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'Foot Orthotics are not only worthless, but actually harmful."

Discussion in 'Biomechanics, Sports and Foot orthoses' started by sesadler, Sep 21, 2011.

  1. sesadler

    sesadler Member

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    Just ran across this from following a link in the comments from an article on Barefoot Running in the Economist (http://www.economist.com/blogs/gametheory/2011/09/running-fads) and was astounded by the negative tone towards FO's in just the first few sentences:
    Ditch Your Orthotics: Just as athletic shoe design is flawed, so is the concept of immobilizing the foot with an orthotic. Orthotics are not only worthless but actually harmful. Whether flexible or rigid, made of foam or plastic, an orthotic detrimentally increases joint torques and pressures. Even a minimal, flexible, off-the-shelf orthotic increases knee joint torques and forces that are associated with knee osteoarthritis.
    (http://oeshshoes.com/technology/) [Expanded Text here: http://oeshshoes.com/technology/ditch-your-orthotics/].

    Not surprised mind you, it is after all a marketing site for these 'new' shoes, just a little surprised at some of the claims:

    "Medical professionals historically have recommended wearing foot orthotics for anything ranging from foot, knee, back, to even shoulder and neck problems. In fact, orthotics are often recommended for people who don’t even have problems, particularly, people with “flat feet” who have been told they “overpronate.” The idea was that orthotics create a more normal posture and indeed, orthotics have been shown to reduce pronation (the inward turning of the foot). The problem though – and this is what gait laboratory research kept demonstrating – is that while the posture might look good, the measured forces and torques associated with that posture are actually not good at all."

    I don't necessarily disagree with all of this, I think some if it has been discussed on this site. I question the lack of links to the 'research' mentioned (if I missed those links on the footwear site I apologize. I did look around but did not find them). And to put out a blanket statement that all 'orthotics are harmful' is disingenuous at best and harmful to the consumer / patient at worst.

    The questions of 'how' and 'why' foot orthotics 'work' aside, the fact that many people DO find LONG TERM relief from using them (I think we all have them in our practices be you MD, DPM, DO, CO, PT or CPed) that this sort of marketing drives me batty!!

    Anyway, that's all for my morning rant. When I read through this I thought of all of you and simply had to share. :bash:

  2. Craig Payne

    Craig Payne Moderator

    Those that choose to make such claims need to be held accountable and explain:

    1) why every single patient satisfaction study, outcome study, randomised controlled trial on foot orthotics actually show they work. Not one of them has shown that they do not work (and there are more than 50 of them).

    2) not one study has shown any link to knee osteoarthritis (though foot orthotics have been shown to both decrease and increase knee torques, so you could cheery pick the increase studies)

    3) not one study has shown they do any harm

    4) why those who make these claims actually have a product to sell (which usually has zero evidence associated with in when compared to (1) above)
  3. Orthican

    Orthican Active Member

    For these things too shall pass...

    This is a simple example of a type of formal fallacy called "appeal to probability" among others...as there will always be an agonist there will surely be an antagonist.

    In all this debate I am left wondering if someone such as this can actually be held accountable for ignorance. Inability to research what you are going to say before you say it publicly and make a claim shows very little in the way of intelligent forethought.
    We have to our credit vast amounts of information to the contrary in any argument of this type. The naysayers with an agenda will always be there and will always have a fallacious argument to back up a fallacious claim. The tipping point will be when someone of some societal significance develops a problem and begins to dig a bit deeper.

    We will always be looked upon as having a bias. So anything we say will be looked at in that way from such people with limited field of view.
  4. Craig Payne

    Craig Payne Moderator

    There is no debate. The science is unequivocal
    That may well be the case, but the science is unequivocal. I am biased towards science. Those who think we are biased, need to explain the science in my post above.

    As Paul Shearer said in the intro to his recent book:
  5. dtv5144

    dtv5144 Member

    there are no bad orthotics, only bad podiatrists
  6. Orthican

    Orthican Active Member

    I think everyone would agree there is good and bad in every profession. The world is full of people in every walk who are quite willing to talk people into just about anything as long as it makes them a buck. Venality nothing but. I see it all the time.
  7. Orthican

    Orthican Active Member

    I fully agree that making claims means nothing without backing it up.

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