What Features Should Shoes for Orthotics Have? The Complete Checklist

A removable insole is the single most important feature in any shoe you plan to wear with orthotics. Without it, your orthotic will sit on top of the factory insole, raising your foot too high inside the shoe. This causes heel slip, cramping across the top of the foot, and instability.

Your orthotic needs to rest directly on the midsole of the shoe, in the space the factory insole occupied. That is the only way it can function as intended.

In-shop test: reach inside the shoe, grip the insole near the heel, and give it a gentle pull upward. If it lifts out cleanly without resistance or tearing, the shoe passes. If the insole is glued down, move on to the next shoe.

Even after removing the factory insole, the shoe needs enough internal depth to accommodate your orthotic plus your foot. Many fashion shoes are simply too shallow, because they are designed for appearance rather than to hold an insert.

Extra depth means there is sufficient vertical space inside the shoe so that your foot is not pressed up against the upper or forced into a cramped position across the toes and instep.

In-shop test: compare the thickness of your orthotic to the thickness of the factory insole you just removed. If your orthotic is noticeably thicker, you need a shoe with extra depth. Try the shoe on with your orthotic inside and check that there is no pressure on the top of the foot.

The heel counter is the rigid cup built into the back of the shoe. Its job is to hold your heel firmly in place and stop it from rolling or slipping. When you wear an orthotic, a firm heel counter becomes even more important, because the device raises the heel slightly and any lateral movement is amplified.

In-shop test: pinch the back of the shoe between your thumb and forefinger. A good heel counter will resist the pressure and spring back to shape. If it collapses easily or feels soft and floppy, the shoe will not hold your heel securely over the orthotic.

Laces, Velcro straps, or buckles allow you to fine-tune the fit around the instep after inserting the orthotic. This is essential because the orthotic changes the internal volume of the shoe, and you need a way to compensate.

Slip-on shoes, ballet flats, and most loafers offer no adjustment at all. Once the orthotic is inside, you have no way to tighten the shoe to prevent movement.

In-shop test: with the orthotic inside, fasten the shoe and check that you can snug the instep comfortably. You should be able to tighten or loosen the fit without creating pressure points.

A wide, rounded, or square toe box gives your toes room to spread naturally. This is important for everyone, but especially for orthotic wearers, because the device can push the foot slightly forward inside the shoe.

Pointed or narrow toe boxes compress the toes, which can cause blisters, bunions, and pain, particularly if you already have a foot condition.

In-shop test: with the orthotic inside and the shoe fastened, wiggle your toes. You should be able to move all five toes freely. If any toe is pressing against the side or front of the shoe, the toe box is too narrow or too short.

The NHS generally recommends a maximum heel height of 3 to 4 centimetres for orthotic wearers. Anything higher tilts the foot forward, destabilises the orthotic, and shifts pressure onto the ball of the foot.

This applies to all footwear, including trainers with thick platform soles. A flat-soled trainer with a 4 cm platform and no drop is different from a heeled boot with a 4 cm heel, but both add height that can affect how your orthotic sits.

In-shop test: place the shoe on a flat surface and look at it from the side. The heel should be close to the same height as the forefoot. If the heel is visibly elevated, measure it and keep it under 4 cm.

Your orthotic needs a firm, stable platform to sit on. Shoes with air bladders, gel pockets, liquid-filled compartments, or extremely soft foam midsoles can interfere with the way the orthotic controls your foot.

These cushioning technologies are designed to compress and bounce back, which sounds appealing, but they create an unstable surface underneath your orthotic. The device cannot do its corrective work if the ground beneath it is constantly shifting.

In-shop test: press your thumb firmly into the midsole (the layer between the outsole and the insole). It should feel firm with a small amount of give. If your thumb sinks in deeply or the sole feels like a sponge, the shoe is too soft for reliable orthotic use.

Use this table as a reference every time you shop for orthotic-compatible shoes:

Feature	What to Check
Removable insole	Grip and lift the insole near the heel. It should come away cleanly.
Extra depth	Compare orthotic thickness to factory insole. Try on with orthotic inside.
Firm heel counter	Pinch the back of the shoe. It should resist and spring back.
Adjustable fastening	Laces, Velcro, or buckles. Avoid slip-ons.
Wide toe box	Wiggle all five toes freely with the orthotic inside.
Low heel (under 4 cm)	View from the side on a flat surface. Measure if unsure.
Stable sole	Press thumb into midsole. Should be firm with slight give.

Do I need to buy specialist orthopaedic shoes?

Not necessarily. Ordinary shoes from mainstream brands will work perfectly well if they have all seven features listed above. Specialist shoes are useful when you have a particularly thick device or unusual foot shape, but they are not always required.

What about shoes with memory foam insoles?

Generally, no. Memory foam compresses unpredictably over time and creates an unstable surface for the orthotic. Remove the memory foam insole and replace it with your orthotic device instead.

Can I just pick any mainstream trainer brand?

No. Compatibility depends on the individual shoe model, not the brand. One trainer from a brand may have a removable insole and firm heel counter, while another model from the same brand may not. Always check each shoe individually.

How long should orthotic-compatible shoes last?

Most well-made shoes will last 12 to 18 months with daily wear. Running shoes may need replacing sooner. See our guide on how long orthotics and shoes last for detailed advice.

Buying for a child? School shoes have specific requirements. Read our guide on features to look for in school shoes for orthotics.

Browse our full Orthotic Shoe Buyer Guide for more detailed advice on every aspect of buying shoes for orthotics.