they don’t replace an ankle brace, good shoes, or rehab.
• Best use cases: high arches (cavus), overpronation, poor balance after a sprain, hard-floor sports, or foot pain that changes your gait.
• Evidence snapshot: ankle braces have the strongest proof for preventing re-sprains; orthotics help when foot mechanics are part of the problem.
• Start with your shoes, then try high-quality OTC inserts; go custom only if you’ve got stubborn issues or a complex foot shape.
• For acute sprains: manage swelling, support the joint, then add inserts during the return-to-activity phase.

What really links sprains and inserts

A sprain is a stretch or tear of a ligament. Most ankle sprains are lateral-your foot rolls in (inversion) and the outside ligaments get hammered. Once you sprain an ankle, the risk of doing it again climbs, because the joint gets lax and your balance sensors (proprioception) go a bit fuzzy.

So where do inserts come in? They change how your foot sits inside the shoe and how force travels up your leg. They can boost arch support, tilt the heel slightly (rearfoot posting), or add cushioning under sore spots so you don’t limp. If your foot posture makes you tip, twist, or collapse at the wrong moment, that’s where an insert might quietly keep you out of trouble.

Not all feet-and not all sprains-are the same. A few common patterns:

• High arches (cavus foot): the heel tends to sit inverted, which puts you closer to that roll-over position. A lateral forefoot post or a mild lateral wedge can help lower inversion torque.
• Flat feet/overpronation: the arch collapses, the tibia rotates inward, and the ankle drifts. A firmer arch support and heel cup improve alignment and can calm sloppy movement.
• Post-sprain wobble (chronic ankle instability): the joint is lax and the brain gets less reliable feedback. Textured top covers or firmer inserts can sharpen sensory input, though balance training still does the heavy lifting.

What the research says, in plain English:

• Prevention: Lace-up braces show consistent reductions in ankle sprain rates in athletes (around 50% in high-school sports RCTs, e.g., McGuine et al.). Inserts alone don’t show that level of prevention across the board.
• Mechanics: Foot orthoses can improve alignment and reduce pain in conditions like plantar fasciitis and patellofemoral pain. When foot posture contributes to ankle rolling, orthoses make mechanical sense.
• Recovery: Guidelines (JOSPT Clinical Practice Guideline for Lateral Ankle Sprain and Chronic Ankle Instability, 2021; NHS/NICE guidance in the UK) back early movement, progressive loading, balance work, and functional supports. Orthoses are an adjunct when foot mechanics are part of the picture.
• Proprioception: Small studies on textured insoles in chronic ankle instability show improved postural control, but samples are small and effects vary.

Takeaway: inserts can be the right tool for the right foot, especially if your foot shape is part of the problem or you’re still wobbly after a sprain. But your biggest wins still come from the basics-supportive shoes, ankle bracing in high-risk sport, and a proper rehab plan.

How to pick and use inserts for prevention and recovery

You don’t need a biomechanics PhD to make a good choice. Use this simple plan.

Step 1: Fix the shoe before you add anything

• For sport: a firm heel counter (the stiff bit around your heel), midfoot torsion control (shoe doesn’t twist like a towel), and the right width so your foot isn’t swimming.
• For daily wear: if you’re on hard floors, choose a cushioned yet stable trainer or work shoe with enough depth for an insert.

Step 2: Decide your main goal

• I roll my ankle: look for stability-firmer arch support, deep heel cup, and a mild lateral wedge if you have a high arch/inverted heel.
• My foot aches and changes my gait: choose cushioning under sore spots plus moderate support so you stop compensating.
• I’m wobbly after a sprain: consider a firmer insert or a textured top cover to nudge sensory feedback, plus balance exercises.

Step 3: Quick self-checks (2 minutes)

• Wet foot test on a paper bag: a narrow midfoot print suggests a higher arch; a full midfoot print suggests a lower arch.
• Single-leg balance: 30 seconds eyes open; then eyes closed. If you’re shaky, that’s a cue to prioritise balance work and consider a firmer insole surface.
• Shoe wear pattern: heavy outer heel wear hints at inversion tendencies; crushed medial midsole hints at overpronation.

Step 4: Choose OTC vs custom

• OTC (off-the-shelf): great first line. Look for semi-rigid shell, deep heel cup, and replaceable top cover. Price band in the UK: £20-£60.
• Custom: consider if you’ve had multiple sprains with a distinct foot shape (very high arches, marked leg length difference), stubborn pain despite good shoes and OTC inserts, or a clinician recommends it. Private UK price: roughly £200-£500; sometimes covered within NHS podiatry when clinically indicated.

Step 5: Break-in schedule

1. Day 1-2: 1-2 hours, easy walking only.
2. Day 3-4: 3-4 hours, add light activity.
3. Day 5-7: full-day wear if comfortable.
4. Sport: start with drills, then practice, then matches. If you’re in a cutting/jumping sport, still use an ankle brace during return-to-play.

Step 6: Pair inserts with the right rehab

• Early phase (acute sprain): POLICE approach (Protect, Optimal Loading, Ice, Compression, Elevation) to control swelling and pain. Inserts are optional early on; focus on comfort.
• Middle phase: range of motion, calf strength, resisted eversion and inversion, and balance training (wobble board, single-leg tasks). Now is a good time to add inserts if foot mechanics are an issue.
• Late phase: hopping, cutting, deceleration, sport-specific drills. Consider a lace-up brace during high-risk sessions for 12 weeks or longer.

When to skip or rethink inserts

• Acute swelling that makes shoes unbearable.
• Severe pain, deformity, or you can’t take four steps-get an X-ray to rule out a fracture (Ottawa Ankle Rules used in A&E).
• Numbness, color changes in toes, or new back-of-leg pain-see a clinician.

Scenarios, comparisons, and quick tools you can use

Three real-world scenarios to map your choices.

1) The runner with overpronation and repeat sprains

• Pattern: foot collapses inward, tibia rotates, ankle drifts. Long runs end with aching arches; last year’s sprain keeps nagging.
• What to try: stable running shoe, semi-rigid OTC insert with firm arch support and deep heel cup, calf/hip strengthening and balance work. Use an ankle brace for trail runs or races while you rebuild control.
• Why it helps: the insert supports the arch so your ankle isn’t chasing a collapsing foot; brace handles surprise terrain.

2) The footballer with high arches who inverts on cut moves

• Pattern: narrow heel, cavus foot, rolls laterally when changing direction. Boots are tight, stud pattern is aggressive.
• What to try: firm heel counter boots with the right width, slim-profile insert with mild lateral forefoot posting, lace-up ankle brace under socks if league rules allow, balance drills eyes closed.
• Why it helps: slight lateral posting reduces inversion torque; brace buffers the joint in chaotic play.

3) The retail worker on hard floors with a wobbly ankle

• Pattern: long stands, tired calves, ankle gives way when stepping off a curb at the end of the day.
• What to try: cushioned yet stable trainer, semi-rigid OTC insole with heel cup, calf raises, and single-leg balance twice a day. Consider a softer top cover for comfort.
• Why it helps: inserts cut pressure hot spots so you stop compensating; balance and strength handle the stability gap.

Fit and function checklist

• Heel sits centered and hugged by the cup; no lift when you walk.
• Arch feels present but not painful; mild pressure under the arch is normal for the first week.
• Toes have space; the insert doesn’t force your foot forward.
• Shoe still feels stable when you twist it midfoot in your hands.

Maintenance checklist

• Air them out nightly; remove from shoes once a week.
• Wipe with a damp cloth; avoid soaking.
• Replace top covers if worn; swap the whole insert when the shell loses spring (usually 9-18 months depending on use).

Mistakes to avoid

• Stacking soft on soft. A floppy shoe plus a spongey insert equals a wobbly platform.
• Skipping rehab because the insole “feels supportive.” Support isn’t strength.
• Buying too small. If your foot hangs over the edge, you’ll create new pressure points.
• Jumping straight into full-day wear. Your feet need a few days to adapt.

Price and lifespan guide (UK context)

• OTC inserts: £20-£60; last 9-18 months depending on mileage and bodyweight.
• Custom orthoses: £200-£500 private; lifespan 2-4 years with top cover replacements.
• Ankle braces: £20-£60; replace when the elastic loses tension.

FAQ, next steps, and troubleshooting

FAQ

• Can inserts fix an acute sprain? No. In the first 48-72 hours, manage swelling, protect the ankle, and start gentle movement as pain allows. Add inserts when you’re back in normal shoes and starting to load the foot.
• Do inserts prevent sprains? Sometimes. They help when your foot shape and mechanics put you at risk. For sport, a lace-up brace still has better prevention data.
• OTC or custom-what’s better? Start OTC. If you’ve got a very high arch, recurrent sprains, or failed OTC options, custom might be worth it after an assessment by a podiatrist or sports physio.
• Will inserts weaken my feet? No. They change load and alignment; they don’t shut muscles off. Keep doing strength and balance work.
• How long should I wear them? Daily for a few weeks, then as needed. For sport, keep them in your sport shoes. If symptoms return when you stop, consider longer-term use.
• Can kids use inserts? Yes, but growing feet change fast. Use OTC first and review fit every 6 months. Get specialist input for pain or frequent sprains.
• Do they fit in football boots? Often yes, but space is tight. Choose slim-profile models and check league rules if pairing with a brace.

Next steps (pick your path)

• I’ve just sprained my ankle: follow POLICE, consider a short period of taping or a brace for support, and book a physio if you can. Add inserts later if your foot posture needs help.
• I keep re-spraining: wear a lace-up brace during sport for the next 12 weeks, do daily balance work (eyes closed), and try a semi-rigid insert that matches your foot type.
• I have a high arch and roll often: try a mild lateral post insert, ensure your heel is well-captured by the shoe, and prioritise balance drills.
• I overpronate and get arch pain: choose a firmer arch support with a deep heel cup; strengthen calves and hips; re-test single-leg balance weekly.
• I’m not sure what foot type I have: film your bare-foot squat from the front and side; if your knees dive in or arches collapse, choose support. If ankles tilt out, consider mild lateral posting. When in doubt, see a clinician.

Troubleshooting

• Arch soreness: normal for a week. If it persists, try a slightly softer model or have a clinician lower the arch height.
• Numb toes: likely too much forefoot pressure or the insert is too long. Trim carefully to the shoe’s insole outline.
• Heel slipping: your shoe may be too big or the insert too thick. Swap to a thinner top cover or tighten the heel lock lacing.
• Knee twinges after adding inserts: reduce wear time, check that the heel is level, and avoid aggressive posting unless prescribed.
• Squeaking: dust a little baby powder under the insert or try a fabric top cover.

Credible sources behind these tips

• JOSPT Clinical Practice Guideline: Lateral Ankle Sprain and Chronic Ankle Instability (2021) for rehab, balance training, and external supports.
• NHS/NICE guidance on ankle sprain management in the UK: early movement and functional support over long immobilisation.
• Randomised controlled trials showing lace-up braces reduce ankle sprain incidence in youth sports (e.g., McGuine et al., American Journal of Sports Medicine).
• Systematic reviews on foot orthoses for lower-limb conditions showing benefits for pain and alignment, with mixed direct prevention effects for ankle sprains.

One last nudge from someone who’s rolled an ankle on a rainy pavement more than once: inserts can steady the base, but your brain-body connection is the real hero. Two minutes of balance work after brushing your teeth beats a month of wishful thinking.