Close Look at Orthotics Raises a Welter of Doubts

[Greg Mihalik]

Interesting, verrry interrresting….

Close Look at Orthotics Raises a Welter of Doubts

[W I S N E R !]

Fascinating that they found orthotics can cause 50% more muscle work in some cases.

I will not cast doubt on those that claim orthotics work for them personally, to each their own, I can't argue with your experiences.

But I have to wonder:

1. Whether or not they're simply "helping" with problems created by footwear to begin with.

2. Most importantly, how much of this is about making the Almighty Dollar through creating fear, doubt, and "required equipment" to participate in the oldest physical activity on Earth. When a shoe store sells you a pair of $120 shoes and then turns around and suggests you that you also need a $30 pair of Superfeet and a few $15 dollar pairs of socks…

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I can't help but contrast this with a few million years of human evolution with nothing but bare feet or woven plant or hide/leather soles.

I just don't subscribe to the idea that we're born with broken running mechanics and need technology to fix it. I've been suckered on that route; motion control shoes and "doctor recommended" technology on my feet led to nothing but injury. I went the opposite route (barefoot/minimal) and all the problems of my past went away.

[James holden]

tres interessant ….

[Steven Hanlon]

in July of 2009 i developed very painful plantar fasciitis on my left foot. by that fall, i was unable to walk and went to the doctor. after some x-rays the diagnoses was confirmed, PF. the first thing the foot doc did was try and sell me custom foot beds for my shoes. i declined.

after nearly a year i am now able to hike a full weekend without pain. i do get some soreness in the morning, but after a mile or so, everything is warmed up and feels good.

how did i recover? i simply stretched, kept off my feet, and got better fitting shoes. i did use some off the shelf foot beds to add some cushioning, but nothing corrective.

now i have 30 additional pounds to shed that i gained sitting around for a year while healing

[Roger Caffin]

Hi Craig

> I just don't subscribe to the idea that we're born with broken running mechanics and need technology to fix it.

You are absolutely right.
But this is not going to help the retailers who need your wallet … :-)

Cheers

[Joshua Gray]

Actually not that interesting. The problem is that many healthcare providers are just prescribing orthotics because that's what patients ask for. See it all the time.

If you look into his results, they proved beneficial for the most commonly prescribed reasons for orthotics, plantar fasciitis and tibial stress fractures. But, most of the data he is pulling from were underpowered studies, so the results of his analysis is also underpowered.

Since there are a vast difference in types of orthotics and methodology for using them, such a review article would have to break each type of orthotic down by density of material, reason for prescribing, methodology for fitting orthotics, etc…in which you would have to have an extremely large cohort to do.

Enough for my rant, just tired of news talking about research that is poorly done then spoon feeding it to the public like it is the almighty truth. Considering I'll be a physician soon enough, it also worries me that a lot of my colleagues don't know how to objectively look at research either.

I do agree with you all, for the most part, we don't need any sort of orthotics and that minimalist shoes would probably help the vast majority of people. BUT there are people that orthotics do benefit. I have seen it work for a lot of athletes i have worked with in the past for foot and tibial stress fractures and also for plantar fasciitis. Of course, we prescribed them for the short term and eventually transitioned them back to normal footwear.

Lastly if you are talking about gel inserts and smartfeet sort of stuff, they are nearly worthless if you have properly fitted shoes.

[Diane “Piper” Soini]

>2. Most importantly, how much of this is about making the Almighty Dollar through creating fear, doubt, and "required equipment" to participate in the oldest physical activity on Earth. When a shoe store sells you a pair of $120 shoes and then turns around and suggests you that you also need a $30 pair of Superfeet and a few $15 dollar pairs of socks…

Exactly.

I hiked the PCT in 2008 and was driven off the trail because I bought motion control shoes that gave me stress fractures. My feet were fine before those shoes and within 100 miles of those shoes my feet were killing me.

In 2009 I bought more flexible shoes and never had any trouble.

Nowadays I've been experimenting with making my own shoes. My shoes aren't perfect, but they do lack arch support, motion control and a raised heel. They are totally flat. My feet only hurt now because of flaws in my shoemaking, never because of the lack of arch or heel rise. In fact, that part feels so much better, as does the enormous toe box I built.

[Roger Caffin]

Hi Joshua

I understand your concern, but how about these paragraphs from the article?

'Every medical specialist Jason has seen tried to correct his flat feet, but with little agreement on how to do it.
Every new podiatrist or orthopedist, he told me, would invariably look at his orthotics and say: “Oh, these aren’t any good. The lab I use makes much better ones. Your injury is probably linked to these poor-fitting orthotics.” '

Cheers

[W I S N E R !]

I like what I've seen of your shoes so far Piper, I'll have to PM you about a few details as I want to give it a go as well.

[Greg Mihalik]

Roger,
Re-read Joshua's post. Aside from disliking the less-than-scientific approach, he said…

"I do agree with you all, for the most part, we don't need any sort of orthotics and that minimalist shoes would probably help the vast majority of people. BUT there are people that orthotics do benefit…. Of course, we prescribed them for the short term and eventually transitioned them back to normal footwear."

Now all that has to happen is the attempt at a well controlled, cross-matched, double-blind study. Of course, that's not likely – I can imagine the outcome.

[Joshua Gray]

Roger,

Like Greg pointed out, I agree with the minimalist footwear movement with special exceptions I went into in my previous post. And I would love to see someone try to do a proper study of orthotics and the response by the orthotics community if it were actually published…haha, like that will ever happen.

The article gives you no insight into why Jason was prescribed the orthotics in the first place. Thats the advantage of reporters, the ability to state only what they want, to support their story. Was it simply b/c he had flat feet? Did he have some other pathology going on at the time? I do agree flat feet don't just need to be corrected for no reason. And eventually almost all should be weaned off the orthotics. The ortho I used to work with often remarked "if it ain't broke, don't fix it!" We saw a lot of athletes with pes cavus, pes planus, bad q angles, and many other so called medical problems, but they had no pain or mality, and were playing at a D1 college level and we didn't do a darned thing. And you have to think a lot of practitioners do just keep prescribing things for the almighty dollar, don't need to go any further that the recent cardiac stent fiasco…but that's a whole other beast.

-Josh

[Joseph Reeves]

"… Every new podiatrist or orthopedist, he told me, would invariably look at his orthotics and say: “Oh, these aren’t any good. The lab I use makes much better ones. Your injury is probably linked to these poor-fitting orthotics.”

The same thing was told to me by three podiatrists. I bought a new pair of orthotics from the second podiatrist, but told the last one the story and explained I wasn't going to fall for it a third time. I've since replaced orthotics with superfeet and am far better off both physically and financially.

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