Summary
Orthotic shoe inserts are very effective in providing symptomatic relief of lower extremity complaints in running athletes. Inserts adjust the biomechanical variables associated with running injuries and reduce the effect of high stresses produced by running activities. Orthotic treatment is based on an understanding of complex coupling of rotation of the lower extremity with pronation and supination of the subtalar joint. Orthotic fabrication is initiated by determining the neutral position of the foot and obtaining an accurate cast of this position.
Successful treatment with orthotic shoe inserts is dependent on careful evaluation of the runner and formulation of a properly fitted orthosis. When correctly utilised, orthotic shoe inserts are beneficial for a broad range of disorders experienced by runners. Since biomechanical deficits may be related to injuries along the entire lower extremity, specific diagnoses may be of lesser indication; however, accurate identification of the underlying biomechanical deficit is critical. Problems related to excessive or prolonged pronation are most amenable to orthotic treatment. While treatment of the cavus foot with orthotic shoe inserts is sometimes worthwhile, the clinician should be aware of limited success in this instance.
Finally, orthotics are only one facet in the overall treatment plan for injured running athletes. Most overuse syndromes will respond to rest, training modification, and a change in the running surface or shoe. Equally important is the use of a proper conditioning and stretching programme both for injury prevention and for treatment of specific injuries. Treatment with orthotic shoe inserts should not be used as a substitute for any of these approaches.
Similar content being viewed by others
References
Andelaar RS. The practical biomechanics of running. American Journal of Sports Medicine 14: 497–500, 1986
Bates BT, Osternig LR, Mason B, James LS, et al. Foot orthotic devices to modify selected aspects of lower extremity mechanics. American Journal of Sports Medicine 7: 338–342, 1979
Bordeion R. Practical guide to foot orthoses. Journal of Musculoskeletal Medicine 6: 71–88, 1989
Brody DM. Running injuries. Clinical Symposia 32: 2–36, 1980
Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthopedic Clinics of North America 13: 541–558, 1982
Clancy WG. Symposium: runners’ injuries. American Journal of Sports Medicine 8: 137–144, 1980
D’Ambrosia RD. Orthotic devices in running injuries. Clinics in Sports Medicine 4: 611–618, 1985
D’Ambrosia RD, Douglas R. Orthotics. In D’Ambrosia & Drez (Eds) Prevention and treatment of running injuries, pp. 155–164, CB Slack Inc., New Jersey, 1982
Dugan RC, D’Ambrosia RD. The effects of orthotics in the treatment of selected running injuries. Proceedings of the 16th Annual Meeting of the American Orthopaedic Foot and Ankle Society. Foot and Ankle 6: 313, 1986
Gross NL, Davlin LB, Evanski PM. Effectiveness of orthotic shoe inserts in the long-distance runner. American Journal of Sports Medicine 19: 409–412, 1991
Jacobs SJ, Berson BL. Injuries to runners: a study of entrants to a 10,000 meter race. American Journal of Sports Medicine 14: 151–155, 1986
James SL, Bates BT, Osternig LR. Injuries to runners. American Journal of Sports Medicine 6: 40–50, 1978
Lutter LD. Cavus foot in runners. Foot and Ankle 1: 225–228, 1981
Lysholm J, Wiklander J. Injuries in runners. American Journal of Sports Medicine 15: 168–171, 1987
Mann RA, Baxter DE, Lutter LD. Running Symposium. Foot and Ankle 1: 190–244, 1981
Marti B, Vader JP, Minder CE, Abelin T. On the epidemiology of running injuries: the 1984 Bern Grand Prix study. American Journal of Sports Medicine 16: 285–293, 1988
Schwellnus MP, Jordaan G, Noakes TD. Prevention of common overuse injuries by the use of shock absorbing insoles. American Journal of Sports Medicine 18: 636–639, 1990
Sheehan, GA. An overview of overuse syndromes in distance runners. Annals of the New York Academy of Science 301: 877–880, 1977
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gross, M.L., Napoli, R.C. Treatment of Lower Extremity Injuries with Orthotic Shoe Inserts. Sports Medicine 15, 66–70 (1993). https://doi.org/10.2165/00007256-199315010-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-199315010-00006