Orthotics Rant

Amazing – orthotics can prevent the incidence of injury by up to 50%!

The gait analysis seminar presented by biomechanics guru Dr Kim Ross on the weekend was one the most useful professional development days I’ve ever attended. The ability of orthotics to improve proprioception has been a recent improvement on the old ‘sub-talar joint neutral theory’ still being passed as fact by many orthotic-casting podiatrists, but to hear that orthotics actually help in the swing phase of gait goes a step further (pardon the pun).

Proprioception is the ability of our joints to know where they are in space. It is a sense highly governed by ligaments and tendons around the joints themselves. The theory that orthotics help to improve this joint sense rather than ‘control’ movement has been well documented for the previous decade or so, and it seems a natural evolution of this idea that orthotics should be prescribed based on dynamic movements (eg walking or running) rather than in standing or sitting. Is a pressure plate the way to go? Well, so far the compliance of the orthotics we’ve been prescribing has been close to 100%, rather than the 50-80% from rigid casted orthotics (the figure varies because a lot of people simply don’t wear them as they are too uncomfortable). At this stage I don’t think there is any perfect method, but using the gaitscan pressure plate is definitely the best I’ve come across in 13 years of practicing.

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