8 replies to this topic

[Craze]

I know we have a few running pods who might be able to give opinions on orthaheel products. I quite often like to wear sandals around the house or outside in summer, but obviously I can't wear my orthotics with these. I noticed that orthaheel have a sandal with a built in orthotic. Would it be beneficial to wear these rather than my current sandals?
For someone who has worn custom orthotics would the other orthaheel products be a step backwards? - I'm assuming they would be because they aren't custom made for a particular person's deficiency.
My last question is that I'm due for a new pair of orthotics specifically for running (10k runner) as I'd be happy to use my old pair for general use. My current pair is a half length carbon fibre with a full length insole attached on top. My old pod saw them and said he could make something a lot better and lighter and use the existing insole of my runners for the forefoot. He was a pod who custom made his orthotics (didn't send them to a lab) for runners. He was also a runner and made them for a lot of top runners in Melbourne but is now overseas so I can't get them done through him. What sort of orthotic would he have been suggesting so that I can pass this info on to my new pod (who isn't a runner)

[Roffy]

Hi Craze, I am not a podiatrist,however I am an osteopath who has been in practice for about 15 years, a runner, and have tried and prescribed heaps of different off the shelf orthotics over the years. The orthaheel stuff is pretty good, they generally try to put your ankle at what they call a "neutral" position, so at worst will do nothing for you but may actually be very beneficial. I actually prefer the off the shelf stuff as an initial starting point for orthotics as they are a fraction of the price, generally a lot more comfortable and often have a very good effect. I know some podiatrists get a bit defensive about this but that has been my experience time and time again over 15 years.

[BEN-HUR]

Roffy, on Apr 22 2007, 11:08 AM, said:

Hi Craze, I am not a podiatrist,however I am an osteopath who has been in practice for about 15 years, a runner, and have tried and prescribed heaps of different off the shelf orthotics over the years. The orthaheel stuff is pretty good, they generally try to put your ankle at what they call a "neutral" position, so at worst will do nothing for you but may actually be very beneficial. I actually prefer the off the shelf stuff as an initial starting point for orthotics as they are a fraction of the price, generally a lot more comfortable and often have a very good effect. I know some podiatrists get a bit defensive about this but that has been my experience time and time again over 15 years.

Hi Roffy,
Just a few friendly pointers ... so read carefully. I will address the points I outlined in red in your post. Firstly it isn't the ankle joint which is controlled by an orthotic to keep it functioning around "neutral" - it is primarily the Sub Talar Joint (STJ) followed by the Mid Tarsal Joint (MTJ) - a major anatomical thus physiological/biomechanical difference. An orthotics' role is to promote the foot to function around the individuals STJ neutral position thus creating a stable base & reducing excess rotation/movement of the joints & bones of the foot & lower limb. This reduces excess stresses to joints, tendons & muscles thus preventing injury or allowing an over use type injury to heel i.e plantarfasciitis, Tib. Post. Tendonitis. An 'off the shelf' device such as an orthoheel are mass produced according to size with a usual inbuilt corrective element of about 4 degrees varus. Thus if an individual's calcaneal (heel) bisection is around 4 deg. everted (valgus position) they may benefit from a device like this. Don't be fooled by the diagram you see on the packaging - from memory the individuals resting calcaneal bisection looks to be closer to 8-10 deg. valgus but when standing on the orthoheel device the bisection is sitting at vertical (0 deg.). That is 8-10 deg. of valgus (eversion) correction by a 4 deg. varus (inversion) corrective device - this is misleading & false advertisement!
Secondly- Podiatrists don't get defensive about the use of 'off shelf devices' (OSD's) over custom made devices. I use OCD's regularly when it is appropriate to do so as do all other Podiatrists ('running podiatrists') I know. You might benefit from reading the pronation article in the latest R4YL magazine which does refer to different types of orthotic therapy. What Podiatrists may get annoyed about is when health professionals (& lay people) put forward a point of view which is ignorant of the specific functions/roles of various types of orthotics & when they should be used. We may also get annoyed at the apparent lack of knowledge of anatomy, physiology & its biomechanical implications in the realm of orthotic therapy & subsequent foot function in controlling pronation & sometimes supination. Another thing Podiatrists (as should the general public) may get annoyed at is the misleading exaggerated claims made by the manufacturers of 'off shelf devices'. Having said that they do have an important role to play in the realm of controlling the lower limb.
Hope this helps.
Kind regards,
BEN-HUR.

[BEN-HUR]

Craze, on Apr 21 2007, 03:18 PM, said:

I know we have a few running pods who might be able to give opinions on orthaheel products. I quite often like to wear sandals around the house or outside in summer, but obviously I can't wear my orthotics with these. I noticed that orthaheel have a sandal with a built in orthotic. Would it be beneficial to wear these rather than my current sandals?
For someone who has worn custom orthotics would the other orthaheel products be a step backwards? - I'm assuming they would be because they aren't custom made for a particular person's deficiency.
My last question is that I'm due for a new pair of orthotics specifically for running (10k runner) as I'd be happy to use my old pair for general use. My current pair is a half length carbon fibre with a full length insole attached on top. My old pod saw them and said he could make something a lot better and lighter and use the existing insole of my runners for the forefoot. He was a pod who custom made his orthotics (didn't send them to a lab) for runners. He was also a runner and made them for a lot of top runners in Melbourne but is now overseas so I can't get them done through him. What sort of orthotic would he have been suggesting so that I can pass this info on to my new pod (who isn't a runner)

Hi Craze,
There are two main points that I outlined in red in your post. Firstly there are sandals which can accommodate custom orthotics. These are sandals made by Kumfs & Homy Peds (ecco may be another brand)- Homy Peds are the cheaper of the two. These work due to having a lip around the base of the foot bed of the sandal which keeps the orthotic in place.
The type of orthotic that may have been suggested could have been a lower profile carbon fibre or polypropylene (i.e 2mm, as opposed to 3-4mm) material - this means the orthotic shell flexes a bit more & is a bit lighter. An EVA (rubber material) fill for underneath the orthotic may have also been suggested - this aids in softer control (as well as easily adjustable-if needed) & gives more shock absorbing properties (ideal when running alot). A full length cover would have been advised with PPT or Poron with this covered by a vinyl/leather type material - spenco could be another top cover material used (although, often not as durable as the previous suggestion).
As for the Orthoheel device - it is hard for me to say if this would be suitable for you being that I don't know how much correction is needed & your injury history, as well as other factors i.e weight. If you have a mild amount of out phase pronation they may be suitable. If yes, I would suggest you look into the full length variety as these are more suitable for running & running shoes. Having said this there are better 'off shelf devices' than orthoheel.
Hope this helps.
Kind regards,
BEN-HUR.

[Roffy]

Ok, that didnt take long to piss someone off. Ben hur this was the reaction I thoguht I might get. I was speaking in general terms as i dont think this is the forum to get too carried away with technical jargon, therefore I didnt use terms such as valgus and varus or mention the sub talar joint and so on. Ok, maybe i should have said ankle "and foot" when using the term neutral. But too a lay person (which we must assume everyone is on this site) I thought neutral was a better term.
Finally I dont get caught up in the packaging, only whats inside it. As I said I have tried many different styles of pre fab orthotics over the years, I am only concerned with how they look when the patient is standing on them and what corrective effects they are having through the entire lower extremity, pelvis and lumbar spine.

Cheers

[BEN-HUR]

Hi Roffy,
I am not p/offed at all . I saw things in your post that needed to be addressed & felt obligated to correct them; otherwise people would get the wrong message & ideas about the role of orthotics &/or biomechanics. This forum is a medium to also educate people so I feel using the correct terms are important as long as you attempt to explain what they mean. The Sub Talar Joint (joint under ankle ) is of primary concern when talking on this topic - thus why I stated what I did. To be fair I understand where you are coming from, but as a Podiatrist (& the fact that Craze was directing the post to Podiatrists - & I am not excluding the contributions from other health professionals such as yourself) I felt I should elaborate on the topic.
You may not get caught up on the packaging but the general public (as well as other health prof.) do thus I make a valid point. Your original post did state Podiatrist get defensive on this issue which is why I discussed this point. I am sure you would feel obliged to do likewise if I made a generalised statement about osteopaths.
Kind regards,
BEN-HUR.

[Jason M]

I've asked my sister about this. She is currently completing her honours in podiatry. Her opinion and that of a couple of her lecturers, one of which is my own podiatrist state these products do have their use. But, and there is a big but! They should only be used if precribed by someone qualified. The biggest risk is someone self diagnosing their own problem and getting it wrong. By using a product that is inappropriate there is a good chance that the condition will be made worse.

[brizza]

trivia-i was working at AOL when the line was being designed,then later i started to see them lying at the side of the road in triathlons when people had taken them out of their shoes and tossed them,the full length device was not better than the old formthotic which was at least able to be modified and customised.at the risk of appearing to endorse something i'm getting keen on a recently released range of modular orthotics unfortunately only available to practitioners,i'm sure you'll start to see them around-briz

[PodRunner]

As a pod, I also occasionally use formthotics and generic equivalents for my patients.

They are quite useful for lightweight, mild over-pronators. Unfortunately they do tend to warp and compress fairly quickly, reducing their lifespan and accuracy, so I tend to prescribe them mostly for racing (spikes and flats). I used to use formthotics in my track spikes, as they were very low-bulk and lightweight, but they weren't supportive enough for my training shoes.

For heavier runners and more severe problems, the "one-size- fits-all" solution doesn't work very well.

As mentioned above, best to know what you're treating before you self diagnose- see a sports podiatrist. Good luck!