adjusting to orthotics

Why not walk around barefoot to actually strenghten your weak muscles?

If your feet are arching then you should try massaging the bottom of them with a golf ball.

I love how some people say strengthening is always the cure to everything. What if you have a biomechanical issue that cannot be resolved just by strengething. I'm not saying that strengthening doesn't work because most of the time it does. If a runner has a degree at the subtaler joint or is just structural built inefficiently, sometimes orthotics are the only way to go, you gotta give yourself a chance.

I have been doing a lot of foot strengthening in addition to having been given orthotics. Barefoot walking, balance exercises, you know the things to get at the root of the issue because I realize orthotics are a crutch of sorts and would eventually like to gradually wean myself off of them if that's a possibility. Just wondering if it's normal to have different aches and pains when starting out running in them, or if everything just feels awesome straight away.

Yes, an adjustment period is definitely needed. But after a month you should start to feel adjusted. Maybe it has not been a month since the last adjustment to the orthodics was made and this could be a factor? I hope they work out for you, and I say definitely continue the strengthenin exercises, but you are right, strengthening alone may not be enough. Especially if it has already been a couple of months with that routine.

Let me know how they turn out, I am breaking in a new pair myself these days.

It depends on the design of the orthotic device and type of correction along with the shoe you're wearing it in. Most of us who prescribe orthotics put our patients on a wear schedule, starting with one hour the first day and progressing an hour each day from there. With runners, its a matter of using the devices for short runs at first and building mileage per run over several weeks. It takes several weeks for ones feet and lower legs to adjust to and orthotic (toughening the tendons, bones and ligaments) Typically, you get a few more problems with a more aggressively designed device (such as a MASS device such as a Sole Support design or a Blake inverted design), because of their high medial longitudinal arch positions.

For some, an orthotic is a bridge device; you use it to allow soft tissue structures to heal and in the interim allow the runner to get back to training, and then wean them off of it. During the weeks that the runner uses the device you get them involved in corrective exercise. Saying all of that, exercise just doesn't correct all of the problems - its not just a matter of weaning everyone down to barefoot/minimalist training. Some runners need orthotics long-term; their plantar support structures are trashed, their windlass mechanism doesn't work because of limited 1st MTP motion, etc. For those, all of the barefoot running in the world won't strengthen their intrinsic foot musculature, posterior tibs and such to change their foot position during mid-stance and push-off. I've found that you have to look carefully/slo-mo at one's barefoot and shod running on the treadmill and not just rely on the biomechanical exam when fitting/adjusting orthotics.

Saying all of that, I do believe that most of us do need to do some barefoot training, generally recommend more minimalist footwear if the runner's structure will allow it and recommend lower leg training, balance training, plenty of hip abductor/pelvic girdle and plank exercise to build neutral trunk stability.

Probably more info than you wanted with all of the above - Get back with your PT and keep on working on finding the right balance.