Within physiotherapy there has been a big trend to distinguish between active and passive treatments with the general considerations that active treatments are better and the evidence does generally link better outcomes coming from the active treatments. Passive treatments are generally those that are done to the patient such as manipulations, massage, TENS and dry needling. Active treatments are those that the patients does to themselves such as exercises.

Given this division within physiotherapy, the question comes up as to if foot orthotics come under the active or passive category. I assume the answer to this could be based on someone’s preconceived biases as they want them to be a passive treatments when active treatments are seen as better. I do not think foot orthotics come under either category. Arguments could be made either way. There are other types of treatments that do not fit into one or the other category either, so why would you want to try and put them into one or the other? Is there any point trying? If you need foot orthotics, you need foot orthotics. If you don’t need them, then you do not need them. Does it matter if they are considered active or passive treatments?

I do agree that active interventions are probably preferable for a whole lot of reasons that I will not get into here. That does not mean that there is anything wrong with passive treatments (but there is a lot wrong with some of them and others do not have a lot or any evidence supporting them). For example, what is wrong with self massage for plantar fasciitis with something like a PediRoller? Passive treatments are probably better options during the acute phase of an injury.