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Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis
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  • Published on:
    Do Foot Orthoses Benefit the Symptoms of Plantar Heel Pain and How Might they Work? Further Considerations in Designing Research Protocols for Foot Orthoses.
    • Andrew M Horwood, Lecturer, Podiatrist, Foot Health Product Designer. Podiatry Innovations Limited, HealthyStep Ltd, Staffordshire University.

    I would like to raise some comments regarding the paper ‘Foot orthoses for plantar heel pain: a systematic review and meta-analysis.’ Whittaker et al, 2018, Br J Sports Med. 52(6): 322-328, and the editorial ‘Foot orthoses research: identifying limitations to improve translation to clinical knowledge and practice’, Griffiths & Spooner 52(6) in the same edition.

    I would like to applaud the intention of the paper by Whittaker et al, to try and establish a conclusion to the question of foot orthoses efficiency in treating heel pain symptoms. This same praise I also give to the editorial in bring into the discussion the potential issue of the validity of random control trials as a research method to test foot orthoses efficiency. However, some key issues with the paper need exploring beyond the issues raised in the editorial in regarding how orthoses may work.

    There are several key issues with the paper by Whittaker et al, which overall is a noble attempt to make sense of the present research on using orthoses for plantar heel pain. The issues are; plantar heel pain is a symptom not a diagnosis (therefore some of these studies may include multiple conditions); the studies are subject to potential bias (addresses by the authors); the studies do not compare like with like studies and seemed to have been shoe horned together to achieve a conclusion; and finally, foot orthoses do not logically conform to randomised control trials. Despite the best efforts of th...

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    Conflict of Interest:
    Design consultant for foot health products including foot orthoses at HealthyStep (Sensograph) Ltd.