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MBT shoes- do they work?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by peterjluce, Jun 4, 2010.

  1. peterjluce

    peterjluce Member


    Members do not see these Ads. Sign Up.
    Does anyone have any knowledge or informed opnions re the MBT range of footwear? I talked with one of their salesmen recently. They seem to be a sort of rocker bottom shoe but are also convex transversely, the idea being to act as a permanent wobble board thus keeping the muscles active both while walking and while standing.

    It makes sense to me that this would strengthen the less used muscles, especially for people like shop assistants who stand up all day- but wouldn't it also make you tired?

    Their website is www.mbt4fitnessandposture.co.uk

    Their brochure quotes some supportive research, but nothing that I can access.

    Pete Luce
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. CamWhite

    CamWhite Active Member

    I have sold MBT shoes for a few years at my store in Austin. The shoes are generally well tolerated by most, including shop assistants working on hard floors. Because the shoes induce instability in both the sagittal and frontal planes of motion, muscles are challenged more in your lower extremities.

    MBT shoes are best worn on relatively flat, level, predictable surfaces. The instability of the shoe is easy to control on flat surfaces. But I advise my customers to be careful about their footing on uneven terrain, including grass, sand and cobblestones. The MBT will go wherever the terrain takes it.

    As for fatigue, we recommend that our customers break the shoes in gradually during their first week of wear. Maybe 2 hours the first day, then gradually increase wear each day. They will usually feel "workout soreness" in their calf muscles, hamstrings and glutes. To be honest, I felt muscles I never knew I had the first week of wearing MBT shoes.

    We do not recommend MBT shoes for people with balance problems or vertigo. Many of these people will feel "sea sick" as soon as they stand up in the shoes. People must also be able to walk correctly in MBTs. If they are visibly over-pronating in the shoe, we coach them to stay on the lateral half of the shoe and let the shoe do the work. If this is too difficult for the wearer to achieve, we will not sell the shoe and suggest an alternate shoe. Hope this helps.
     
  4. DAVOhorn

    DAVOhorn Well-Known Member

    I believe the Massaai do not wear them!:boxing:
     
  5. CamWhite

    CamWhite Active Member

    Well they SHOULD! For the love of god, the brand bears their name!;)

    Actually, I heard quite a different story about the origination about the "Masai" association with MBT shoes. According to the story, the inspiration came from Asian workers in rice paddies. They had good posture and few orthopedic problems with their lower extremities. Karl Muller (inventor of MBTs). living in Korea at the time, observed their gait, and developed the MBT. Since branding a $250 product around a "peasant culture" seemed ludicrous, they chose the Masai tribe for it's "mystique".

    I can't validate this story, but I found it interesting.

    Furthermore, I seriously doubt the Masai tribesmen spend the majority of their time walking on concrete, tile and hard surfaces. They would be better suited wearing sandals or Vibram Five Fingers! Ouch, I didn't say that!!!
     
  6. From what I hear the standard footwear for a massai tribesman is a sandle made from a rubber tyre!

    I find it quite amusing that we as a society have this utopean view of "natural health". We have all the footwear we want and the fashion runs to barefoot or shoes which claim to simulate barefoot. We have proper medicines and the fashion is to lust after "natural" herbal and alternative medicine. Wheras the cultures we aspire to who use alternative medicine and such are desparate for real medicine and decent footwear!

    Got to laugh.
     
  7. Mystique

    Mystique Member

    It somewhat seems ironic to me that we as podiatrists normally encourage shoes that will enable a more efficient gait, and therefore, require less muscle exertion to wear them, not shoes that challenge your leg muscles!
     
  8. Griff

    Griff Moderator

    Peter,

    Here is a research paper from 2006 which showed that there were no significant differences in pain reduction or static balance between the MBT and a good walking shoe (over a 12 week period and with respect to knee osteoarthritis).

    Ian
     

    Attached Files:

  9. Nah, thats not ironic.

    Whats so good about challenging the leg muscles then?

    You make an unsupported assumption there, that a more efficient gait requires less muscle exertion. Orthotics (can) improve the efficiency of gait and (can) strengthen intrinsic muscles. MBTs increase demand in some muscles but they also cut hallux dorsiflexion right down (thats why they are hell on wheels for SHl) so they will decrease demand in other structures. Gross statements about "strengthening muscles) are perhaps not the most accurate or defensible in the world!

    Here's fun.

    MBT's -> less hallux dorsiflexion.
    Less hallux dorsiflexion -> less windlass function
    Less windlass function over long period -> ???????

    Got nothing against MBTs. I recommend them for certain things. But the general claim that they are better because they strengthen or "challenge" muscles is, in my humble opinion, an absolute crock.

    Cool name by the way. Are you blue?

    Regards
    Robert
     
  10. Tell you one way absolutlely certain to increase muscle demand in ALL the relevant gait muscles by 10% though.

    Tell your patient to walk 10% further.

    Works, and its free!
     
    Last edited: Jun 6, 2010
  11. Leah Claydon

    Leah Claydon Active Member

    I have had occasion to wear some MBTs and find them mostly comfortable but they tend to put alot of stress on the 1st MPJ and so are probably not suitable for hallux limitus/rigidus patients. I've found they are very beneficial for patients in standing occupations (such as hairdressers) that have severe heel pain, this is because in stance position all the weight is in the midfoot and the patients can 'rock' whilst standing to redistribute the pain away from sore areas. I've had two patients with confirmed painful heelspurs say that their MBTs have literally saved their careers.

    Leah Claydon
     
  12. Griff

    Griff Moderator

    Leah,

    This is one of the few patient sub-sets I would have thought MBTs are suitable for (they are, after all, merely a rocker bottom shoe). Could you explain your view on this further? What do you mean when you say 'they tend to put alot of stress on the 1st MPJ'?

    Ian
     
  13. CamWhite

    CamWhite Active Member

    We have found that heel-to-toe rocker sole shoes with rigid midsole construction, such as MBT and Ryn shoes have been highly beneficial for hallux rigidus and for those with very limited ROM in their 1st MPJ. There is almost no forefoot pressure, and the rigid midsole construction ensures a smooth toe-off without a harsh toe-bend.

    If the customer is not comfortable in an MBT/Ryn shoe for any reason, we may suggest a forefoot rocker shoe, such as Alegria.
     
  14. Leah Claydon

    Leah Claydon Active Member

    Yes, the reason is because of the convexity in two planes, you not only wobble posterior to anterior but also lateral to medial - therefore if you have a delayed toe-off you are suddenly thrown onto the medial border at accelerated speed which causes a sharp dorsiflexion of the hallux. In my own case, I have a pronated foot in stance but dynamically supinate before prior to TO - in my MBTs I am suddenly launched to the medial border resulting in stress from the straps on the dorsum and pain in my 1st MPJ (which has very limited dorsiflexion).

    If they were simply a rocker posterior to anterior this would not cause so much problems I think. They definitely have a place in certain foot pathologies though.

    Leah
     
  15. Griff

    Griff Moderator

    Hi Cam,

    My experience with rocker sole shoes, such as the MBT, has been the same as yours. Hence my confusion regarding Leah's comments.

    Ian
     
  16. CamWhite

    CamWhite Active Member

    A Ryn shoe or a firm forefoot rocker, such as Alegria would be a better shoe for you. The Ryn shoe has very good medial/lateral stability, because it incorporates a structured air tunnel, rather than collapsing memory foam.

    If we notice customers that have difficulty controlling the medial/lateral instability of MBT/Skechers shoes, we immediately switch them to Ryns, usually with success. If not, there are other tools we can use.
     
  17. I don't think so.

    1. You can't have a sharp dorsiflexion in a hallux rigidus. On account of its rigidusnessness.

    2. The sole unit of the shoe does not bend much / at all under the 1st met. Therefore any dorsiflexion which takes place must be inside the shoe lifting the toe off the sole and caused by extensor function which exceeds internal plantarflexion moments in the MPJ caused by the dorsiflexion of the 1st met in response to the sub talar pronation and the subsequent increased tension in the plantar apeurneurosis.

    2b. I don't believe that such could possibly occur. The internal plantarflexion moment is vast, the dorsiflexion moment from the hallux extensors puny.

    3. How do you know / why do you think this sudden dorsiflexion takes place?
     
  18. Leah Claydon

    Leah Claydon Active Member

    Hi Cam,

    The point about the collapsing memory foam is an important one, you should see how the memory foam under my 1st MPJ and plantar phalangeal area has bottomed out on my MBTs. In my case I think the problem is sharp deviation from lateral border to medial, I can understand that a straight forward pronator is not going to have the same forces applied. I have to point out though that my MBTs are not the newly designed ones - ie the new MBTs have less convexity than the older models, maybe these don't have same problem.

    Logic dictates that a rocker sole is good thing for hallux rigidus/limitus patients but to say that MBTs don't put any stress on the forefoot is definitely not my experience.

    Leah
     
  19. CamWhite

    CamWhite Active Member

    Leah,

    Part of this deviation to the medial column is probably due to the design of MBT shoes. It is a rigid heel-to-toe rocker, with a semi-curved last. With this design, it is very difficult to supinate at toe-off.
     
  20. Leah Claydon

    Leah Claydon Active Member

    Hi Robert,

    I don't have hallux rigidus, I was talking about my hallux and yes when I wear my MBTs (which I've stopped wearing after only about 6 outings) I have severe dorsal impingement pain at my 1st MPJ - ergo my hallux is dorsiflexing, ie it is being forced by the shoe (not extensor action). To serve this debate I have just put them on and gone for a walk in them - when I wear them my foot function completely alters. I am a natural supinator (as demonstrated by Footscan and my usual shoe wearmarks) but in my MBTs I pronate severely, even though I have only worn my MBTs about 6 times there are deep impressions where my hallux and 1st MPJs are (my MBTs are lined in newbuck and it is really obvious worn here). I've even managed to deform the sole (by the way, I have a normal BMI).

    My opinion is that because of my forefoot instability, as I try to pronate from a supinated position, the convexity of the shoe (laterally to medially) forces my foot to pronate in an accelerated movement hence the increased force through my hallux. Whatever you say, the pain in real!

    I am not knocking the shoe, I simply saying they are not for everyone and perhaps especially forefoot instability.

    Leah
     
  21. So you actually bend the mbt at the met level more than in an ordinary shoe?
     
  22. Yep, what are we talking about?
     
  23. Granted the abstract is mainly concerned with the stiffness of the foot being higher than the stiffness of the shoe. But the point I highlighted was the one I was trying to make. The forefoots stiffness is cumulative between the shoe stiffness and the foot stiffness. THerefore it would seem reasonable that a shoe with more stiffness (MBT) would result in less, not more, dorsiflexion than one with less stiffness.
     
  24. Maybe. But not necessarily, if the shoe resulted in the forefoot being less stiff: shoe stiffness + forefoot stiffness = net stiffness.
     
  25. Deborah Ferguson

    Deborah Ferguson Active Member

    Hi All
    I am interested to know how an orthotic device functions in an MBT shoe as opposed to a shoe with a non-rocker bottom sole.
    If a patient with orthoses who wears both MBT's and a `normal` shoe and switches the in-sole between these two shoe types is there a difference in the way the device functions?
    Thanks in advance
    Deborah
     
  26. CamWhite

    CamWhite Active Member

    I think it's probably far less how the orthotic functions and more about how the shoe functions. From personal experience, I notice very little difference switching orthoses from MBT shoes to ordinary shoes.

    Orthotics are meant to stabilize the foot. The MBT and Skechers shoes are unstable (in both sagittal & frontal/coronal planes). In my opinion, they cancel each other out. For my part , I prefer wearing rocker soles with better medial/lateral stability, such as Ryn when I wear rocker sole shoes with orthoses.
     
  27. efuller

    efuller MVP

    In gait, I don't see so much reason for a change of how the devices work between a regular shoe and rocker bottom shoe.

    However, in stance, the MBT forces you to make some choices. You can stand with your weight on your heel or on your forefoot, or you can try and balance on the rocker. If you choose to balance on the forefoot then your Achilles will have to have more tension to keep the weight on the forefoot. This will reduce pressure on the heel and you will lose the effect of a medial heel skive.

    Cheers,

    Eric
     
  28. I wonder. I'd love to see a dynamic in shoe pressure comparison. I would suspect that the forefoot would load faster but that peak pressure would be much lower.

    Anyone got an in shoe VLS and a spare 5 minutes?
     
  29. Abel

    Abel Active Member

    Hello All the colleges here and the rest of the forums , I am not very good in english , but i think your question is , how is your experiences with the pacients .
    I saw a few people with this shoes and not all are comfortable . i remember one of them had the Aquiles tendon damaged only with one week wearing the mbt , other had a plantar fascitis , other damaged peroneo astragalino anterior ligament...
    i hope hold you
     
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Standing in an unstable shoe increases postural sway and muscle activity of selected smaller extrinsic foot muscles.
    Landry SC, Nigg BM, Tecante KE.
    Gait Posture. 2010 May 21. [Epub ahead of print]
     
  31. efuller

    efuller MVP

    Nice promo for the MBT. There is leap in logic that is left out of this sales pitch. Is there enough inactivity in stable shoes to cause atrophy? We often recommend "stable" (or anti pronation shoes) to prevent overuse injuries.

    So, if postural sway reduced over the 6 month period, did muscle activity also decrease? When you sway you use muscles to bring your center of pressure under your center of mass.

    Cheers,

    Eric
     
  32. JB1973

    JB1973 Active Member

    morning all
    also what about the smaller intrinsic muscles, what effect (if any) do the rocker bottom shoes have on them. if the MBTs make the extrinsic muscles mentioned more powerful, stronger muscles, is this to the detriment of the important intrinsics?

    cheers
    JB
     
  33. CamWhite

    CamWhite Active Member

    I'm not sure that MBTs are more detrimental to the intrinsic muscles of the foot than other shoes, with the possible exception that the forefoot of the shoe is a rigid curved rocker that does not promote a full toe bend. Great for hallux rigidus/limutus, but does less toe flexion weaken some of the intrinsic muscles of the foot?
     
  34. JB1973

    JB1973 Active Member

    hiya
    according to the results of above, "standing in the unstable shoe increased activity of the flexor digitorum longus". if the job of the lumbricals for instance is to
    help to keep the toes from clawing from over-recruitment of the flexor digitorum longus, then would logic dictate that prolonged use of the MBTs will cause clawing of the digits?

    cheers
    JB
     
  35. CamWhite

    CamWhite Active Member

  36. efuller

    efuller MVP

    I'd have to agree with Cam that I don's see why MBT would be different than any other shoe in regards to intrinsic (lumbricles) muscle activity. If you think about barefoot gait, the important time for the lumbricles is during swing phase when the toes have to clear the floor. In a shoe the anterior tibial muscle will ensure that the toes clear the floor. However, barefoot you have to make sure that you don't stub your toes. What other time would you need the toes to be straight?

    Also, the study implied that you might get stronger muscles, but it did not say that stronger muscles were found. The question is does normal walking/ activity use the muscles enough to maintain/ increase strength so that you don't need to add an additional workout from your shoes. If you think the shoes are comfortable wear them. If you want stronger muscles work out. You don't necessarily have to combine the two concepts.

    Eric
     
  37. Shuru

    Shuru Member

    After reading some of the post about MBT's & if there any good or not, I've worn them but really only for striding, let me tell you It's a work out. Couldn't wear em all day though. Would you Pods recommend wearing them with your rigid orthotics ? Has there been a study on there use with orthotics? Would anyone know ? Cause when I got involved many years back, I was told they should not be worn with MBT's. I have since RE customised them to suit my personal gait and stride. Feels like I'm running when I'm not. It's to do with the downhill uphill motion... Anyways Keep on Smiling folks....

    Shuru OUT.
     
  38. carolethecatlover

    carolethecatlover Active Member

    I got a 'free' pair for selling them at a retirement expo. My experiences mirror CamWhite's.
    Very good for standing on hard surfaces. Hard to walk and run in. If your balance is not good, to be avoided. I too, discovered muscles I did not know existed. Carole
     
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