So much of the use of foot orthotics is based on compromises. The ideal foot orthotic and the ideal foot orthotic prescription is often modified away from that ideal to take into account the footwear that they are to be used in. This is particularity a problem in things like tight football boots or ballet flats when you need some form of arch support. These types of shoes are not designed for any sort of support or foot orthotic to go into them. They are minimalist by design. Often what I do for these types of patients is use a self adhesive silicon gel arch support which takes up very little room, but does give some support. There is a little bit of trial and error to get the placement in the shoe right for comfort. It is less than ideal, but better than nothing.