Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Its been a busy week moving to new domain and new server and new platform. We still have a lot to do. The basic functionality is there, but we working long hours on the rest and awaiting the new design.
    Dismiss Notice

MBT rocker sole footwear, for hallux limitus?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by kmb204, Jun 12, 2007.

  1. kmb204

    kmb204 New Member


    Members do not see these Ads. Sign Up.
    after reading a little about the benefits of the mbt footwear in shock absorption i was wondering if they could be recommended for hallux limitus? any thoughts please
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Ted Dean

    Ted Dean Member

    I can't help you with the mbt, but the best shoe that I have found for shl is the Etonic Minato. This shoe has an excellent rocker sole. I can even make it rigid without needing to add to the rocker. The rocker also starts proximal to the mets which helps with lots of other forefoot problems.


    Ted Dean CPED
     
  4. Asher

    Asher Well-Known Member

    Yes I would and have recommended MBTs for symptomatic structural hallux limitus and rigidus with good results. Don't recommend them for anything/anyone else but I get lots of queries from patients about them.
    Rebecca
     
  5. montagu356

    montagu356 New Member

    Hi there

    I wear MBT shoes for a hallux limitus condition and am pleased to say that I remain symptom free by wearing them. Hope that helps you. I also recommend them to my patients with similar conditions.
     
  6. julietmollica

    julietmollica New Member

    Hi,

    I have had quite a lot of clinical experience with MBTs and I have found them to be very good for the treatment of hallux limitus and especially in the case of post operative treatment for sugical fusion of the first MPJ where dorsal pressure can occur with orthotics. I have found that they are mainly problematic when there is hypermobility present, especially in the knees. I would contraindicate them in unstable ankle joints, when genu recuvatum is present, and also when neuromas are present as it is seems that the increased movement of a mobile forefoot seems to aggrevate this. However I have found it to be very good for plantar fascitis. I have found them too heavy to run in so I feel orthotics are always a much better option for this. Hope this helps.
     
  7. jghphd

    jghphd New Member

    I have bilateral h. Rigidus and have worn mbt's for years. They have worked fine for my toes, but are, by design, unstable from side to side and unsuited to uneven surfaces. I just discovered a great pair of running shoes. Nike air torch runners (316124 010). They are stiff enough, stable, and flex at just the right spot! They are way lighter than mbt's and put less stress on my knees and hips. I'm going to buy 5 pairs as they are out of production. The soles are hard rubber and are available on other Nikes, so there may be other options. They look a little weird for work, but so do mbt's. Way cheaper $60 at Sports Authority. Walk around the store in various sizes, as the toe flex has to happen in just the right spot, which is not crucial in hard rocker soles.
     
  8. Boots n all

    Boots n all Well-Known Member

    Before you do anything, get a client/friend that's being wearing the MBT for 6 months and then video their gait at ground level from both behind and in front and make your choice
     
  9. Katiebruce

    Katiebruce Member

    Have had personal experience of MBTs. They are fabulously comfortable not just for feet but great shock absorption for backs and knees.Have advised a number of patients to try them for hallux limits with great success ESP as now a wide selection of styles and one shop allows you to try at home before you buy. Have had some patients use them instead of anti pronatory orthoses as they encourage supination. Not good in icy weather though.
     
  10. Griff

    Griff Administrator

    Really??
     
  11. efuller

    efuller Well-Known Member

    Any rigid shoe could be good for hallux rigidus. As you can see from the testimonials above, some people love them. I've also had patients hate them. Whenever I recommend shoes like these I tell people that some people love them and others hate them.

    Eric
     
  12. David Smith

    David Smith Well-Known Member

    I found that Sketchers Shape ups and their derivatives have been great for relief of my right hip pain and right forefoot pain, especially when walking around London all day and dancing salsa. When dancing I can move around on the mid foot and so keep my forefoot offloaded and when walking on pavements and in superstores I can just feel my gait being more propulsive. Terrible for walking on rough ground though, so then a I use a pair of Caterpillar walking boots that have a shallow rocker fore and aft and side to side. I often recommend Sketchers to my patients when appropriate.

    regards Dave Smith
     
  13. Katiebruce

    Katiebruce Member

    Yes ,a few patients don't want to bother trying to accommodate orthoses and have found MBTs seem to reduce their pro nation symptoms. Katie
     
  14. Griff

    Griff Administrator

    That isn't my experience with MBTs at all. Numerous cases of exacerbated Tibialis Posterior symptoms with them come to mind. I haven't noticed them consistently increase STJ supination moments (external) either.
     
  15. blinda

    blinda Well-Known Member

    Tend to agree with IG here. Had more than a few pts with PTTD complain of increased pain following the use of MBT`s directed by well meaning friends/health professionals. Care to elaborate on their ability to reduce `pronation symptons`?
     
  16. Katiebruce

    Katiebruce Member

     
  17. mike weber

    mike weber Well-Known Member

    Katie don´t believe things a rep tells you invested interest and all, hear what they say and investigate you might find they were telling porky pies.

    MBT´s and rocker bottom shoes do work and have place in clinic practice, but it is important to understand how they work and " reducing pronation " is not one of them IMO
     
  18. RobinP

    RobinP Well-Known Member

    Agreed. If you want to give someone a rocker soled shoe to help with hallux rigidus/severe structural hallux limitus, I would suggest a Ryn shoe. Same shape as an MBT/Sketchers Shape up but without the soft poron heel cushion. I'm of the school that doesn't believe that shock absorbing cushioned shoes are all good

    http://www.ryn.ie/index.php?option=com_frontpage&Itemid=1

    Obviously don't believe the propaganda on their website about toning etc. They are just rocker soled shoes without such a spongy bit at the back that tends to increase external STJ pronation moments(in my experience)
     
  19. Griff

    Griff Administrator

    I agree.

    Hence my reply:
    to the comment:
     
  20. alessandro costa

    alessandro costa Active Member

    i guess they don't work on pronating foot, the foot moves too much side to side
     
  21. footpower

    footpower Well-Known Member

    World renown US Pedorthist Dennis Janisse will give a presentation called "Effect of Rocker Soles on Plantar Pressures and Lower Extremity Biomechanics" at the IVO2012 congress in March in Sydney. This is not specific about a particular product it promises to be interesting.
     
  22. Atlas

    Atlas Well-Known Member



    Spot on.

    Rigidity is the cake. Rocker is a good icing though.



    Ron Bateman
    Physiotherapist (Masters) & Podiatrist
     
  23. jennrocky

    jennrocky Member

    I tried on these shoes and couldn't believe how much motion was going on in the rearfoot. Too much pronation. I could foresee many problems resulting from this. I certainly will not be recommending MBTs to my patients.
     
  24. CamWhite

    CamWhite Well-Known Member

    I have had excellent results fitting Ryn shoes for those with hallux rigidus, or very limited ROM in the 1st MPJ. Customers remark that they like the (frontal plane) stability and have better sense of control when they walk in the shoes. Ryn has a very rigid, reinforced PU midsole with almost no bend. Also find them to be very helpful for those with midfoot & ankle arthritis, and for some people suffering from plantar fasciitis.
     
  25. markjohconley

    markjohconley Well-Known Member

    Goodaye Robin, I'm not disagreeing, don't know enough, but I would have thought that there would be less external pronatory moments than a solid lateral flared sole would make?, any replies from anyone appreciated, mark
     
  26. efuller

    efuller Well-Known Member

    The Nigg paper from way back looked at pronation velocity vs midsole hardness and lateral flare. The pronation was faster, consistent with higher pronation moments from the ground, with more lateral flare and harder midsoles. This would be counter to the assertion that the spongy heel would increase pronation moment from the ground.

    Eric
     
  27. RobinP

    RobinP Well-Known Member

    Hi Mark, you are right, that was poorly worded. The soft spongy bit doesn't increase the external pronation moments.

    It would depend on the cop but the foot that has a medially deviated STJ axis that suffers with pronation related pathology will probabaly find that there will be greater internal supination moments required to prevent structures being damaged by residual external pronation moments versus a solid midsole shoe through the midstance portion of the gait cycle................................I think!
     
  28. alessandro costa

    alessandro costa Active Member

    where can we find something about this presentation? thank you, alessandro
     
  29. alessandro costa

    alessandro costa Active Member

  30. Boots n all

    Boots n all Well-Known Member

    Alessandro, if you are coming to IVO 2012, seek me out and will introduce you to Dennis personally.

    In the mean time l will see if we cant put his abstract here.
     
  31. Boots n all

    Boots n all Well-Known Member

    Dont confuse this type rocker sole with the marketed rocker sole by MBT and others as their main feature that has caused(?) so many issues is the S.A.C.H and the instability this can cause for some, not the forefoot rocker.

    Abstract as promised..........

    Effect of rocker soles on plantar pressures and lower extremity biomechanics

    Dennis J. Janisse, C.Ped.
    Jacqueline J. Wertsch, M.D.
    Gerald F. Harris, Ph.D.
    John P. Klein, Ph.D.
    David W. Brown, B.S.

    Hypotheses/Purpose
    The rocker sole is the most commonly prescribed external shoe modification. The purpose of this study is to analyze how rocker soles redistribute plantar and suprasegmental forces and affect the timing of these forces. Our hypothesis is that rocker soles not only affect plantar pressures but also have suprasegmental effects.

    Conclusions/Significance
    A significant decrease in peak pressures and pressure time integral was seen under first through fourth metatarsal heads with all three rockers. Kinematic changes are seen in sagittal plane throughout the lower extremity; more significant kinematic change is seen at the hip and ankle than at the knee. Increased cadence and decreased stride length was noted with the toe-only rocker.

    Summary of Methods/Results
    A total of 40 subjects (ages 30-61, 20M/20F) participated weekly for a one-month evaluation period with the three types of rocker soles (toe-only rocker, negative heel rocker, and double rocker) randomly assigned.

    The control shoe was used for weekly baseline measurements to allow comparison with rocker sole gait metrics. Multiple DMAPP (dynamics, motion and plantar pressure) analysis of insole plantar pressures and segmental foot, ankle, knee, hip and pelvis 3-D gait metrics (kinematic and kinetic, dynamic EMG) was done with both baseline and rocker shoes in three day-long weekly sessions for each subject with randomization of subjects and rocker soles.

    A portable Holter in-shoe pressure data-acquisition system was used for measuring plantar pressure distribution during walking. The system continuously collected pressure data between foot and shoe from 14 sensors at a 60-Hz sample rate (per channel). The data reflects over 48,000 steps with comparisons considered significant at 0.01 confidence level. Gait analysis was acquired with each subject while walking at a comfortable and natural speed on a ten meter walkway.

    A Vicon motion analysis system using six infrared video cameras and passive reflective markers were used to record and analyze joint kinematic data. Ground reaction forces were acquired with a strain gage force platform (AMTI,OR6-5) level with the walkway surface.
     
  32. alessandro costa

    alessandro costa Active Member

    David, I will not be there but I'll be in the summerschool in manchester in june, will you be there? I'm really interested in this abstract because we don't really know if this shoes are working good, in wich are indications of prescription or wich cases we can't use it. of course who sells this shoes says the are good anyway, but that's just marketing. I'm trying joya shoes and I have my own impressions on my flat pronated feet..... thanks alessandro
     
  33. Boots n all

    Boots n all Well-Known Member

    l think and l dont know, but l would imagine the footwear was not a particular brand as the abstract states "external shoe modification" and they mention brand of the measuring equipment but not the shoe brand, so l would have thought they are standard shoes that were modified, no sales pitch.

    Late last year l modified 20 pair of shoes for a research project, l doubt the brand of footwear will get a mention as they are testing the modification of the soles effects on the body not the shoe.

    No l wont be attending the summer school.
     
  34. Or David, you can use my abstract on all various clinical applications, but rejected by the NSW Podiatry conference, deemed unsuitable. Funny, cause they are the standout choice for most RA and OA feet, but weren't included in the footwear for RA feet study, presented at same conference 2 years ago. Interestingly, there are now approx 30 copies that I know of. In my clinic I have used these and other rocker/ micro wobbleboard footgear/devices for 7 years now, amongst other Tx modalities. Still learning all the time, can you believe that even some of the worst structural H/Limitus cases after suitable time AND gait retraining can now be moved towards minimal shoes to help restore correct function. Why? Because joint pain and inflammation have resolved with both the rocker and muscle activation and proprioceptive stimulating features. Do not underestimate the last 2, so important to restoring good foot function.If you know of another clinician who has more than my experience/expertise 7+ years, I would love to rap with them. Why would you think a triple arthrodesis would now have stronger feet/better joint position after 3 years wear AND the fixation hasn't failed? See why I say am continually learning. These people love being able to move across to Fitflops. Check out 2 videos on my website if interested. Hypermobility, they are a knockout for BUT not until you correct overstriding gait. Try "barefoot" walking gait training and most don't need bracing orthoses.And Tib Post cases can be great for if you know what you are doing, I often use a straight extended Varus wedge inside shoe, under a Barefoot Science insole, and the response from increased sensory stimulus can be dramatic. If you haven't supervised these people, in clinic, you would not dream that they respond so well to de-orthoticising. Correct gait technique is pivitol, but easier to change decades old gait patterns with different neurosensory feedback. I don't know too many Pods who say they think they can help an 88yr old, poor balance, 3 sets of recent functional orthoses, shocking spine,fusions, poor mobility post TKR post op infection and more. These are the sort of cases where these techniques can be profound, and I love seeing them smile, stand straighter and walk better when they leave the consult.
    Forget about "Barefoot Running" until you reclaim "Barefoot Walking"for your patients. See MBT website for technique. By the way, did you know APOS is the Israeli knockoff with a difference? About $5K if my maths is correct, surgeons using these for post op knees. BUPA have at least 3 centres in UK+Singapore, but won't even pay a rebate here anymore, despite being TGA med grade fw classif. I will show a couple of interesting cases at IVO.
     
  35. Boots n all

    Boots n all Well-Known Member

    Sorry Bronwyn, l didnt attend your session, so much going on for me during IVO.

    Having a little trouble following what your saying lets work backwards please.............

    "By the way, did you know APOS is the Israeli knockoff with a difference? About $5K if my maths is correct, surgeons using these for post op knees. BUPA have at least 3 centres in UK+Singapore, but won't even pay a rebate here anymore, despite being TGA med grade fw classif...."

    What is APOS ? google doesnt come up with any footwear under that?
    Do you have a link?

    What is about $5k in your maths?

    "...can you believe that even some of the worst structural H/Limitus cases after suitable time AND gait retraining can now be moved towards minimal shoes.."

    No offense, but no l cant believe that. Unless your gait retraining is to get them to walk aBducted? Unless the HL is not structural? or am l missing something?????

    l agree with you there is always so much more to learn.
     
  36. GMiller

    GMiller Member

    sorry for the spam, posted by mistake and can't find the delete button
     
Loading...

Share This Page