Here's a quick post about the use of foot orthoses in podiatry and the debate surrounding their benefits. Because everyone seems to have a different opinion regarding their use, especially since barefoot running came to prominence.
What are they?
Foot orthoses are devices prescribed and fabricated by podiatrists to change the way feet work, offload bones or soft tissues and reduce discomfort. They are commonly recommended for for some comditions such as plantar fasciitis, hallux rigidus or posterior tinial yendon dysfunction. This blog post seeks to explore the benefits and limitations of using foot orthoses.
Types of Foot Orthoses
There are several types of foot orthoses that are commonly prescribed by podiatrists. They are often classified as either functional or accommodative orthoses. Functional foot orthoses are designed to control motion while accommodative orthoses are used to cushion and re-distribute forces acting on the foot.
Benefits of Foot Orthoses
Foot orthoses have been found to be beneficial in managing a variety of foot and lower limb conditions. Functional foot orthoses are effective in changing foot alignment, reducing foot pain, and preventing foot-related injuries. Accommodative foot orthoses, on the other hand, are beneficial in reducing pressure and pain in people with diabetes, rheumatoid arthritis or other chronic conditions.
Limitations of Foot Orthoses
Although foot orthoses have been found to be helpful in managing foot and lower limb conditions, they have some limitations. They can sometimes be uncomfortable to wear, especially if not fitted properly and almost always alter gait which can impact lower limb mechanics, creating aches or pain at other joints. Foot orthoses can also be expensive, especially if they need to be custom made.
What does the research tell us?
There is strong evidence to suggest that foot orthoses can effectively treat a variety of foot conditions. In a study conducted by Landorf et al. (2016), it was found that foot orthoses were effective in reducing foot pain and improving function among individuals with plantar heel pain for example.
However, the use of foot orthoses in podiatry is also a topic of debate. Some argue that they are overprescribed and not always necessary in treating foot conditions. Additionally, there are concerns about the potential negative effects of foot orthoses such as discomfort and muscle weakness.
In a study by Kuhn et al. (2018), it was found that providing evidence-based information to patients about the use of foot orthoses can lead to more appropriate use of the devices and better treatment outcomes. This suggests that education and informed decision-making are important factors when prescribing or receiving foot orthoses.
Conclusion
Foot orthoses are an effective treatment option for various foot and lower limb pathologies. They help to support or relieve structural abnormalities, ease foot pain, and distribute plantar pressure when used correctly. Podiatrists play a crucial role in the fabrication of orthoses, because each prescription must be carefully considered taking into account the presenting complaint (injury or problem) and the specific needs of the individual. The limitations of orthoses must always be considered and communicated with the user when deciding on treatment options. Further research is required to explore the long-term effects of foot orthoses on foot and lower limb function.
References:
1. Williams AE, Rome K, Nester CJ. A systematic review of the effect of foot orthoses and shoe characteristics on balance and walking in older people. J Foot Ankle Res. 2009;2:23.
2. Whittaker GA, Munteanu SE, Menz HB, Tan JM, Rabusin CL. Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int. 2017;38(4):386-395.
3. Huang F, Wang S, Zhang Y, et al. Effects of plantar pressure-based individualized foot orthoses on foot pain and disability in patients with plantar fasciitis: a randomized controlled trial. Clinical rehabilitation. 2019 Jun;33(6):1038-49.
4. Kuhn, D. R., Yochum, T. R., Cherry, A. R., & Rodgers, S. S. (2018). Immediate and short-term effects of custom-made versus prefabricated foot orthoses in patients with plantar fasciitis: a multicenter randomized controlled trial. Journal of orthopaedic & sports physical therapy, 48(2), 85-93.
5. Landorf, K. B., Keenan, A.-M., & Herbert, R. D. (2016). Effectiveness of foot orthoses to treat plantar fasciitis: a systematic review and meta-analysis. British Journal of Sports Medicine, 50(19), 1180-1189. doi: 10.1136/bjsports-2016-096116
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