What evidence is there that orthotics have any benefit?

Not sure about probation, but orthotics are essentially placebos.

none. wooooo

there is a difference between orthotics and orthosis's. there are many types of orthotics(OTC inserts/functional/accomodative/UCBL etc).

you can buy OTC Dr. scholls inserts. they wont provide much more than cushion and comfort-which is what some people need to feel better.

some people need more than that. young and active people that suffer from common foot ailments(plantar fasctiis, capsulitis, post tib tendinitis, etc) may need something more controlling like a functional orthosis. these can be made from plaster or 3D foot strike mapping. Its true that some people dont need these but if they are made correctly, they can absolutely help.

Accommodative orthotics are more for diabetic patients with pedal prominences-hence "accommodating"

Some parts of biomechanics are based on theory but to answer your question,yes orthotics can most definitely help and there are studies to prove it.

Make sure the orthotics are custom made, not some store that will ask you for $400 and claim they are custom made. they are a rip off and its sad to see people spend so much money and not get any relief.

I asked for evidence, not arbitrary claims that beg the question.

Well, without my orthotics (prescription, fitted to compensate for weak arches) my chondromalatia patella would have eventually kept me from running at all

I asked for evidence, not anecdotes.

Podiatry = Foot Chiropractic wrote:

I asked for evidence, not anecdotes.

You're confused. An anecdote may not be proof but it is indeed evidence. As a lawyer I can tell you that most personal testimony in a courtroom is anecdotal if you think about it, and if you have a sufficient number of anecdotes, they can deemed proof.

I could not run without orthotics due to plantar fascitis.

hate them. makes my feet work harder and I get PF.

STFU

ive got completely flat feet and have never run with any orthotics. i get different injuries ranging from short/ long term mainly in my right leg. i recently went for a running form analysis at a uni that found i land mid foot on my right and heel strike on my left. i also roll significantly inwards when landing and my pelvis also moves far too much.

i am getting orthotics as a last roll of the dice as in the last 5 years i would say i have been injured 60% of the time. and i seem to be picking up long term injuries every 3 months meaning im not able to get in pb shape.

if it stops me paying 100s a month in physio bills etc im definitely going to try it

Barefoot running cures flat feet.

There isn't any evidence that I'm aware of that pronation causes injuries. I believe that was essentially propoganda started by people who wanted to sell you things.

There are however a spattering of studies that have shown a modest reduction in injury rates. These are usually in populations of military recruits with no injury history, hence the results are for the prevention of acute injury and not the treatment of chronic injury.

Orthotics are not really a cause-prevention measure; they are for symptom treatment. They are demonstrably useful in case studies of chronic injury where the underlying cause cannot be removed, like some kind of physical/mechanical abnormality. It is the same for every part of your body. Everything works perfectly well as provided unless there happens to be some kind of defect present.

If you want to know more then post up and I'll go find some links for you when I have time.

PV runner wrote:

Podiatry = Foot Chiropractic wrote:

I asked for evidence, not anecdotes.

You're confused. An anecdote may not be proof but it is indeed evidence. As a lawyer I can tell you that most personal testimony in a courtroom is anecdotal if you think about it, and if you have a sufficient number of anecdotes, they can deemed proof.

I could not run without orthotics due to plantar fascitis.

As a lawyer, I can also tell you that testimony of a lay person is insufficient to prove something that requires expert testimony. And expert testimony cannot be based on anecdotal evidence.

There have been lots of studies on orthotics.

People do report relief for various injuries when they wear orthotics. But, interestingly, studies have shown that overpronation does not necessarily cause these injuries.

My personal anecdote is that I have low arches that will break down and fail when running longer distances. I have many times tried running with and without orthotics. With a very minimal soft orthotic, I have generally been injury free for several years. Without orthotics, I have had a number of injuries (metatarsal stress fracture, plica syndrome, Achilles, upper hamstring).

I do not think we really understand the biomechanics of injury simply because it is impossible to find two runners who run the same and have the same injury.

In the real world of actually treating patients, what research shows doesn't really matter at all. Research rarely if ever, proves something beyond a doubt. Research done on a clinical setting may not translate into the real world settings. You can't possibly account for all the variables that can influence outcomes. The purpose of research is to give researchers jobs.The only thing that really matters is what works for the individual. Some people cannot run pain free without orthotics. These people probably have never scoured the internet for research on how orthotics could help them or for what injuries. There are other people who continue to get injured, even with orthotics.Anecdotal evidence given by thousands and thousands of people has as much credibility as a single study with thousands and thousands of participants.Just because they didn't work for you doesn't mean they won't help someone else, regardless of whether or not there is research to support it or not. Keep in mind that those who rely solely on research says and use that as a badge of honor are idiots.

Podiatry = Foot Chiropractic wrote:

The idea behind foot orthotics is that probation causes injuries when ambulating. What evidence is there to support this claim and the claim that orthotics reduce injuries?

Podiatry = Foot Chiropractic wrote:

The idea behind foot orthotics is that probation causes injuries when ambulating.

This may be true for some orthotics, but it is certainly not universally true.

Podiatry = Foot Chiropractic wrote:

The idea behind foot orthotics is that probation causes injuries when ambulating. What evidence is there to support this claim and the claim that orthotics reduce injuries?

Here are three studies that discuss the efficacy of orthotics in treating plantar fasciitis:

Pfeffer, G.; Bacchetti, P.; Deland, J.; Lewis, A.; Anderson, R.; Davis, W.; Alvarez, R.; Brodsky, J.; Cooper, P.; Frey, C.; Herrick, R.; Myerson, M.; Sammarco, J.; Janecki, C.; Ross, S.; Bowman, M.; Smith, R., Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciits. Foot & Ankle International 1999, 20 (4), 214-21.

Landorf, K. B.; Keenan, A.-M., Effectiveness of Different Types of Foot Orthoses for the Treatment of Plantar Fasciitis. Journal of the American Podiatric Medical Association 2004, 94 (6), 542-549.

Roos, E.; Engström, M.; Söderberg, B., Foot orthoses for the treatment of plantar fasciitis. Foot & Ankle International 2006, 8 (27), 606-611.

The general consensus from the research is that orthotics do seem to help with plantar fasciitis, but it's not entirely clear how—custom orthotics, for example, don't actually outperform over-the-counter insoles like SuperFeet, which indicates that there is not a strong understanding among DPMs about the biomechanics that underpin designing a custom orthotic.

Many podiatrists would have you believe otherwise—one of the most fascinating things for me is the huge controversy in the podiatry world about the best "system" to design orthotics. You can picture it sort of like debates on LRC about training philosophy: a lot of hot air and anecdotes, but essentially no science supporting either side. Two podiatrists could prescribe a totally different orthotic to the same patient for the same problem.

With regard to other injuries, the evidence is lacking. This study found orthotics as a successful way to prevent shin splints in military recruits:

Moen, M. H.; Tol, J. L.; Weir, A.; Steunebrick, M.; De Winter, T. C., Medial tibial stress syndrome: a critical review. Sports Medicine 2009, 39 (7), 523-546.

But there is no research on orthotics for shin splints in a non-military setting. Research on other injuries is either lacking or not supportive of orthotic use. Most injuries above the ankle appear to be more related to proximal mechanics (i.e. the hip) than distal mechanics (i.e. the foot) anyhow.

This study, for example, found that orthotics conferred no additional benefit when added to a rehab program for patellofemoral pain syndrome ("runner's knee")

Collins, N.; Crossley, K.; Beller, E.; Darnell, R.; McPoil, T.; Vicenzino, B., Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. British Journal of Sports Medicine 2009, 43 (3), 163-168.

The leading theories on orthotics now are not that they necessarily change foot motion. Instead, they alter the distribution of forces within your body. So if you pronate a lot, and you wear orthotics, you're still going to pronate just as much. The difference is that the structure of the orthotic is going to alter the way the forces of walking or running are distributed in your foot and in your leg. You could imagine how this could be a good or a bad thing depending on the individual biomechanics of the person in question. It's possible to design an extremely aggressive orthotic that would actually alter foot mechanics in a meaningful way, but good luck trying to run in that.

There are a few large controlled studies underway that should provide more answers on to what extent orthotics can be useful. No clue on the timeframe for them, though.

What, specifically, do you mean when you say a "soft" orthodic? Perhaps a gel insole? What brand? I have tried various kinds, and while they seem to help with my feet, I think they have brought about problems elsewhere (medial knee and and lower hamstring/tendons). Out of all of the OTC orthodics, I have concluded that the Dr. Scholl's "Sport" is probably the best. It has softness, but some decent arch support, too. Some of the the more expensive types (such as SuperFeet) seem way too hard.

outsiderunner wrote:

What, specifically, do you mean when you say a "soft" orthodic?

Very basically, going by the different types of orthotics/orthoses that I have used to help me, a "soft" orthotic is made out of a sort of EVA type of material whereas a "hard" orthotic is made out of a carbon fibre or hard plastic type of material.

My podiatrist explained quite clearly how chondromalacia patella is caused by flat feet (or weak arches):

When the foot lands the inside collapses slightly as the arch flattens. This very slight downward motion on the inside (medial) of your leg causes your knee cap to also pull very slightly to the side. So instead of tracking "in line", it is jerked out of line and the patella cartilage is being subjected to abnormal rubbing against the thigh bone. The rubbing causes inflammation and eventually cartilage damage- it will begin cracking and flaking off.

The orthotic supports the arch and prevents the out of line ("jerking" or "yanking" is the word she used) movement of the knee cap.

Here's the NIH:

http://www.nlm.nih.gov/medlineplus/ency/article/000452.htm