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MBT's - good or bad?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Jacqui Walker, Jan 21, 2009.

  1. Jacqui Walker

    Jacqui Walker Active Member

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    Hi all,
    This is my first attempt at submitting a thread - being new to the arena, so forgive my shortcomings - please?
    Having recently been on the receiving end of some hard pressure salesmanship regarding MBT's (and I was only looking at the stand whilst my husband paid for his shoes!) I was wondering what the general consensus was on these ridiculous looking canoes? The salesman added to his spiel by informing me that 80% of his staff were wearing them, one of whom said she wouldn't be without them, only wasn't wearing them that day because she couldn't wear them two days in a row, and sometimes couldn't wear them for more than a couple of hours. I can see that they would have benefits for certain patients, but this is also coupled with a deep mistrust of people who are desperately trying to sell me something I didn't ask about. If anyone has some first hand experience that puts them in a better light than the sales assistant I would welcome the responses.
    In anticipation:confused: - Jacqui
  2. drsarbes

    drsarbes Well-Known Member

    Hi Jacqui:

    They are getting popular.

    Frankly, as has been stated previously here (somewhere) salespeople are just that, sales people. Few if any have any clue about the function of the shoe or the foot for that matter. They are just doing their job, which is selling a product.

    I have worn MBT (in store) and they do shift weight to the heel and off the metaheads. My take is a slightly proximally located rocker bottom with a soft heel depression.

    Now, I'm not sure what exactly this has to do with the african tribe - (who walk barefoot) - that the shoe is named after.

    I'm sure the biomechanical members can explain the biomechanics.

  3. Jacqui Walker

    Jacqui Walker Active Member

    Hi, thanks for the reply,
    It is probably the name that is adding to my concerns, I can appreciate that a rocker bottom shoe would help certain patients, but it is the promotional stuff that makes me question the research - I understand the concept was that they are based on the predominance of a rocker bottom foot in Masai tribesmen, who reportedly do not have back problems, but having been to Kenya wondered who they would take their back problems to and how they would pay for it once there? :confused:Hospitals and clinics not being something that predominates in the Mara! :rolleyes:Saying that, how did you actually find they worked for you, and would you recommend them?
    Thanks, Jacqui

  4. Jacqui:

    The Masai Barefoot Technology (MBT) shoe is popular in some areas of the US. There is a lot of promotional advertising for this shoe which makes no sense and has no research to back it up so your initial impressions that the salesman was giving you a sales pitch filled with bunch of horse manure were probably true.

    The MBT has a rearfoot midsole wedge that is of a low durometer material that seems to absorb heel strike shock and also has a rocker soled design. I have walked in a pair of these shoes that were given to me but, after 10 minutes, decided I didn't like the feel of them since they were making my legs hurt. I have, however, had many patients that swear by them and some seem to think it helps their plantar heel pain and other pathologies. Other patients have found them to be an expensive pair of shoes ($200.00+) that work no better than the running shoes that they can get at Costco (a large discount warehouse chain in the US) for $20.00.

    I believe we did have a discussion on these shoes some time ago on Podiatry Arena. You may want to check the archives. Hope this helps.
  5. Euan McGivern

    Euan McGivern Active Member


    I believe the Masai reference in the name has been used to represent the postural changes (improvements?) that the manufacturers claim they have made.

    I have sold these shoes, prior to studying podiatry, and have heard some very positive feedback from customers who have used these, (Please note I am not presenting this as an argument for the shoes, as evidence this is probably worse than useless) and some less positive feedback from those who haven't got on with them.

    They are certainly very unstable, and customers are given an introduction when they buy where they are advised on the best "way to walk," in the shoes (short stride length, heel strike, avoid allowing the foot to excessively to pronate / supinate, keeping their head up and back straight] I did hear some concerns that they can encourage some genu vecuvatum due to the creation of a functional equinus (Nigg et al 2006 certainly report increased ankle dorsiflexion during the first half of stance phase) and I feel that an unstable foot would be allowed to move more in the frontal plane in MBT rather than most other footwear.

    Supported by the supplier the store are very careful when recommending the shoes, and any customer who has a musculoskeletal disorder (that they are aware of) is recommended to go back to their treatment provider for advice before the shoes are purchased.

    Ultimately there is a difference between the sales person who has some training in a product but has a product to sell rather than a health professional who's decisions and recommendations should be evidence based.

    There has been some research published into the effects of the shoes, although some of this was supported by MBT, there are others but here are 3;

    Nigg, B.M., Emery, C., and Hiemstra, L.A. (2006) Unstable Shoe Construction and Reduction of Pain in Osteoarthritis Patients. . Sci. Sports Exerc. Vol 38(10)

    Nigg, B,. Hibtzen, S. and Ferber, R. (2005) Effect if Unstable Shoe Construction on Lower Extremity Gait Characteristics. Clinical Biomechanics Vol 21

    Stewart, L.m Gibson, J.N.A., and Thomson, C.E. (2007) In-Shoe Pressure Distribution in "Unstable" (MBT) shoes and Flat-Bottomed Training Shoes: A Comparative Study. Gait & Posture Vol (25)

    Hope this is of some use.
  6. drsarbes

    drsarbes Well-Known Member

    What pathologies specifically do you think the MBT may help with?
  7. Steve:

    The only pathology that I have ever seen MBT shoes work for were proximal plantar fasciitis (i.e. plantar heel pain).
  8. Admin2

    Admin2 Administrator Staff Member

  9. malaligned

    malaligned Member

    Interesting thread ! Cant comment on the shoes but imagine like any rocker bottom soles can be very useful on some people.

    Can comment on the Masai we met in Kenya, they were not barefoot but wore the tread from tyres that were cut to size and strapped to the feet. The ground they walk over was very hard and rocky and the tyre treads certainly gave them plenty off bounce and perhaps had a degree of natural rocker sole .
  10. carolethecatlover

    carolethecatlover Active Member

    I'm another who sold them in a shop for a few days and at a retirement expo.
    I was given a pair ($369.oo in Aussie dollars) and have worn them off and on for 6 months. They do alliviate heel pain,(which I had suffered for a year, since I trod on a large stone a year previously) and are really good if you stand for long periods. Walking not so good. I am tall, 171cm, and they add some 5 cms and make me stand up straight, but they drag for want of a better word. The idea is good, and to some extent, yes, it helps. I want to make the same model in softer, lighter weight material, like Crocs.
    Into my second year of Pod at Uni of Newcastle. Passed all my exams. Been working for a top sports pod during the summer holidays. Yeah! Having fun.
  11. Itchyfeet

    Itchyfeet Member

    MBT's seem to be a purely personal choice but they do look like orthopaedic footwear, and I understand the wearer has to be trained to walk in them - why?

    Has anyone had experience of Earth negative heel footwear? They're supposed to burn off extra calories and I can see they would encourage stretching of the calf muscles. Does any non hippy out there wear them?

    P.S Does anyone know where the venue is for the Birmingham Biomechanics boot camp is in February?
  12. CherylAnn

    CherylAnn Welcome New Poster

    Having formerly worked in biomechanics I was frequently asked what I thought of MBT's. Until recently,like the most, I had no experience of them and therefore no opinion and wouldn't recommend as they are rather expensive to try out. However, I met Joshua Wies, their chief physiotherapist in the UK, and asked him if these shoes had been cased on patients with conditions such as Ankylosing Spondylitis. My husband has this condition and Joshua kindly offered to supply a pair of shoes in return for our feedback. I have to say my husband loves them. They reduce pain in his feet and enable him to be mobile for longer periods than in "regular" shoes or trainers. You must wear them in gradually as with orthotic devices and extra care with those suffering tight TA's as the heel strike is deeper with the rocker sole. It is also good for painful Hallux joint movement as the joint is rested in these shoes. They are not the thing for everyone but I suggest to my patients that they walk around the shop for half an hour before buying. I also like that they make my shortie hubby a wee bit taller!
  13. Frederick George

    Frederick George Active Member

    I was wondering what they did with all the Earth Shoes of the 1970's that didn't sell. You should try walking up a steep San Francisco hill in them.

    Clever rebranding!


  14. drsarbes

    drsarbes Well-Known Member

    "I was wondering what they did with all the Earth Shoes of the 1970's that didn't sell"

    Hi Fred:

    Wait til you hear this!

    I had a patient in on Tuesday; 6 weeks post op Achilles debridement/retrocalcaneal exostectomy. He was all excited that he might be getting back into a regular shoe soon and he told me he was going shopping and wanted to get a pair of EARTH shoes!!!!!!!

    I didn't know quite what to say...... maybe he knew a bit more than I gave him credit for and was joking with me. But no, he was being truthful.

    I told him that if, in fact, he did get some Earth shoes and it ruined my "good work" that I'd consider putting his bone spurs back in! lol

  15. Frederick George

    Frederick George Active Member

    Hi Steve

    I didn't know they still made them. The line was that the inventor was walking on the beach and noticed that his heels were sinking deeper in the wet sand.

    When I was in pod school, they were great for clinical experience.


  16. jane.e.benson

    jane.e.benson Active Member

    I had some MBT's, bought them to try and correct my terrible posture, but I have rheumatoid arthritis with quite large nodules on the plantar aspect, the insoles DID NOT HELP! in fact they were really painful. I did follow the instructions fully, then tried my cleron insoles which only helped a little (they usually releive all problems I have with harder soled shoes.)
    Take the removeable insoles out of a pair and have a look at the sole underneath I think it's made of mdf!
    So they may help some people but they don't help all!
  17. tricia

    tricia Welcome New Poster

    I had also been asked about MBT's by clients and thought the best research I could do was to try then myself. I followed the guidelines given by the sales team accurately. By the time I could enjoy a walk without contstant leg and foot correction, they were seriously affecting my tendonitis. However, a friend who purchased them at the same time for aid with a spinal injury, can't take them off. He finds them so helpful that I saw him the other night wearing a tuxedo and MBTs. The client will only find out the pro's and cons by wearing them I'm afraid. And it is a costly excercise to find out that they don't suit you
  18. Soux

    Soux Member

    we sell them in the company that I work for and I have to agree with Tricia, it is a very individual experience, but a costly one. I wear them. At first, they hurt my feet and my lower back, but this may have been due to wearing them all day before "breaking them in." Now, I can't wear ordinary shoes as they donit provide the rocker soles and the heel strike from my shoes are too stark. They really do help with my lower back, plus I have Hallux limitus. I don't find that it has made any changes to my stomach muscles, (still a bit flabby!!) All in all, I am very happy with them. Out of curiosity, have the Masai people been given any accreditation for this design, off their intuition? (ie royalties..monies..
  19. Fraoch

    Fraoch Active Member

    Not yet tried these myself - thinking "Gimmic" to be an appropriate response. Had about four pts try them; end result = knee pain. It seems that they cannot control their pronation (differing levels of control for these 4 people) suitably and follwing this all suffered from posterior knee pain and some visible swelling. Now about 18 months on from this NONE of them wear the damn things. I do not know if they followed any advice or whether any was given at time of purchase. As they all paid silly $ for this it is now the "subject we don't talk about' and they are all now back in their orthotics and runners, doing well.

    I do however have one woundcare pt doing well with this. She didn't like the post-op healing shoes provided, does very little walking so not really able to comment on their overall effectiveness.
  20. efuller

    efuller MVP

    When standing on a rocker that is in the middle of your foot you can choose to put your weight forward (increased Achilles tension weight on forefoot), you can choose to try to balance on the rocker point (Mental effort and constant muscle activity, but level) Or you can put your weight on your heel (Ankle dorsiflexed, possible AT muscle activity) Sometimes, one of these balance choices will relieve symptoms, other times they will make them worse.


  21. Fraoch

    Fraoch Active Member

    Thanks Eric, I appreciate the lesson.

    Begs the question: if you have to think that much about how you are walking then are you not straining something else in the process? Why not buy a healing sandal with defined purpose to offload and therefore acheive what you are intending rather than hoping your pt will "get it" not not cause some other injury such as hyperextending the knee.

    After some distance/time most people's brain sends them back to their "normal". One of my mentioned pts was brain damaged in a RTA, another has balance issues.

    I'm not intending to argue; jsut points to ponder. Hrrrmmmmmmmmmm.

  22. Fraoch

    Fraoch Active Member

    Thanks Eric, I appreciate the lesson.

    Begs the question: if you have to think that much about how you are walking then are you not straining something else in the process? Why not buy a healing sandal with defined purpose to offload and therefore acheive what you are intending rather than hoping your pt will "get it" not not cause some other injury such as hyperextending the knee.

    After some distance/time most people's brain sends them back to their "normal". One of my mentioned pts was brain damaged in a RTA, another has balance issues.

    I'm not intending to argue; just points to ponder. Hrrrmmmmmmmmmm.

  23. efuller

    efuller MVP

    Orthotics were dispensed for many years because they increased "stability" without regard to stress on specific tissues. A lot of the time they worked. You pays your money and you takes your chances. I prefer to design a device to relieve stress on what hurts.

    Any rocker can be a problem for patient's with balance issues. A rocker shoe effectively decreases the amount of contact with ground. More specifically it decrease the distance your center of pressure can travel while staying under your center of mass. If you center of mass "sways" more than this distance then you have to take a step to prevent from falling over.

  24. Spike

    Spike Member

    Hi, they seem to be Ok for those with 1st MPJ pain/hallux rigidus...I suppose doing the job of the good old rocker bottom that a cobbler used to fit.
  25. Peter

    Peter Well-Known Member

    Patient of mine had them, and they now sit in a box (not the pt).

    They caused him grief in his achilles tendons, and posterior knee joint capsule.#

    Oh, and when my pt with atherosclerosis told his vascular consultant, the consultant did his nut!

    The hard sell always makes me concerned to keep my hands firmly deep in my pockets.
  26. Don ESWT

    Don ESWT Active Member

    I was a DVA footwear prescriber/supplier for over 10 years and in that time I recommended rocker bottom soled footwear for only specific complaints.

    In Australia you can get rocker bottom soled footwear from Gadeans, P.W Minor, Homy Ped, MBT, Rockport and Orthopaedic footwear makers

    Care must be taken, if a person does not need this type footwear then they should not be prescribed.

    Don Scott
  27. Peter

    Peter Well-Known Member


    Couldn't agree more. The problem with commercial shoe retailers is that they will recommend their shoe for absolutely anything and never inform of the foot type/morphology which could precipitate pathology in a given person.
  28. Fraoch

    Fraoch Active Member

    Absolutely agree with you meet; overprescription whereprescriber knows naff all/ not enough about what they are doing.

    However I love the quote in post #23 re orthotics " you pays your money and takes your chances" ???????? Not my my bloody clinic you don't. Well thought out, well prescribed and oh by Jimminy... they actually work! If I say so myself.

    I spend a lot of time lecturing pts on their footwear, pleading them to discard the nasties ; otherwise what's the point? It''s all got to work together man, like one big happy world dude.
  29. conp

    conp Active Member

    Due to the nature of the MBTs there are various applications.

    Some people love MBTs for just comfort or plantar heel pain relief or hallux limitus pain relief or improved posture or balance training. Some people feel they don't make any difference at all.

    HOWEVER as health professionals I believe it would remiss of us not to direct the OA ankle pts to MBTs. This one is a 'no-brainer' to me now, after my experiences with MBTs

    What other effective treatments do we have for them. Orthoses? AFOs? Fusion/s? Shoe modifications?

    You will find that these people have a new lease of life with them. The only reason I am involved in some capacity with this footwear is because the positive feedback I get with these pt's is very fulfilling. Whether it is pre or post ankle surgery this type of pt will improve dramatically with MBTs.

    Some are fortunate to have immediate relief but most require up to 5 -6 weeks of acclimatising before significant relief is experienced.

    I am not talking about any other symptoms except OA ankle pain that requires careful consideration of MBTs.

    Best Regards and Best Intentions,
  30. Con:

    Rocker soled soles have been a standard shoe sole modification for probably a half-century or more for people with ankle osteoarthritis (OA) and ankle arthodesis. These modifications may be added to many styles of shoes at approximately one half the cost of purchasing an MBT shoe. Why would a podiatrist first recommend an MBT shoe, as you suggest, since rocker soled shoes seem to also help patients with this pathology, at half the cost? Have you compared a standard rocker soled shoe addition to an MBT shoe clinically to see which is more effective on your own patients with ankle OA?
  31. conp

    conp Active Member


    Compliance is the issue with rockersole modification/additions. Pre-MBT I would go through the whole cycle of treatment options with OA ankle pts. However even rockersole modifications were uncomfortable for these pts.

    My guess is that it is not only the softness of the pivot point which gives comfort on heel strike and guides them slowly over the pivot point (slower than conventional rockersoles), but also the way it (soft heel pivot) has been implemented in the EVA part of the sole.

    I for one have tried to emulate it with the help of a boot maker without success.

    I suppose I am saying it is a rockersole with great compliance.

  32. Con:

    Thanks for that information. Have you tried using the MBT in patients with ankle arthrodesis also to see if it helps or not? Looks like a great research project.....I would bet MBT would provide free pairs of shoes for that sort of research.
  33. Atlas

    Atlas Well-Known Member

    I like your thinking Con.

    So many in the paramedical profession come to an early conclusion based on "lack of research" or "sales". Guess what, if a patient returns and is certain that their MBTs have helped what numerous evidence-based and non-evidenced based clinicians have failed to assist, then I don't give a rats toss-bag (Blightism).

    Yes, I reckon the sales people regurgitate rubbish. But, the MBT's have there place and are a tool for the musculo-skeletal lower-limb practitioner.

    The thread is titled "good or bad"? This is a thought provoking thread from a first timer, but the "good or bad" is symbolic of the dichotomous health professional. As a physio, I treat some back pain in flexion; others in extension. Is flexion good or bad for back pain? There is no one answer. As health professionals we love simple answers that are the rule every time.

    The MBT rocker component is a winner IMO. I have tried to get orthotist, pods, shoe makers, boot repairers etc. to make a rocker addition, and the results have been below par. I have tried myself and the below par, suddenly looks good. The "chung-shee" (pronounced) has a more abrupt rocker and is more proximally placed in relation to the MBT.

    The softer heel section feels as though one's heel is sinking into wet cement at heel contact, which actually forces the knee into more extension. The warning is that some degenerative knees hate knee extension, so this should be ticked off before purchase.

    The soft heel surely has some attenuation or shock abs properties (forget technicalities). And I think this, combined with the more fluid smoother transitions of MBT altered gait, must be the reason why some have returned with less LBP.

    Physiotherapist (Masters) & Podiatrist
  34. Peter

    Peter Well-Known Member


    And what abour directing your pt with OA Ankle to a good orthotist to cast him/her for an immobilisation AFO, along with the rocker soled footwear?
  35. Atlas

    Atlas Well-Known Member

    I'm a big fan of AFO's for certain conditions and have recommended them in the past for ankle joint dysfunction etc....
    There are a few reasons though to avoid AFO IF possible. If the rocker/MBT is providing symptom relief and good function, will the wearing of a costly, aesthetically challenging, perspiration retentive, add-on... give the OA sufferer many many more benefits? Because if it doesn't, why bother?

    Physiotherapist (Masters) & Podiatrist
  36. Peter

    Peter Well-Known Member

    Thats a thoughtful post Ron, but in defence of a single well fabricated, designed and pitched AFO, the cost over the years is negligible, doesn't demand expensive shoes to be used all the time, and is often transferable.

    I had a pt last week, who needed his AFO refurbished. It was the 1st adjustment since his CVA in 1991.

    I use a combination of footwear mods, Ankle Braces, AFos and periosteal acupuncture for OA ankle as I see fit and in according to the pts lifestyle/needs, and not a one treatment suits all approach.

    Thats my beef with MBTs, the sellers have the belief that it can do anything.

    flog the sellers
  37. conp

    conp Active Member

    Agree this would be a great study for pts with a triple athrodesis (I have to laugh here because my auto spelling insist I write 'triple aphrodisiac')

    I have suggested some studies to be performed in Australia in order to substantiate or refute anecdotal evidence concerning MBTs.

    Ron and Peter,
    I think you are both saying the same thing. I understand your frustration Peter at something pushed as the sole(forgive me) solution.

  38. Peter

    Peter Well-Known Member


    If a pt says that their MBTS have helped their symptoms, i cannot dispute that, after all, don't we validate our treatment protocols by asking our pts how they are doing with what we have prescribed them.

    As I have said before, its the sales pitch I am concerned with, and the risk of neo-pathology to some pts
  39. caf002

    caf002 Active Member

    If there is ever a shoe that has generated more discussion, arguement and research, then this is the MBT. There is no doubt that all this has contributed to the massive sales success of this product.

    The research and discussion, plus my own personal view is that it is not all about the product but is about the dispensing of the product that is critical. A good referral, a good assessement and the patient compliance will give the best outcome (doesn't it always)?. A great shoe, will become a poor shoe if incorrectly delivered.
  40. Atlas

    Atlas Well-Known Member

    Us health clinicians go on-and-on about patient compliance. The last aim of blame is actually at ourselves. Our challenge is get the diagnosis/intervention correct, and balance the intervention with a semblence of comfort.

    (As I have discussed at greater length in the FHL project thread) With the physio hat on, there are so many different presentations of LBP. The specific treatment will depend on the specific presentation/category. There are particular strains of LBP that will get worse with walking/weight-bearing. If the GP/Physio/Chiro prescribes more walking, and this patient refuses to walk/stand after trying, well I call the patient "smart" rather than "non-compliant".

    As for MBT's (I don't have anything to do with them), I am a fan. Foot/ankle practitioners have been one/two-trick ponies for too long. Rigid-orthotics? Gastroc-stretching? ...will fix most things we thought. We have under-used things like rocker-soles, shock-abs/atten materials, braces/AFO's etc. That is perhaps one reason that the orthotists have got results that we sometimes couldn't get.

    The MBT is a retail option that instantly provides more therapeutic options, that we haven't necessarily arrived at first in the clinical setting.

    Physiotherapist (Masters) & Podiatrist
    Last edited: Feb 13, 2009

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