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  1. Members do not see these Ads. Sign Up.
    One of the talks at the recent SCP Conference was about "insolia".

    Here is Howard giving the layman's / laywomen's version (can't see many men using this one to be honest).

    What say you

    Regards
    Robert

    PS, in case anyone is confused, this is inSOLia. Peter Andre does not endorse this product ;)
     
  2. cornmerchant

    cornmerchant Well-Known Member

    Robert

    Should there be a link on your posting? It doesnt make sense without! I was not at the conference so I didnt hear the talk.

    Sorry to be dumb but I dont get the joke about peter andre.

    Cornmerchant
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. My missus likes 'em .
     
  5. blinda

    blinda MVP

    So do I. Can definately wear silly shoes for longer when I wear them.

    Got mine from Canonbury.
     
  6. Paul Bowles

    Paul Bowles Well-Known Member

    That's the only evidence I need! That quote made me laugh so hard for a Monday morning thanks Simon!

    Howard should consider putting that on the packaging:

    Simon Spooner - "My missus likes 'em".

    ;)
     
  7. Ninjasox

    Ninjasox Active Member

    Erm isn't that just encouraging women to wear a shoe that's inherently unstable for longer, thus creating the potential for ankle stability problems?

    I mean if I swapped my 205 tires for a pair of 105's and still expected to have the same handling, you'd most likely find me stuck in a ditch... Or am I missing the point?
     
  8. I guess its like putting seatbelts in a zonda.

    You're still much more likely to crash than in a volvo... but the risk is somewhat reduced.
     
  9. Ninjasox

    Ninjasox Active Member

    As an enabling device for prolonged high heel wear, what's to stop a patient from starting a law suit using the argument 'hey this device of yours allowed me to wear shoes that are bad for my ankles longer, and now my ankle just snapped off......'

    If you can sue brewers for making booze easier to drink ie alcopops and tobacco companies for cigarettes that are easier to smoke ie menthol, then why not insolia? All it takes is an over enthusiastic lawyer and an expert witness.......
     
  10. Paul Bowles

    Paul Bowles Well-Known Member

    ....because I am sure Howard prefaces their use by saying "Hey you shouldn't be wearing those shoes, but if you choose to then this is an option that may help."

    Anyway where is the evidence to say that high heels are "technically" bad for all of us? Is that statement just a myth or do we actually have some hard data to support it?
     
  11. CraigT

    CraigT Well-Known Member

    On the subject of the insolia inserts... has anyone seen the new Vasyli McConnell OTC inserts?
    They are very similar to the insolia.
    Not sure the what the link to Jenny McConnell's expertise is apart from her being on the 'thinktank'...
     
  12.  
  13. Paul Bowles

    Paul Bowles Well-Known Member

    Yes we have been using them in our practice for a few years - nice adjunct in those tighter fitting shoes where space is a premium!

    Mr Weber - I agree whole-heartedly with your sentiments, they can be useful and I am sure certain portions of the populous tolerate them very well. Just wondering why we are pigeon holing them as "bad for you" when they probably have less detrimental effects on your health than some other shoes on the market. If they were "that bad" for you, by sheer public disapproval they would cease to exist......
     
  14. Mike or Michael will do fine Paul as I guess we can say these days My Grandpa was Mr Weber... I guess it is abit like Pronation is bad arguement it will take a long time for most to get over 20-30 years of being told that it is.
     
  15. :bang:
    Paul:

    Using your above logic, then obesity, cigarette smoking and alcoholism should cease to exist because it is "bad" for people? You are assuming, with your above statement, that people only do things that are good for their health...this couldn't be further from the truth. Wearing high heeled dress shoes that exert excessive medial-lateral external compression forces on the digits likely causes a number of foot pathologies and I don't think women should be encouraged, in any way, by foot health specialists to wear these shoes. Can you imagine the endocrinologist telling their diabetic patients that eating sugary ice cream on a daily basis is just fine, as long as they only have half a serving?:bash:
     
  16. Paul Bowles

    Paul Bowles Well-Known Member

    But Kevin you are taking the extreme stance. I am not stating that obesity, cigarette smoking or alcoholism is "good" for people. What I am simply stating is show me the evidence that heels cause issues in all of the population?

    You state yourself the word "likely" - I agree, it may be likely and it may also increase your risk, but in some patients it is also unlikely to cause issues. Lets not take a broad broom and sweep everyone under the same table.

    Just as patients with diabetes can be managed at different levels diet controlled, oral hypoglycaemics, injectable insulin - I am sure female footwear and our patients can also be managed at different levels - wouldn't you agree?

    My above statement was not also not meant to be broad weeping (apologies if it was taken that way) but in the clinical context I may see 10 female patients a day who wear heels, when only 50% have an issue directly relating to the heel itself. I think this thread has incorrectly implied that Howard is "encouraging" the use of heels with insolia. Howard is merely trying to make the best out of a bad situation which I am sure he has advised the patient of but it is one he cannot change.

    C'Mon Kevin are you saying all your patient abide by your strict rules and walk into your office in the appropriate motion control runner swearing that bad footwear never touches their pristine feet? Maybe all your patients who have diabetes also swear complex carbs never pass their ruby red lips!!! Oh if all my patients would just agree to wear every shoe I recommend....hahahaha. That will never happen in my practice!

    ;)
     
  17. Ninjasox

    Ninjasox Active Member

    Lots of interesting points here gentlemen, but where are the long term studies that prove that wearing high heels cause foot pathologies? they seem rather thin on the ground

    I still think insolia encourages use of bad footwear, if you look at the insolia website you'll see statements like

    'Shifts Weight Off the Balls of Your Feet
    Wear Your Favorite Heels 3 Times Longer
    With Truly Comfortable High Heels'

    There is a disclaimer but its not glaringly obvious. In my small experience of ladies and their favourite heels, its usually the ones that are far too tight with an excessive heel, but oh so lovely in a sparkly red. So do we want to allow wearing of these shoes for up to 3 times longer?

    It seems a given that high heeled shoes are bad (not in all cases mind), but to what degree ie when does the height of the heel become 'unacceptable'? Some ironclad research to back up what seems so far to be anecdotal evidence would be great.

    My worry is how long will it take before someone cottons on that wearing high heels 24/7 is not the best idea in the world, but here comes this new fangled device that's just made it that bit more easy, so lets go ahead and do it anyway. And now that my feet look like mangled squash rackets, i'm going to let my lawyer pick holes in your disclaimer.

    Most patients quite happily stop wearing high heels once they realise what their feet may look like, just as long as they have a glamourous (albeit sensible) alternative.
     
  18. Paul:

    I am not taking "an extreme stance". I did, however, make exception to your comment:

    So are you saying that high heeled shoes with pointy toes which are much more narrow than the shape of the foot can't be that "bad" for patient's feet since the public hasn't disapproved of them enough to outlaw the sale and wearing of these styles of shoes?? I am just trying to understand the logic of your above statement since it is quite contrary to what I have observed over the past quarter century of being a podiatric physician.

    My viewpoint is as follows:

    1) Most ethical physicians realize that many of their patients choose to do things that are "bad" for their health.

    2) These same physicians tell their patients repeatedly that these things are "bad" for their health.

    3) These patients know that these things that they do repeatedly are "bad" for their health.

    4) However, these same patients, because they like to do these things, still continue to regularly do these things even though are fully aware that they are "bad" for their health and they are against the medical advice of their physicians.

    However, Paul, you now say: "If they were "that bad" for you, by sheer public disapproval they would cease to exist......"

    Your statement simply worries me as to our role as members of the medical profession. Isn't it our jobs, as foot-health care professionals that presumably should be looking out the best interests of our patients, to recommend to our patients that they shouldn't be wearing shoes that may injure their feet? Or, do you believe, as your statement indicates, that since these shoes still exist, and they haven't been outlawed by society, they can't be that bad for the public?

    I am not trying to be argumentative. What I am trying to do is make the point that we must be very careful what we recommend to our patients regarding their shoes and shoewear habits since if we, as podiatrists, don't make a stand against shoes that can harm the public, who will make that stand?!
     
  19. Dananberg

    Dananberg Active Member

    Good morning everyone,

    As the inventor of Insolia, I think its about time that I reply.

    Kevin wrote "Isn't it our jobs, as foot-health care professionals that presumably should be looking out the best interests of our patients, to recommend to our patients that they shouldn't be wearing shoes that may injure their feet? "

    Kevin is right on target with this comment. We, as foot-health professionals have a responsibility to do what we can, when we can, and to make our patients comfortable in their activities of daily living. We have all treated young athletes with varieties of foot/lower leg issues and do what we can to keep them "in the game". We do this despite also seeing the effects of sports injuries later in life as those 50+ year olds with arthritic football knees and ankles limp into our practices daily. Does the fact that we see the effect of sports trauma in later years ever stop us from helping the young athletic warriors? Of course it doesn't...and it never should. Equally, I would venture that everyone on this discussion has at one time or another trimmed a 5th toe heloma in a high heeled shoe wearer. Does this not facilitate their returning to high heels and therefore render us an "evil" provider? Of course not...and how foolish a thought!

    Having studies the effects of Insolia on foot pressure, the 25% reduction is load is quite significant. In addition, Sarah Curran has studied the effect of Insolia on VO2 Max in subjects walking with flats and high heels with an without Insolia. O2 uptake with Insolia in a 70mm high heel was essentially equalivant to flats....ie, it made high heeled walking metabolically more efficient. Most surprisingly, however, is that Insolia was rated by the wearers in the Curran study as providing the greatest amount of forefoot cushioning. Considering it doesn't even extend to the forefoot nor provide any cushioning would speak quite clearly as to the positional affect vs. simple gel cushioning (which really doesn't work longer term).

    Until you have sat in on a women's focus group, and listened to the comments of how higher heel shoes make them feel, can the impact of a product like Insolia be understood. Being forced to stop wearing higher heels makes women feel "old" and "useless". They report feeling like their youth is behind them. Once they can use a higher heeled shoe for that special "dress up" occasion, their youth is once again captured. I have heard this countless times, and listening to this first hand was a real eye opener for me. The social impact was far greater than I had ever anticipated. Prehaps this is why women routinely ignore the advice podiatrists have provided for decades about the "dangers" of higher heeled footware.

    Life is about balance. Taking a rigid stand about high heels makes podiatrists appear out of touch with their female patients. Understanding their concerns, and offering a viable solution which encompasses both symptom relief while remaining currently fashionable, would seem to make the podiatric opinion far more acceptable, seemingly knowledgable, and, in a fashion sense, socially responsible.

    Howard
     
  20. Dananberg

    Dananberg Active Member

    Good morning everyone,

    As the inventor of Insolia, I think its about time that I reply.

    Kevin wrote "Isn't it our jobs, as foot-health care professionals that presumably should be looking out the best interests of our patients, to recommend to our patients that they shouldn't be wearing shoes that may injure their feet? "

    Kevin is right on target with this comment. We, as foot-health professionals have a responsibility to do what we can, when we can, and to make our patients comfortable in their activities of daily living. We have all treated young athletes with varieties of foot/lower leg issues and do what we can to keep them "in the game". We do this despite also seeing the effects of sports injuries later in life as those 50+ year olds with arthritic football knees and ankles limp into our practices daily. Does the fact that we see the effect of sports trauma in later years ever stop us from helping the young athletic warriors? Of course it doesn't...and it never should. Equally, I would venture that everyone on this discussion has at one time or another trimmed a 5th toe heloma in a high heeled shoe wearer. Does this not facilitate their returning to high heels and therefore render us an "evil" provider? Of course not...and how foolish a thought!

    Having studies the effects of Insolia on foot pressure, the 25% reduction is load is quite significant. In addition, Sarah Curran has studied the effect of Insolia on VO2 Max in subjects walking with flats and high heels with an without Insolia. O2 uptake with Insolia in a 70mm high heel was essentially equalivant to flats....ie, it made high heeled walking metabolically more efficient. Most surprisingly, however, is that Insolia was rated by the wearers in the Curran study as providing the greatest amount of forefoot cushioning. Considering it doesn't even extend to the forefoot nor provide any cushioning would speak quite clearly as to the positional affect vs. simple gel cushioning (which really doesn't work longer term).

    Until you have sat in on a women's focus group, and listened to the comments of how higher heel shoes make them feel, can the impact of a product like Insolia be understood. Being forced to stop wearing higher heels makes women feel "old" and "useless". They report feeling like their youth is behind them. Once they can use a higher heeled shoe for that special "dress up" occasion, their youth is once again captured. I have heard this countless times, and listening to this first hand was a real eye opener for me. The social impact was far greater than I had ever anticipated. Prehaps this is why women routinely ignore the advice podiatrists have provided for decades about the "dangers" of higher heeled footware.

    Life is about balance. Taking a rigid stand about high heels makes podiatrists appear out of touch with their female patients. Understanding their concerns, and offering a viable solution which encompasses both symptom relief while remaining currently fashionable, would seem to make the podiatric opinion far more acceptable, seemingly knowledgable, and, in a fashion sense, socially responsible.

    Howard
     
  21. Howard:

    Good to hear from you again. Hope all is well.

    I agree in essence with what you say. My last article for Podiatry Today on Shoe Battles briefly touches on the psycho-social-physical difficulties that most women have in trying to look feminine in today's Western Society but also be healthy and comfortable at the same time. If my female patients need to wear dress shoes for their work or pleasure with heels then I educate them on the detrimental effects that higher heel height and cramped toe box fit can have on their foot over time. I even make orthoses for their dress shoes on occasion. I know that I can't totally change their shoe-wearing habits, but I feel that my duty, as an advocate for their foot-health, is at least try to get them to modify their shoe-wearing habits so they can lead more healthy, happy and productive lives.
     
  22. Hi Howard,
    This is interesting. Did she speculate on how this was achieved? Do you have a copy of the paper you could share with us?
     
  23. Dananberg

    Dananberg Active Member

    Kevin,

    Efforts toward educating patients is always the right way to go. Giving them a way, however, to simultaneously remove the stress while having them have the ability to dress fashionably was the goal of Insolia. I always knew that there would be a subset of podiatrists who would see Insolia as negative. Going back to Simon's comment...."My missus likes 'em" says it all...some podiatrists do find this an acceptable solution.

    Howard
     
  24. Dananberg

    Dananberg Active Member

    Simon,

    The paper is not yet published...so I am not sure sharing this is possible yet. I will check and get back to you. I do know that her methods were quite strict and you will find this paper as a very scientific approach to this topic.

    Howard
     
  25. Howard, I'm interested in foot interface stiffness characteristics and its effect on metabolic cost. I wonder if the change in stiffness resulting from the insolia may account for some of the observed effect?
     
  26. RobinP

    RobinP Well-Known Member

    There are some points that perhaps require raising in this discussion

    1. There seems to be an implied assumption that high heels are the only type of shoes which have a limited amount of space at the forefoot. The current fashion in the UK is for young girls(not exclusively!) to wear "dolly" shoes. These have no pitch (or very little) and are generally very tight over the toe box both in terms of depth and inappropriate shape. Could these have just as great an effect on forefoot pathologies?

    2. Giving them a way, however, to simultaneously remove the stress while having them have the ability to dress fashionably was the goal of Insolia.

    Whilst we are all aware that this was Howard's goal and that he has some scientific data to back up the reduced forefoot pressure and O2 consumption claims, the implication of a product like Insolia, to the lay person, is that wearing heels is OK because by using Insolia, there is less pain, i.e. not harmful.

    I'm not saying that heels are, or are not, OK but at least in clinic, we can influence the way in which our patients think about footwear. However, insoles being sold over the counter at approx £6 per pair do not come with that kind of in depth advice. Perhaps that is why people/members of the podiatric community have a slightly negative view of Insolia

    3. My missus loves them too!

    4. At an exhibition last weekend, I picked 10 people walking past my stand wearing between 2 inch and 5 inch heels and gave away a set of Insolia to each person. I will be contacting them at the beginning of next week to ask how they found them via a market research style questionnare.

    I'll post the results of this ultra scientific study asap for those who are interested?

    Regards,

    Robin
     
  27. Paul Bowles

    Paul Bowles Well-Known Member

    Robin no need to publish the results we have all the data we need:

    Both your wife and Simon Spooners wife approve! Thats all the data we will ever need!

    ;)
     
  28. Sarah Curran

    Sarah Curran Welcome New Poster

    The paper Howard is referring to is due to be published in March in The Foot and Ankle Online Journal.

    I am limited to what I can provide at the time of writing. However, as an overview we compared flats (15mm), moderate heel (45mm) and a high heel (75mm). We also had a further 2 conditions a high heel with the McConnell insert and the high heel with the Insolia. Participants walked on a treadmill for 10 minutes at a standardised speed. Heart rate, oxygen consumption (i.e. VO2/kg) and respiration exchange ratio were recorded along with the number of steps taken (using a pedometer). The Footwear Comfort Scale was also used for each of the five conditions.

    The McConnell and Insolia inserts were better than the high heels alone and as Howard said forefoot comfort in particular appeared better with the Insolia.

    Sarah
     
  29. Sarah:

    Welcome to Podiatry Arena!

    Did the Insolia or McConnell insert decrease oxygen consumption versus wearing the same shoe without the insert? If they did, then this will be the first time ever within the worldwide scientific literature that research has shown that the addition of foot inserts into shoes decreases oxygen consumption during steady state exercise.
     
  30. Sarah Curran

    Sarah Curran Welcome New Poster

    Hi Kevin,

    Yes, the McConnell did reduce oxygen consumption as well, but the Insolia seemed to be better. I forgot to mention in my previous post - we also assessed the physiological cost index (PCI)*, which to my knowledge is the first time it has been used to measure energy (efficiency) when walking in high heels.

    Sarah

    *PCI calculation: Walking heart rate – resting heart rate divided by speed (m/min).
     
  31. Paul Bowles

    Paul Bowles Well-Known Member

    Thanks Sarah,

    Can't wait to get my hands on this paper - sounds like good work, congratulations!
     
  32. Sarah, well done look forward to reading your paper. It's about time someone else looked at physiologic cost of foot orthoses. Although, I'm afraid you are not the first. http://www.podiatry-arena.com/podiatry-forum/showpost.php?p=31275&postcount=9
    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=7511
     
  33. Sarah Curran

    Sarah Curran Welcome New Poster

    Thanks Paul and Simon.

    Simon - thanks for the info about PCI and orthoses. However, I was talking in the context of the PCI, orthoses and high heeled footwear. I am sure my search strategy missed some articles/conference abstracts!

    Sarah
     
  34. Dananberg

    Dananberg Active Member

    Kevin,

    Kevin wrote: "Did the Insolia or McConnell insert decrease oxygen consumption versus wearing the same shoe without the insert? If they did, then this will be the first time ever within the worldwide scientific literature that research has shown that the addition of foot inserts into shoes decreases oxygen consumption during steady state exercise."

    The answer to your question is YES. Shoes were tested in their "as is" state, and then again with Insolia and McConnell insoles. The comparison to which I referred was

    Howard
     
  35. CraigT

    CraigT Well-Known Member

    Interesting stuff.
    So the Insolia and McConnell inserts are not the same...
    I have only seem the Insolia in passing- could you care to comment on the difference between the 2 Howard?
    Thanks
     
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