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A biomechanical perspective: do foot orthoses work?
  1. B Heiderscheit1,
  2. J Hamill2,
  3. D Tiberio3
  1. 1Osteopathic Medical Center, Des Moines University, Des Moines, Iowa, USA
  2. 2University of Massachusetts jhamill@excsci.umass.edu
  3. 3University of Connecticut

    https://doi.org/10.1136/bjsm.35.1.4

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      Foot orthoses have become an integral part of the treatment of injuries of the foot, ankle, and lower extremity. From a biomechanical perspective, they offer a means of resolving symptoms by placing the foot and the lower extremity in a more advantageous position thus altering applied tissue stresses. Ample evidence exists, based on subjective pain relief and symptom resolution, to support the continued use of these devices. However, scientific evidence to confirm these observations is equivocal.

      Research findings

      If there is a biomechanical basis for patient improvement, one of many possible kinematic or kinetic parameters should be altered by foot orthoses. Increased magnitude of the pronation angle and increased pronation velocity have been postulated as risk factors for lower extremity injury. A number of investigations have shown the potential of an orthosis with an external medial post to decrease the magnitude of pronation.1 Not unexpectedly, a decrease in tibial internal rotation has also been shown with medially posted orthoses.2 However, Johanson et al1 observed that a non-posted orthotic shell reduced the maximum pronation angle as much as either a forefoot or a rearfoot post, as well as a combination of a forefoot and …

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