And yet orthotics could still be worth trying for some conditions — particularly if you do have a fairly obvious biomechanical problem. Good orthotics are a reasonably good way of trying to “tinker” with any gait or postural dysfunction that may have contributed to your pain in the first place. For instance, unusually high arches are a plausible factor in runner’s knee. 12 My own example: orthotics that helped plantar fasciitis (but not IT band syndrome) This is the kind of conclusion that orthotics makers really do not want anyone to know about. Achilles tendinitis is exactly the kind of condition that custom orthotics can supposedly treat, and failing this test so completely is really damning for that industry. Unsurprisingly, the researchers were harshly criticized, and they responded at length — and I don’t think any of the criticisms hold up. Assuming all of the above work out, you will still need to get the correct prescription, properly made.

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The diagnosed problem must be relevant to your injury. This usually has to be a shot in the dark, because most RSIs are not clearly associated with any known biomechanical problem. No, not as far as I’ve ever been able to tell: my own IT band syndrome was always quite symmetrical, never much better or worse on either side, with or without orthotics. And after years of being recovered, I’ve never had a recurrence of IT band syndrome, on either side. There can also be much more exotic factors, like the genetics of healing mechanisms, that may dwarf other factors — that is, some people will get Achilles tendinitis if they so much as go for a walk, whereas some people can run marathons for decades without any tendon trouble. These sorts of things are all explored in great detail in my free repetitive strain injury tutorial. All I want to get across here is that treating RSI is definitely not just a case of “fix those biomechanics!” It’s much harder to know if RSIs can really be treated with orthotics than you probably thought. Do runners with anatomical quirks get more injuries than symmetrical and aligned runners? This study was another attempt to settle an old question that just won’t die.In a double-blind placebo-controlled clinical study in which participants were diagnosed with plantar fasciitis, in 30 days, they experienced significant: I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles. The problem must then be correctable at least in principle. Quite a few problems simply cannot be fixed by orthotics. It depends on the problem. Do running shoes have positive or negative impacts on joints? Researchers analyzed peak joint forces in barefoot walking versus three different types of shoes: stability, motion control, and cushion. Results showed an increase in knee and hip flexion forces in all shod conditions during the early stance phase (the part of our gait when we are “standing” for a split second), mostly due to increased step length. This is not clear evidence that “shoes are bad” — more forces are not necessarily bad — but it is an interesting addition to the debate about the biomechanics of shoes versus going barefoot. Wait-list groups are a crappy control. They suffer from “frustrebo” — poor outcomes caused by disappointment of knowing that you are not getting any treatment (see Power). This is a major flaw. As Dr. Stephen Ward tweeted, “ Waiting list control, schwaiting list control.”

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There may still be some realistic hope for injury prevention with more specialized shoes. One of the more promising and instructive examples I know of is OESH Shoes, the creation of Dr. Casey Kerrigan, who left a promising career in biomechanics research to make shoes for women. Her goal was to simulate running on a springier surface by putting a literal spring in your step. More spring in the surface means less spring and bending in the joints. 17 Hips, knees and ankles all bend less when you walk or run on a springier surface — or on springier shoes? Certified Pedorthists ( C.Ped(c)) and Certified Orthotists ( CO(c)) are the professionals that I recommend. Unfortunately, many people have never heard of them and don’t know why they are the best choices, or where to find them … and other professionals won’t refer, because they want to sell you orthotics themselves. We train for many years and we take our jobs very seriously. It’s great to see support for pedorthists, and recognition of the difference between podiatrists and pedorthists. I have a problem with a professional who is allowed to diagnose, prescribe, and dispense within a 15-minute appointment. Prescribers are not providers for a reason!Superthotics® was developed by doctors with a patented innovation that instantly corrects your foot and ankle alignment, so the rest of your body can be relieved from pain from your feet up all the way up throughout your entire body. Altman AR, Davis IS. Prospective comparison of running injuries between shod and barefoot runners. Br J Sports Med. 2016 Apr;50(8):476–80. PubMed26130697❐

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The Pedorthic profession in Canada is moving in a great positive direction with integrity, attracting only University educated individuals to become certified pedorthists,” says Paul Rauhala of OKAPED in Canada’s Okanagan Valley. That training translates into an impressive experience for the patient: I have been a patient at OKAPED in the past, and was blown away by the thoroughness and technical expertise of their assessment, which included slow motion video. My own limited training in orthopedic assessment gave me just enough knowledge to realize how much more Mr. Rauhala knows about it than I ever will — in the leg, anyway! Superthotics realigns your feet to relieve pain, restore balance, and provide stability and comfort.Richards CE, Magin PJ, Callister R. Is your prescription of distance running shoes evidence-based? Br J Sports Med. 2009 Mar;43(3):159–62. PubMed18424485❐ Superthotics are the medically designed shoe inserts made with patented technology designed to relieve pain, align your feet and provide unbeatable comfort

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Richter RR, Austin TM, Reinking MF. Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis--critical appraisal and commentary. J Athl Train. 2011;46(1):103–6. PubMed21214358❐ PainSci Bibliography53613❐ In a recent clinical study, Superthotics wearers reported a significant reduction in their pain in as little as two weeks! Within 30 days of wearing Superthotics, wearers reported that: With Our Biodynamic Balance Inserts-just choose the level you need so your foot can hit the ground at the right angle, in other words, correcting pronation. Wunsch T, Alexander N, Kröll J, Stöggl T, Schwameder H. Effects of a leaf spring structured midsole on joint mechanics and lower limb muscle forces in running. PLoS One. 2017;12(2):e0172287. PubMed28234946❐ PainSci Bibliography53523❐The repetitive strain injuries that runners, walkers, and hikers get are common and difficult, and they are probably the main thing that gets most people wondering if they need some orthotics. This is based on the flawed notion that RSIs are caused by flawed biomechanics. Munteanu SE, Scott LA, Bonanno DR, etal. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med. 2015 Aug;49(15):989–94. PubMed25246441❐