CHANGES IN MECHANICS

Does an over-the-counter orthotic device control foot motion just as well as a custom-made orthotic? Unfortunately, a review of the scientific literature reveals that very little research has been done to specifically answer this question. Moreover, orthotics are prescribed and/or purchased to treat lower extremity pain or injury but the vast majority of studies to date have involved healthy people.3,5,6,8 Regardless, all of the research1–9 indicates that there are no differences in foot mechanics when running or walking in different types of orthotics.

RESEARCH SUMMARY

One of the first studies to investigate this question was done in 1986 when Smith et al7 determined if custom-made or over-the-counter orthotics affected foot and leg movements while running. Eleven, well-trained runners, who already wore an orthotic device, was given a new custom-made orthotic and an over-the-counter device. These runners ran barefoot, with shoes but no orthotic, and with both orthotic devices while biomechanical data were collected. Overall, these researchers concluded that there were no differences in foot mechanics while wearing an over-the-counter versus a custom-made orthotic device during running.

Brown et al1 in 1995 to determine if custom-made or even simple arch supports had any effect on controlling foot mechanics. They collected 2D data on 24 subjects while walking on a treadmill and concluded that neither arch supports nor orthoses can be preferentially recommended for their ability to control foot motion.

More recently, two studies have been conducted at the University of Delaware2,9 to determine if there were any differences in rearfoot motion control while wearing custom-made or semi-custom orthotics during walking and running. For the two studies, the researchers collected data from 19 and 37 healthy runners, respectively, who were each given the two different devices and 14–18 days to accommodate and incorporate the orthotics into their running regimes. Participants returned to the lab and 3D biomechanical data were collected. The results indicated that there were no differences in rearfoot motion control between the two different orthotic devices while running or walking for either study. Thus, these researchers concluded that an over-the-counter orthotic controlled foot motion comparable to a custom-made device.

CONCLUSIONS

Based on the results of this research, it can be concluded that custom-made and over-the-counter orthotics control foot motion equally. However, as was mentioned in a recent review article4 from the Running Injury Clinic at the University of Calgary, several limitations are apparent in the research literature. First, all studies conducted, to date, have involved small groups making it difficult to apply the results to the general population. Second, some studies have investigated a semi-custom orthotic which is not structurally or functionally similar to an over-the-counter device sold commercially. Third, and most importantly, all studies have involved healthy runners. Thus, future research involving large subject populations, runners with current injuries, and over-the-counter devices are necessary.

REFERENCES

  1. Brown GP, Donatelli R, Catlin PA, Wooden MJ. The effect of two types of foot orthoses on rearfoot mechanics. J Orthop Sports Phys Ther. 1995; 21(5): 258-267.
  2. Davis IS, Zifchock RA, DeLeo AT. A comparison of rearfoot motion control and comfort between custom and semicustom foot orthotic devices. J Am Podiatr Med Assoc. 2008;98(5):394-403.
  3. Donatelli R, Hurlbert C, Conaway D, St. Pierre R. Biomechanical foot orthotics: a retrospective study. J Orthop Sports Phys Ther. 1988;10(6):205-212.
  4. Ferber R. The influence of custom foot orthoses on lower extremity running mechanics. Int Sportmed J. 2007;8(3):97-106.
  5. McPoil TG, Cornwall MW. Rigid versus soft foot orthoses: a single subject design. J Am Podiatr Med Assoc. 1991;81(12):638-642.
  6. Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Orthotic comfort is related to kinematics, kinetics, and EMG in recreational runners. Med Sci Sports Exerc. 2003; 35(10):1710-1719.
  7. Smith LS, Clarke TE, Hamill CL, Santopietro F. The effects of soft and semi-rigid orthoses upon rearfoot movement in running. J Am Podiatr Med Assoc. 1986;76(4):227-233.
  8. Trotter LC, Pierrynowski MR. Changes in gait economy between full-contact custom-made foot orthoses and prefabricated inserts in patients with musculoskeletal pain: a randomized clinical trial. J Am Podiatr Med Assoc. 2008;98(6):429-435.
  9. Zifchock RA, Davis I. A comparison of semi-custom and custom foot orthotic devices in high- and low-arched individuals during walking. Clin Biomech. (Bristol Avon). 2008;23(10):1287-1293. Epub 2008 Aug 30.

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