Foot Levelers Orthoses

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I see several patients given "Foot Levelers" orthoses by their chiros here in the US. According to the patients they are "custom" via foam box casting. They are leather and cork with a varus heel wedge, separate medial and lateral arch pads and met pads. I see about two a month through my clinic, and they all look alike. They look like prefabs to me. Does anyone have any info on these devices. They look like a rip-off and patients are usually equivocal regarding their effectiveness. Cost is around $300-350.

 

They are made by Foot Levelers orthotic lab - they are custom, in that the placement of the prefabricated heel wedges, arch pads etc are custom placed on the insole! I am surprised that intelligent health professionals fall for this ....

 

I too see many. "Scam" comes to mind.

 

In australia the chiros have a computerised program that takes a digital photograph of the plantar aspect of the feet(similar to what you would see on a pedoscope). Apparently from here they are made by a computer.... appears very dodgy and the claims of their effects on foot mechanics are just as...
they are sold for around 350.00 per pair with consultation fees on top of this!

 

Foot Levelers

Hey,

has anyone here used "Foot Levelers" before. Apparently its actually been targeted towards Chiro's as "spine and pelvic stabilisers", but have heard that some pods do use them. How has their success been in terms of efficacy? is it worthwhile investing in something like this? or is it just another visual aid and marketing tool? Any thoughts would be appreciated.

Byron

 

Re: Foot Levelers

Hello bstarkey

I can probably give you some insight into Foot Levelers as I am a DC (and a Cped), I was also afforded a pair of their inserts while in clinic.

Foot Levelers is very much entrenched in the chiropractic profession. They sponsor seminars and give a lot of financial support to chiropractic as a whole, as well as marketing to students upon entering clinic by providing them a free pair (even the foam box to cast them from). How they 'stabilize' the spine is anyone's guess really.

They are at best accommodative, customized, prefabricated arch supports (my opinion). In my personal experience I developed heel pain and a neuroma as a result of wearing these for more than a year. This does not mean that they have no merit at all, merely that they would never be my first choice to treat any sort of foot pathology.

Although as chiropractors we studied physiology and biomechanics ad nauseum, it was mostly related to the spine and more proximal extremities. No chiropractic college that I am aware of offers the type of training in its core curriculum that a DPM (or even a CPed) receives in the lower extremity and that lack of training lends to their acceptance of the theories and marketing impugned on them by several insert manufacturers.

Just judging by my experience and foot type, the case can be made that the type of orthoses that the podiatric profession has developed is the benchmark to treat dysfunction conservatively with in-shoe devices.

I have a flexible subtle cavovarus foot. I am an evertor with some tibial varum and functional hallux limitus > on the right. From midstance into full FF load my calcaneus inverts and unable to bear full weight on my hallux I tend to supinate the midtarsals excessively (the supinatory rock that I read about in one of Dr. Kirby's articles I believe).

I certainly was never taught to identify or address these issues in chiropractic college, merely to 'prescribe' a Foot Leveler insert and all would be dandy (especially my pocketbook).

These changes in gait I now understand to are attributed to overloading of my lateral column and creating pressure between my third and fourth toes due to an apropulsive gait pattern. I also had heel pain, Haglund's deformity and Hallux pain as the day wore on.

This was all brought on by wearing a Foot Leveler insert and persisted after being prescribed several OTC and custom orthoses. Later I began experimenting with plaster casting in STJ neutral and an optical system, ScanAny and found a whole different world at my disposal. I also discovered an intense interest in functional orthoses that led to me taking the pedorthic course and dispensing at a much more higher level.

Of course now that I know a little I realize how little that I really know!

The bottom line is that I now wear a rigid device suitable for my flexible foot, casted partially corrected to remove the varus (created by mild muscular involvement), a neutral deep heel cup and first ray accommodations bilaterally. No more pain. I even run in them without a problem.

I know this is a lengthy response but I am hopeful that my colleagues who may be reading this will think outside of the chiropractic box and realize that the feet, their biomechanics and treatment is a highly complex subject and there is no one-size-fits-all paradigm or manufacturer that works in every case.

Many of these companies rely on marketing that is bereft of researched, peer-reviewed and reproducible studies that confirm their assertions. Simply providing the same material to every patient, filling the medial arch and relying on these myopic paradigms to treat every foot problem is not science nor is it progress. It is also somewhat unethical, but I digress...

Regards