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Superthotics are the medically designed shoe inserts made with patented technology designed to relieve pain, align your feet and provide unbeatable comfort Hespanhol Junior LC, De Carvalho ACA, Costa LOP, Lopes AD. Lower limb alignment characteristics are not associated with running injuries in runners: Prospective cohort study. Eur J Sport Sci. 2016 Jun:1–8. PubMed27312709❐ This was a large review of previously published research about the use of custom foot orthoses for the treatment of various kinds of foot pain. Unfortunately, in all that research, “There is limited evidence on which to base clinical decisions regarding the prescription of custom-made foot orthoses for the treatment of foot pain.”
Superthotics
The supply dramatically exceeds the real demand. However, there are four common conditions that orthotics have the most potential to help: Custom foot orthoses or orthopedic footwear or modifications may be helpful for specific medical situations, but it’s probably only truly reliable for a single condition: painful pes cavus (high arches). Everything else is less certain, even quite obvious and common foot problems like hallux valgus (lateral bulging where the big toe meets the foot). 1 Even with wise prescription and skilled crafting, many people will be helped, and many will not. 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. Terrific short myth-busting interview with a running, shoe and biomechanics expert — who is (delightfully) a bit cranky about “so many wrong ideas out there.” It’s all too rare to see this kind of sanity-inducing, hype-reducing talk on this topic. From the article, regarding the position of biomechanics expert Benno Nigg: Nigg has noted that running injuries have not changed over the years despite the massive development of the running-shoe industry. Unlike others, he hasn’t jumped to the conclusion that shoes are bad, or that barefoot or minimalist-running or forefoot-striking is the answer. Instead, looking at the same data, Nigg concludes: Okay, apparently shoes aren’t a big part of the equation. It was the right kind of study (prospective), but perhaps a bit underpowered with only 89 subjects and just 12 weeks of monitoring for new injuries. I wish I could see the same data for a couple hundred runners over six months. Subtle vulnerabilities might take quite a while to crop up, particularly in runners who have already gotten through at least six months without any injury. Still, 24 of these runners did get injured in those twelve weeks — which is a lot! — and “we did not find significant associations between lower limb length discrepancy, Q-angle, subtalar angle and plantar arch index and injury occurrence.”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❐ Orthotics certainly seemed to be a good option for me. I have an obvious biomechanical problem in my right foot. 13 It’s just the sort of biomechanical bogeyman you might be tempted to blame for my own nasty history with iliotibial band syndrome. Surely that gimpy turned-out leg made me more vulnerable to IT band syndrome? I think every pair of orthotics is a minor gamble with some potential to help … or do what those boots did. Shopping for pedorthists and orthotists Unfortunately, you can’t count on wise prescription and skilled crafting: there are many unscrupulous and shoddy suppliers of these products who will prescribe orthotics for almost any problem, or none at all. The science is complex and incomplete. Regulation is a confusing mess. It is nearly impossible for consumers to know if they actually need any of these products, or where to get an expert prescription and a quality product. The good news: there are good sources
Relieve Pain with Every Step You Take - Superthotics
Eight updates have been logged for this article since publication (2002). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreSadly no, probably not, and for all the same reasons that they aren’t exactly a magic treatment bullet. You should definitely be skeptical of any sales pitch for orthotics or custom shoes if you have no particular problem to solve. Many orthoses are sold with the promise that they will prevent injury. Even if prevention is not the main reason for the prescription, it is often thrown in as a bonus reason to buy. But it has been tested, with poor results. Running and walking shoes that try to be like orthotics Orthotics are not risk-free. The risk is not large, and so not much needs to be said about it. However, good or bad, they can be difficult for a body to adjust to, disrupting fine-tuned postural adaptations and forcing new ones which either feel awkward just because they are unfamiliar, or because they are just uncomfortable (the difference between hiking books that just need to be broken in to get comfortable, and hiking boots that will never become comfortable). Get PainSci updates in your inbox, mostly small, 0–3/week depending on coffee dosage. More info. Related Reading Professional focus and training and certification standards for podiatry vary quite widely around the world. Dr. Mark Heard, in Australia, agrees with my assessment that most North American “Pods” are surgery focused, but explains that other Pods around the world are more focused on biomechanics:
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Undoubtedly the most damning example in recent history was a beautifully done 2015 Australian trial of custom orthotics for Achilles tendinitis, completely persuasive. 11 Custom orthotics bombed the test — completely failure —and dropped a bomb on the orthotics industry. I wouldn’t be surprised if those researchers got death threats. They handled all the criticism with class and, more importantly, good logic and evidence. Custom orthotics do not work for Achilles tendinitis. And if they don’t work for that, there’s probably a bunch more they don’t work for either. Oesh shoes and other spring-loaded shoes are interesting and legitimately science-inspired. A similar spring-sole design was tested in 2017 and found to “reduce lower limb muscle forces.” 20 Whether such shoes actually prevent injury is another matter entirely, and no one knows that yet. But at least it’s a good idea, which is more than we can say for an awful lot of competing products. What you might not realize is that the problem almost always starts with the improper alignment of your feet. When your feet are out of alignment, your whole body is out of alignment and that causes pain! Many chronic problems like shin splints, tendonitis, sciatica, sports injuries, stress fractures and others, can cause immobility and put a damper on your everyday quality of life, when they just don’t have to. 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. 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.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❐ 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? Undergraduate training around the world doesn’t go so far as the US in surgical training. It’s an option in other countries, but greater training is required. So most Pods here tend to be more biomechanically focused, and more interested in a holistic approach to musculoskeletal health. We have the option of surgery, but it requires considerable post graduate training. My own training allows me to undertake superficial surgery (i.e. for ingrown toenails, removal of warts etc), but that only makes up a small amount of my practice. 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❐
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