Talking orthotics in laymans terms

[davidsmith]

Hi Robert and all

To kick off (excuse the pun) the new forum here’s a point of discussion. Below is an advert extract from a web site selling, what I would describe as semi custom orthoses. They describe then as sport specific; this is the football orthotic blurb.

Football ~ Rugby ~ Field Sports
Field Sports: Running on uneven surfaces, frequent sudden stops, and quick changes in direction apply intense and abnormal weight and pressure to the balls of the feet, the arches, and especially the ankles. Our custom-made sports orthotics for football (fieldsports)are designed to comfortably keep the feet in a neutral (or normal) position, allowing them to meet these forces and pressures with the greatest support and shock absorbency possible; thus fatigue and pain are reduced. To "keep you in the game," and pain free, we have designed an orthosis which takes the abnormal weight and pressure incurred, and gently re-distributes it evenly across the entire foot. This will reduce foot pain and fatigue, and help to prevent injuries.

What do you think about the entire content? Do you think it is reasonable make the claims that are made in this advert? If we give the benefit of the doubt and assume that the content is probably intended for the general public and not directly for the professional. The rest of the web site is definitely designed for communicating to the health professional . The web site is for an orthotist /orthopaedic company producing all types of orthoses for foot, ankle, leg and any other part of the body.

I believe that when advertising to the general public we must be allowed some lee way to express the benefits of the product in a way that is understandable with limited knowledge, how far can we go before we get into the realms of fantasy and misleading statements?

So referring to the above advert, they proclaim to make sport specific orthoses and in this case they are for football / rugby. They say

“ Our custom-made sports orthotics for football are designed to comfortably keep the feet in a neutral (or normal) position,”

What while playing football?!! How do you turn and change direction and accommodate uneven surfaces and still be in neutral. Would you want to be? Could you do these activities if this were true?

“we have designed an orthosis which takes the abnormal weight and pressure incurred, and gently re-distributes it evenly across the entire foot.”

This is just complete rubbish, how can pressure be evenly distributed about the entire foot when your only standing on a small portion of it at any one time while playing sports. This just might be plausible, but unlikely, if you were standing still.

“This will reduce foot pain and fatigue, and help to prevent injuries.”

While the orthoses may reduce pain, where there was pain to reduce in the first place, the statement above is just rubbish and bullshiiiit in terms of the description of orthotic action they explain.

The point here is not to identify the company but to discuss the ethics of using what might at best be described as poetic licence and worst using deliberately misleading information to sell orthoses to the general public.

Also clearly there may be many side issues emerging from this thread that will start other threads and questions.

All the best Dave

[robertisaacs]

Hey Dave

I think you make an interesting point!

David, who now being freed from the need of impartiality will, I hope, be weighing in a bit more now, often makes the case for biomechanics being simple.

This, and a lot like it however, is not merely simplified but downright inaccurate!

Obviously the public cannot be expected to absorb the level of detail and accuracy we would as professionals, however they should surely not be lied to!

For me one of the bugbears is the idea of "normalising". This is something which also winds me up about lots of alternative stuff. The idea that a device / treatment / modality "restores the normal" amount or degree of anything.

I came across an old E'mail Brian sent me today in which he speaks of abnormal engrams of muscle tone and how a proprioceptive signal restores them to normal .

An orthotic can push one way, or the other, but it does not magically stop exerting force at a certain point. A drug which lowers blood pressure will, if overdosed, lower it too far. Thats the whole skill of the clinician, to change the state of a person away from pathological but not too far and out the other side. The Chen balancer / homeopath / Prof Rothbart denies the possibility that their care can do harm and that, for me, is the irresponsible part.

Kind regards
Robert

[Ian G]

Here are some of my favourites from various websites:

As your foot sits comfortably on the orthotic it is gently and consistently directed into the optimum position allowing the foot to function correctly when walking, running and standing. With the help of your practitioner and a pair of our orthotics, pressure points, improper rotation of the feet and painful muscle strain are eliminated, because your feet are functioning optimally.

Another common reason why Orthotics do not work is simply because they have been bought from a shop. These orthotics are mass-produced, feet are not! Every individual has two different unique feet, so, how can a mass produced orthotic from a shop cure a patients pain fully?

The most common form of bad foot biomechanics is over-pronation. This is the dropping of the arches and rolling inwards of the feet and ankles. An estimated 70% of the population suffers from over-pronation. Orthotics correct over-pronation and re-align the foot and ankle bones to their neutral position, restoring natural foot function. In turn, this will help alleviate problems not only in the feet, but also in other parts of the body!

[davidh]

Hi,

Coming back to the football orthoses - Dave, I'm assuming this means soccer unless the cut is from a USA site, it's nonsense, for one reason.

A normal orthosis cannot fit into a soccer boot - not with the foot as well.
A soccer orthosis by definition must be a narrow, thin device which will fit into the boot comfortably.
In my experience such a device can cushion, provide a (very small) heel-lift, and stabilise the foot to some degree with extrinsic forefoot posting.

What it can't do is help to keep the foot in STJ neutral.
In any case, as you point out - why would you want to splint the foot in neutral during a multi-directional sport like soccer?


Cheers,

Davidh