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Adding rocker soles to footwear

Discussion in 'Diabetic Foot & Wound Management' started by malaligned, May 12, 2010.

  1. malaligned

    malaligned Member


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    Hi everyone,
    I am sure I learnt somewhere along the way that there is a specific formula for adding rocker soles to existing footwear to reduce plantar pressures andprovide forward motion.Not sure if it was the steepness of the rock or the position to place with regards to offloading plantar pressures.Does anyone have information on this or can point me in the right direction?
    Thanks
     
  2. Graham

    Graham RIP

    There are various types of rocker sole modifications.

    For the basic MTPJ rocker I use a 1cm full sole lift to the MTPJs bevelled to 0cm at the toe. We add a graphite plate to give the rigidity on the affected side. The same is done on the other side but without the graphite plate. Unless the affected side is a shorter leg then no need to balance correct the other.
     
  3. Graham

    Graham RIP

    One other thing. Look at there angle of gait. The Rocker line should be perpendicular to the line of progression, not the line of the metatarsals.
     
  4. RobinP

    RobinP Well-Known Member

    I know some of the guys in this abstract and they have been working on various things to do with rocker soles over the years. Someone might have access to the actual pdf and post it on here.

    http://linkinghub.elsevier.com/retrieve/pii/S0958259209000066

    However, Steve Hutchins is a lecturer in orthotics at Salford University and if you contacted him, I'm sure he could furnish you with some of the details.

    I don't want to post his e mail address here but if you go on to the Salford University website and search for his name on the staff directory, you should be able to e mail him.

    Agree with Graham about making the rocker sole perpendicular to the line of progression, not parallel to the line of the metatarsal break in the shoe. good luck

    Robin
     
  5. Boots n all

    Boots n all Well-Known Member

    "...a specific formula for adding rocker soles.." hmmm l dont think so, of course l could be wrong?

    l would say l agree with comments by the other posters also.

    The things that need to be considered are where the plantar pressure is that you want to off load, MPJ's? Distal phalanges? Cuboid? heel? all will have effect on the position of the fulcrum as will the gait (ABducted?) and so does the speed that you off load, often it is the time/speed of moving over the effected area.

    The steeper the ascent the quicker the off load in one area and the quicker the loading of the other and so on.

    Talk to your local Pedorthic association they may have a course running on it?

    If you do find a formula would love a look at it
     
  6. Petcu Daniel

    Petcu Daniel Well-Known Member

    Hi,

    Hope it is Ok to post it ....
    In the same time I think the conclusion of the article : Albright BC, Woodhull-Smith WM. Rocker bottom soles alter the postural response to backward
    translation during stance
    . Gait Posture (2009), have to be considered !
    http://www.ncbi.nlm.nih.gov/pubmed/19329317
    "In young healthy adults, shoes with rocker bottom soles had a destabilizing effect to perturbed stance, thereby increasing the potential for imbalance. These results raise concerns that footwear with rocker bottom sole modifications to accommodate an insensate foot may increase the risk of falls"
    Daniel
     
  7. malaligned

    malaligned Member

    Thanks for all the responses,looks like some extra reading this weekend.Dare I ask if met bars are used by anyone anymore and were they helpful?
     
  8. Max

    Max Member

    What stiffness of graphite plate do you recommend (also what brand & where are they purchasable from?) ARe you using the short version that only extneds under the hallux or the long version that it shaped like an inner sole?
    Max
     
  9. Graham

    Graham RIP

    We use a 3mm TL 2100 graphite - here in Canada we get this from National Shoe.

    we use the insole shaped plate from heel to toe grinding a resess in the sole for the plate to sit flush before adding the rocker sole and replacing the origional sole.
     
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