Runners with hip, knee, foot or ankle problems face a really big challenge.

For some people, small anomalies in these areas can be barely noticeable. But for long-distance runners who log a lot of kilometres a week? Huge.

Eventually, custom orthotics may be the answer to keeping lower extremities fit, healthy and injury- and pain-free. Orthotics are designed to correct biomechanical problems in the lower extremities by re-aligning the foot into a more healthy movement pattern. Ranging from over-the-counter arch supports that cost about $20 to a pair of custom-made models that will set you back between $350 and $500, orthotics can be found in the shoes of many active individuals.

MIXED FINDINGS

Are they the answer to every ache and pain from the hip down? Scientists aren't sure. For every study that suggests orthotics help, there's another that finds the opposite. Despite the lack of hard scientific evidence that orthotics can reduce the risk of foot injury, a good number of people who have tried them like them.

A 1991 study in the American Journal of Sports Medicine reported that 75.5 per cent of the long-distance runners polled claimed that orthotics led to complete resolution or at least great improvement of their lower-extremity complaints, including hip, knee, foot and ankle problems. So satisfied were they that 90 per cent continued to use orthotics even after their problem was resolved.

And for those who suffer from plantar fasciitis, an inflammation of the ligament at the bottom of the foot, orthotics have been credited with reducing pain by 80 per cent.

Before you go out and invest in something extra to put in your shoe, take note that not all athletes get relief. Some studies have reported a significant number of participants who gained little relief from orthotics; some orthotics users noted an escalation of symptoms or experienced new complaints after their use.

REPETITIVENESS INCREASES RISK

Why the varied findings? Poorly aligned feet aren't the only cause of lower-extremity injury. Improper training practices, including too many hours spent running or walking, inappropriate shoes, unsuitable terrain, previous injuries and years of running experience are all linked to injury, which makes it tough to pinpoint the cause of the problem.

According to Montreal-area podiatrist Glenn Hebert, it's the repetitiveness of activity that increases the risk of overuse injuries.

Combine repetitive motion and flat, high-arched or flexible feet and it's a safe bet that pain will follow. And even if you've been pain-free so far, there's no guarantee you'll stay that way. Feet change over time. They can even get longer and more lax after pregnancies, which is common.

TAKE THE RIGHT STEPS

So what do you do if your feet are giving you problems? Visit a podiatrist, preferably one who has experience working with athletes, or a sports medicine professional for a biomechanical exam. Bring your athletic shoe and be prepared to answer questions about your training habits.

If you're lucky, a simple over-the-counter device can realign your feet and get rid of the pain. For more complicated problems, a custom-made orthotic may be in the cards.

To make a custom device, the podiatrist will take a mould of your foot and, depending on your activity and your foot, build an orthotic of either rigid, soft or semi-rigid materials.

Once you've made the investment, be it $20 or $300, give your feet time to get used to the orthotic. Hebert suggests cutting your mileage for the first few runs and then slowly increasing it back to your normal level.

If your pain doesn't diminish or if new symptoms appear, return for a follow-up visit. It's possible the correction was too aggressive, says Hebert.

So the next time one or more of the 26 bones, 33 joints, 107 ligaments and 19 muscles and tendons in your foot give you a problem, consider getting your feet examined by a professional before you run or walk yourself into an injury that won't go away.

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WHAT TYPE OF FOOT DO YOU HAVE?

Here is an informal test you can use to find out whether you have an anomaly:

Pour an inch of water into a shallow pan big enough to put your foot in.

Place a length of paper towel beside the pan. Step into the pan, wet the bottom of one foot and then step onto the paper towel with your wet foot.

Look at the shape of the print your foot leaves on the towel. If you see the ball of your foot, toes and heel connected by a wide band on the outside of the foot, your foot is normal.

If you see the shape of your entire foot, or close to it, you have flat or flexible feet.

If the print shows the ball of your foot, toes, heel and a narrow band along the outside of your foot, you have a high arch.

Ran with fact box "What type of foot do you have?", which has been appended to the story.