Foot Orthotics Will Correct The Problem Of Too Much Money In Your Checking Account
A "Dr. Nirenberg" writes at America's Podiatrist:
A middle-aged woman arrived at my office last week complaining of heel pain and carrying a bag of custom-made foot orthotics (orthotics are custom made arch supports that are fabricated from a mold of the patient's feet). Each orthotic this woman had with her was expertly fabricated by a different podiatrist and yet none of them had come close to alleviating her heel pain. At first I thought maybe these podiatrists didn't know what they were doing. But, when I learned their names, I knew this woman had seen competent, skilled and reputable physicians.I asked myself "how could this be?" More interestingly, no two sets of orthotics were even remotely alike. Further, given that nearly all podiatrists learn similar principles of biomechanics, shouldn't orthotics for a given patient be the same regardless which podiatrist makes them?
After reading Biomechanics of Sport Shoes, Dr. Benno Nigg's newest book, I have the answer. It is sobering, disturbing and I don't want to believe it. Unfortunately, Nigg is one of the top biomechanic researchers in the field sport shoes, foot inserts and foot orthotics in the world. In fact, I imagine that Nigg spends more time thinking about biomechanics than a 17 year old boy spends thinking about sex.
Foot Orthotics Debunked!
Nigg reveals that foot orthotics, which are devices designed to align misaligned feet, are actually not aligning the skeleton at all. In fact, Nigg's book reveals many disturbing facts about orthotics, shoes and inserts: including that there is weak evidence orthotics lessen injury. Furthermore, changes in skeletal alignment due to inserts or shoes are inconsistent and minor.
Most importantly, Nigg goes on to warn that one of the dangers of the consistent use of orthotics is that they reduce functional demand on muscles may be associated with the deterioration of the muscles' strength and function. So even though a foot orthotic often helps in the short term, over the long term Nigg warns their use may cause problems.
via @medskep







So if the expets don't get it right, that machine you stand on to determine which $50 Dr. Scholl's insole to buy at WalMart probably isn't ideal, either, huh?
I kind of lost faith in that whole concept when I bought a pair of the custom ones and they were the most durnedably uncomfortable things I'd ever worn.
Grey Ghost at October 25, 2013 12:16 PM
For my issue, pronation, the machine at Walmart was the worse 'solution' I have tried. $45 - returned.
I did try the Costco custom orthotic: $80 - meh.
I did get a custom orthotic: $300 - much better than meh, not perfect. Main complaint if orthotic 1 is $300, I should be able to buy a second for $50.
Best solutions so far seem to be anti-pronation shoes ranging from $100 for Brooks Beast to $god-was-that-expensive-are-you-fucking-kidding-me?
I would love to find something that would let me put on ski boots without feeling I am sticking my feet into a bed of nails.
jerry at October 25, 2013 12:33 PM
I am so glad I am not only who thought those expensive one from Walmart sucked. My feet hurt worse with them than without them. If I am walking for any real length of time or distance nothing beats a good pair of sneakers. I
Sheep mommy at October 25, 2013 12:51 PM
I picked up a pair of off-the-shelf Airtrex (sp?) inserts from a local orthotics shop, sixty bucks or so. They should only last about 6 months, but I'm still wearing them-- I would get home almost crippled from work each day, but these have worked wonders. My feet have gotten stronger, so I can go without them, if I need to.
This topic is close to my work in another way-- Shoeing horses! You'd think shoeing jobs would be pretty similar, since we study from the same books and go to the same schools. In fact, a man's shoeing style is like his signature, no two alike.
It's no wonder that so many horses have foot problems... my main complaint is how many farriers use shoes that are simply too small. Considering how much we charge for this work, every 6 or 7 weeks, you'd like to think your horse is getting a better value.
jefe at October 25, 2013 1:51 PM
I live in flip-flops. I honestly think all these arch supports and inserts nonsense aren't good for us. Were we born to wear shoes? Did nature design us so imperfectly that our feet can't support us without properly fitted shoes with arch supports and heel supports?
And as this article points out, there's some stuff we thought we knew about feet that just isn't true. My mother, when I was little, had lifts put in my shoes because I have flat feet. And we thought back then that flat feet are so dangerous and fragile and prone to injury that we had to correct them.
Turns out flat feet are just fine.
It's fortunate for me that I joined the army when I did. Had a joined a few years earlier, flat feet would have kept me out of the military.
Unrelated, but kind of a funny story. I also have a heart murmur. When I mentioned this to one of my fellow soldiers he scoffed and said, "You do not! They wouldn't let you in the army with a heart murmur!"
/facepalm
Patrick at October 25, 2013 2:06 PM
"I live in flip-flops. I honestly think all these arch supports and inserts nonsense aren't good for us. Were we born to wear shoes? Did nature design us so imperfectly that our feet can't support us without properly fitted shoes with arch supports and heel supports?"
I agree. My father had problems with his feet when he was older, mostly as a result of severe crippling arthritis.
Best thing for him turned out to be a good pair of tennis shoes.
You want to know how to avoid issues with your feet and knees? Go barefoot when you can, and lose thirty pounds, if you have it to lose.
Don 't expect a podiatrist to fix an issue that is most likely self inflicted.
Isab at October 25, 2013 3:01 PM
once my podiatrist turned me on to birkenstock inserts... I never looked back. But only if you've worn birks, and they weren't intolerable. I know some people can't wear them. It was amusing that my podiatrist told me that orthotics weren't really necessary for my flat as a board feet. Since I fixed my pronation in highschool while running cross country, my mechanics were sound w/o orthotics.
funnily enough the change in pronation was mostly in my head. You're off the ground when you are running... how you chose to allow your foot to strike the ground is entirely up to you. So I changed from a flat footed inner foot strike, that I bought special nike equator shoes to help [they didn't] to a correct outer edge to accross foot strike...
by paying attention.
Now, that was when I was 17, so you mightent be able to do it once you are older... but it worked for me then.
Now if I could be so commited to losing the spare tire, finding a date, and getting a better job, how amazing it would be. :very level look: OI.
SwissArmyD at October 25, 2013 4:43 PM
"lose thirty pounds, if you have it to lose" -- Isab
That, right there, will cure (or at least help) a whole host of physical problems.
Gail at October 25, 2013 6:43 PM
"I also have a heart murmur. When I mentioned this to one of my fellow soldiers he scoffed and said, "You do not! They wouldn't let you in the army with a heart murmur!" -- Patrick
Ha, Patrick! I have a heart murmur, too. My childhood doctor diagnosed it when I was quite young and scared crap out of me and my parents. He recommended I take antibiotics before every dental cleaning, lest I die of...I have no idea what I'd die of, actually. I guess some kind of infection? Luckily, my parents had an excellent gut feeling that antibiotics weren't called for, especially since I had an exceptionally healthy set of choppers and never bled during dental exams, and they firmly believed antibiotics shouldn't be taken unless you really need them. (Ironic that mom and dad had more medical savvy than that doctor...)
Many years later, another doctor noticed the murmur and had me go to a cardiologist, just to make sure. The cardiologist noted that not only was nothing wrong with my heart, it was actually exceptionally strong. The "murmur" the doctors were hearing was actually related to the unusually powerful action of my heart valves. He joked that I'd probably live forever.
I think people used to make a really big deal out of heart murmurs. And often they're just no big deal. Your fellow soldier may not have heard the news. Maybe we went to the same pediatrician.
Gail at October 25, 2013 6:59 PM
Gail, is that what caused your "heart murmur"? I wonder if that's true for me as well.
My doctor, when giving me a physical prior to entering college, was listening to my heart. Then all of a sudden, he got a really intense concerned look on his face.
It's a little disconcerting to have a doctor suddenly look surprised as he's listening to your heart. And so I asked, "It's still there, isn't it?"
He says, "I think you have a heart murmur." No idea what that was.
He referred me to his son, a cardiologist, who hooked me up to a bunch of gadgets to listen to my heart and concluded that there was a murmur, but that it was essentially nothing.
Then when I was having dental work done in the U.S., they insisted that I have my heart checked before they did any work on my teeth. The doctor listened to my heart and was unable to hear it, and let it go at that.
Now I wonder if my "heart murmur" is the same thing yours is.
But I don't worry about my heart much. Last year I had a stress test and was able to complete it. The nurse assured me that 95% of the people who can actually complete a stress test (it's a bit grueling, to say the least) never have heart trouble.
Patrick at October 25, 2013 9:48 PM
Patrick, if I remember correctly, you're athletic, right? If so, I'll bet your "heart murmur" has the same cause as mine. And yeah, if you can pass a stress test, I'm sure you're fine.
My cardiologist was a very friendly guy, and a runner like me. Most doctors probably would've just said "you're fine," and shoved me out the door, but he was happy to spend a few minutes chatting about hearts and heart murmurs with me! He said a lot of athletes had the same kind of "heart murmur" I have.
Gail at October 27, 2013 6:18 PM
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