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MBT shoes- do they work?

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

  1. Paul Bowles

    Paul Bowles Well-Known Member

    Aren't this statements a bit contradictory? Were they the well balanced type of retiree's?
     
  2. Kahuna

    Kahuna Active Member

    Hi All

    My experiences of MBTs can be broken down into three areas, let me know what you think to each point ......

    1. In my observations, people who pronate tend to do so even more obviously and visibly when walking in MBTs

    2. I'll dig out the reference (it was in an article I wrote a few years back), but the Society of Physiotherapists, UK, published a very interesting piece c.2006 that had studied a reasonably sized 'n' sample who wore MBTs over a year. Their conclusion was that it was statistically significant that those MBT users developed anterior compartment syndrome.

    3. The local orthopaedic hospital to where I live is now giving out MBTs on the NHS as a fairly routine part of discharge!!! (The ortho surgeons; not the pod surgeons). I've contacted them to ask why, and they provide anecdotal comment only, but their favourite is that patients with an ankle fusion appear - in their opinion - to walk better post-op in MBTs than trainers/shoes.
     
  3. Deborah Ferguson

    Deborah Ferguson Active Member

    I was interested in the comment that NHS orthopods were prescribing MBT's to surgical patients.
    I was recently referred a patient with 18 month H/O PF for assessment and orthoses who had previously seen an orthopaedic surgeon ( but never referred to a Pod. throughout her long and debilitating history !) and the surgeon advised MBT's.
    Needless to say there wasn't much improvement in the patients symptoms.

    Regards

    Deborah
     
  4. Kahuna

    Kahuna Active Member

    Hi Deborah

    Yes, I've found this whole NHS MBT thing very interesting; most significanty (and sadly) because the local PCT concerned doesn't refer many patients for post-op orthoses (due to costs!!!) but gives out at least £80 worth of a pair of MBTs instead!

    Does anyone know where the rationale came from for ortho's to favour MBT's as a post-op rx?

    Cheers
     
  5. Jeremy Long

    Jeremy Long Active Member

    It's my belief that if you look at MBT's in regards to historical orthopedic shoe construction, it works best in situtations where a SACH construction would be prescribed: rearfoot fusions, spinal stenosis, and hallux rigidus. Conversely, the pathologies one would avoid using a SACH construction also applies to MBT: severe rearfoot laxity, ankle inversion, and chronic Achilles tendonitis.
     
  6. Kahuna

    Kahuna Active Member

    That's a great post Jeremy, thanks.

    The SACH construction theory does apply well to MBT, and confirms my experience of local hospitals issuing them for rearfoot fusion cases.................... and my experience of MBTs making people who pronate at the STJ evert even further.
     
  7. I may be doing our medical colleagues an injustice here, it may be more involved. But I would guess the thought process was

    1. Post op cast sandles have a rocker
    2. Mbt's have a rocker
    3. Therefore mbt's are like post op sandles, only the paying wears them for longer post op and therefor better.
    4. QED

    as I say, there may be more to it than that... But I doubt it.
     
  8. Kerrie

    Kerrie Active Member

    Hi Pete,
    I frequently find myself asking the same question I see some people who wear them and claim that they are the best thing known to man, I am personally not convinced though but see if this paper helps. It has some nice F-Scan pictures of the pressure distribution if I remember which is a massive help. I hope that it is the right one as my computer is not letting me open it but I am pretty sure that this is the one, if not I'll try and send it later from a more cooperative PC.
    http://www.backtowork.co.uk/mbt/RP115.pdf
    Take it Easy
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    The effectiveness of an unstable sandal on low back pain and golf performance.
    Nigg BM, Davis E, Lindsay D, Emery C
    Clin J Sport Med. 2009 Nov;19(6):464-70
     
  10. CamWhite

    CamWhite Active Member

    Have you ever tried putting in MBTs? I have, and the results weren't pretty. I am not sure if it was the shoes, but it my worst putting performance ever. Beer could have contributed to the performance. ;)
     
  11. Boots n all

    Boots n all Well-Known Member

    l am no golfer, but dont they need stable footing, e.g they wear shoes with spikes on the soles?:wacko:
    l wonder who financed this study;)

    Mind you this statement might cover them ".....without negatively affecting performance.." you see there is a theory that says "you are so bad at this, surely you couldnt get any worse"
     
  12. lucycool

    lucycool Active Member

    I tried them on and walked about the shop and had PF pain almost immediately. My friend tried on a pair at the same time, thought they were wonderful and bought them there and then..
    Its very interesting though..
     
  13. Griff

    Griff Administrator

    Being a very keen golfer this has caught my eye.

    Knowing the considerable ground reaction force that has to be generated during the golf swing to generate power and maximise club head speed (the speed of the club face at time of impact with the ball and the consequent distance the ball will then travel) it seemed counter intuitive to me that an unstable/rocker shoe such as the MBT could not possibly have a negative affect on performance (depending on how one defines 'performance' of course...)

    Also, anyone who has looked into the biomechanics of the golf swing, (or watched any of the high speed camera footage of the PGA pros on you tube), will know that transferring weight from the back foot to the front foot during the downswing is also an essential power generating aspect of swing execution. I just can't see how an MBT would not negatively affect this either.

    So I have had a cursory glance through the study. And a few things have jumped out at me. Firstly the handicaps of the golfers in the study. Control group: 11.42 (9.73 - 13.11). MBT group: 9.30 (7.28 - 11.32). Clearly the golfers in this study were low-mid handicappers i.e. good golfers. Given that the vast majority of all amateur golfers never get their handicaps below 18 it's fair to say that these results may not be able to be accurately extrapolated to the general public. And that golfers with a less consistent swing (mid-high handicappers) may yield different results.

    Secondly, I don't know about anyone else but when I play golf I measure my performance by how I score (and how much money I subsequently win/lose off of my playing partners!) I'm also pretty sure that score is the biggest measure of performance in professional players, given that the player with the lowest one takes home the spoils/big bucks/trophies/working girls. Yet in this study, there was no mention of scores.

    Lastly, and most crucially is this:

    Soooooo.... the MBT group didn't even play golf in the shoes... probably why they didn't affect performance then. Would playing golf in MBTs affect performance (score) in an average (mid-high handicap) golfer? My verdict... er yeah.
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Comparison of ankle and subtalar joint complex range of motion during barefoot walking and walking in Masai Barefoot Technology sandals
    Sophie Roberts, Ivan Birch and Simon Otter
    Journal of Foot and Ankle Research 2011, http://www.jfootankleres.com/content/4/1/1
     
  15. Boots n all

    Boots n all Well-Known Member

    A couple of thoughts.

    "...during both barefoot walking and walking in the MBT sandal."

    So where is the portion of this trial of the clients wearing a normal sandal for a control unit?

    Finally this corker, remember we fit rocker soles and S.A.C.H. to replace lost ROM or substitute for muscle strength lost.

    ".........MBT sandals increase the range of motion of the ankle and subtalar joint complex in the frontal and sagittal planes."
     
  16. Orthican

    Orthican Active Member

    Very intersting discussion. I too have been asked this same question. I have noted very similar results as the majority. Unstable hindfoot /MBT combo is a disaster and anyone with the hopes of curing P.F. with them better look again particularly where the lack of talocrural ROM was part of the genesis. In my town the shoe stores sell them for $340.00 Can. and when they first came out the sales pitch was one of a "cure all". Time and injury will allow this to play out to it's ultimate conclusion. Fads come and go where footwear is concerned and it is up to the marketing teams at the manufacturers to convince the unaware public that they will be as good as the invention of pre sliced bread. They will always make claims where sales are concerned even if the science is a bit dodgy.
     
  17. CamWhite

    CamWhite Active Member

    We have been selling Ryn shoes for one year. What I have noticed is that we have seen very good success with most of our customers suffering from plantar fasciitis pain. One customer with a TTS diagnosis came in in agonizing pain to try on a different shoe (Z-CoiL), based on his orthopedic surgeon's advice. While the Z-CoiL offered some relief, the Ryn shoe almost completely eliminated his pain.

    Ryn has exceptional medial/lateral stability, and the SACH heel is a structured air tunnel with internal support columns. It has now become one of the shoes I have most customers try if they are suffering from PF.
     
  18. Orthican

    Orthican Active Member

    Thanks for that info Cam. I looked them up and I see what you mean regarding the heel construction. I found the original MBT had far too soft of eva at the heel to afford any type of medial/lateral stability but these RYN shoes look quite different. Still curious though how TTS cleared up with this shoe. It is a particularly nasty problem.
     
  19. CamWhite

    CamWhite Active Member

    I have no idea. I honestly thought Z-CoiL would be a better solution, because the coil unloads 50% of ground impact force and can be adjusted for pronation. In many cases, I have excellent results with Z-CoiL and TTS, but in this case Ryn was the big winner. It's nice to have options.
     
  20. CPedTechie

    CPedTechie Member

    Can anyone explain how a firm rocker sole with a SACH-style heel and skate shoe upper can emulate the experience of walking barefoot in Tanzania? Am I missing something here?
     
  21. Orthican

    Orthican Active Member

    The peak pressures will surely be reduced in the beginning, but over time the soft eva chosen by MBT will begin to give up and the effect is minimised. In fact there is a heel rocker delay with this shoe that as I see the shoe age with different users becomes quite apparent. Rotationally unstable for the STJ sitting outside of any reasonable balance point for the individual. This is a shoe designed to be a 5 month throw away. The shame of it all is that a local dealer is selling them for 360 per par canadian dollars. And in the beginning they were quite literally bieng touted as a foot cure all. Venality in the shoe world is without limit. I was having elderly ladies coming in who were of obvious advanced knee OA sold them as a very good aid to the knee pain. The varus in this poor woman was only made to apply a larger force load through the medial compartment as a result of this shoe.
     
  22. CamWhite

    CamWhite Active Member

    FYI - The sensor in MBT shoes is PU, not EVA.
     
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