Rocker bottom soles alter the postural response to backward translation during stance.
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Albright BC, Woodhull-Smith WM.
Gait Posture. 2009 Mar 27. [Epub ahead of print]
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Improving the design of the curved rocker shoe for people with diabetes
Jonathan D Chapman
PhD Thesis 2014 UNIVERSITY OF SALFORD, SALFORD, UK
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Rocker outsole shoe is not a threat to postural stability in patients with diabetic neuropathy.
Ghomian B, Kamyab M, Jafari H, Khamseh M, Healy A.
Prosthet Orthot Int. 2014 Jul 24
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In all the time l have been producing rocker soles for people with Diabetes, l have not had a single report of a fall as a lack of postural instability.
l guess the question is how are they doing their rocker soles to get that result?
Most clients with Diabetes and PN, do have a tendency to sway backwards, so any heel rocker needs to be formed as a SACH to avoid this IMO. -
This clinical trial was just registered:
That the Use of a Rigid Rocker Sole Reduces the Recurrence Rate of Diabetic Foot Ulcers in Patients With Peripheral Neuropathy.
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Hi guys, do you reckon this sole as rocker sole? This is one of the soles we've been using for making diabetic shoes.
Thanks.
LindaAttached Files:
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It doesnt look like a rocker sole at all, but we would need to see the side profile.
If your doing a rocker sole for a Diabetic, its more about how rigid the sole is and the Last and its toe spring.
Why are you proving the rocker sole in the first place? -
Podiatrists needed rocker sole.
What about your shoes? -
How many degrees? Well our standard Ladies range that we sell has a toe spring of 14 degrees, l wouldnt call that a rocker sole.
Just measured some of our custom made, 25 to 30 degrees for the toe rocker and slightly more for a heel rocker but its over a short distance. -
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A rocker sole for the toe, can mean less force required to move into and through the propulsive phase of gait, reducing the force and movement of the toe's, MPJ's and to a less extent to the Achilles. Its all about the fulcrum.
Whilst a heel rocker can replace the lost movement at the STJ it can also reduce the speed of the foot from heel strike to midfoot stance.
All good mate, l have been called worse. -
Of course rocker bottom "convex bottom" shoes are more unstable.
A rocking horse would not work or be as much fun if it was not "unstable" in the sagittal plane.
Passive Dynamics PD would be hindered-reduced if they did not have a solid-ridged rocker bottom.
Dr. Tadd McGeer did some great early work on PD.
Flat footed structures "may" have more stability but at a cost to the passive dynamics.
If the rocker bottom is not ridged enough then it fails to create a lever.
Think dutch wooden clogs.
So what could be simple machine solution to this mechanical problem?
Add two outriggers to your lever. That's what the Hawaiians did to stabilize their ocean going canoes.
Add a heel and forefoot leaf spring to the lever to assist with sagittal plane stability and energy efficiency.
Then add this to diabetic shoes and test it against the standard rocker bottom shoe. Please.
Legend.
140- pivot point-axis lever
160- is a second pivot point-axis that actuates the bending of a flexing spring plate.
Hoping someone understood this today or someday...
If you want to understand this better contact me.
If you would be willing to refute it, please do.
That is called science.
A hui hou,
Steve -
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Aloha,
What shoe is NOT orthopedic if it is hooked up to a moving musculoskeletal system that crashes into the earth each step?
Are your shoes orthotics? Do they change or manipulate your groundings?
Start making more shoes with carbon fiber mid-soles please so that I may have someone to talk to about them.
A hui hou,
Steve -
Attached Files:
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Depends on the client and the condition they have.
Is it relevant to their needs?
Will it make them a falls risk?
Depending on the size and location of the rocker and it's fulcrum, you are reducing the main platform of the sole that they stand on. Looking at your diagram and the vertical lines, the main platform of the sole is now only 1/3 of the entire sole and would be very unstable for many -
Rocker tip shoes have been shown to reduce forefoot pressures and increase heel pressures. These shoes will also decrease the lever arm that ground reaction force will have on the ankle joint, so they theoretically can reduce Achilles tension.
A heel to toe rocker a show with a gradual curve all along the sole would take a lot of effort to balance on.
Eric -
Aloha,
Well said Eric.
The convexity of the surface is not as stable.
So a solution would be to add poles or outriggers to your rocker shoe-- if you want to increase the area in which the COM may balance above.
Also using composite footwear systems that "Hold an Edge" helps reduce trips and falls.
Otherwise downhill skiers would build their skies out of EVA and PU foam like all the Big Foam Running and Diabetic shoe makers currently do...
35 billion cubic liters of fearsome foam footwear waste per yer per year and growing. Why? When will it end?
If you want a stable system use stabilizing materials like advanced composites not just cushion materials like EVA.
Otherwise we would building our bridges out of EVA Foam correct??
F1D1=F2D2
Levers Do Work,
Steve
Trolloin' for Intellects -
You are right, balance is vital. Whom does this heel-to-toe rocker sole apply to? Forefoot surgery?
Craftsmanship is what i started to learn recently.
Take care.
Talk to you soon.
Linda -
One more question that I need help from you:what are the differences between orthopedic shoes and comfort shoes? I don't think widths is the answer.
Thanks.
Linda -
Which material is your favourite for sole-making? PU, OR EVA?
Talk to you soon.
Linda -
Aloha Linda,
Soles should be made of abrasion resistant materials with higher coefficients of friction, like say rubber?
Old fashioned midsoles made of earth polluting EVA PU foams are currently still used by the Big Foam shoe companies, who also recently followed the example of Crocs and got rid of the rubber outsole all together and just left us glitzy EVA molded bottoms. Less costs= Bigger Profit!
Seriously how does dumbing down shoes to the level of rubber slippers help better protect our children and other loved ones??
You do not understand the technology I have offered in this string yet by asking this question, that's ok most folks do not and have not.
Would you build a tetter totter for your kids out of a sturdy piece of wood or flimsy foam?
A hui hou,
Steve -
Eric -
Eric -
Aloha,
All right this called engagement and i promise to be nice.
Eric what material would you use to build your child's teeter totter?
There is a concept in mechanical engineering called H3 or height cubed.
Whereas if you double the thickness of a material you will cube its strength, (if it is fully bonded like 2x4 vs a 2 inch phone book).
Example, a piece of 4x4 wood would have the bending strength of a 2x4 cubed.
Thus if you are using foam, a material with a low modulus of elasticity, you will need ALOT OF FOAM to make it function as a lever.
Thus you have to build a thicker-higher shoe that just puts more foam in the underland-overfill and lift the user higher off the ground thus making them more unstable on a bed of foam that functions to reduce ground contact peak impulse through cushy lossy impedance, " like walking in soft sand or snow."
When you use carbon fiber "composites" H3 works in your favor by needing less material (composites have orders of magnitude higher modulus than foam) and thus staying lower to the floor and more likely- off the floor.
Composites can be made of earth healthy materials like flax and when used in a reactive impedance manor with a spring lever can offer higher degrees of stability and energy efficiency.
They have higher value for recycling and reuse and also will sink in water so they don't become poisonous fish food in our big blue beautiful oceans.
Now your comment stating that my rocket ship will not reach the moon is based on the fact that you have never seen it nor driven it correct? Tell our readers the truth please.
"I don't think your device would work for reducing forefoot pressure. " E.F.
I am still highly unsure if you fully understand the physics and mechanics yet.
Build your own pair if you dare.
A hui hou,
Steve -
We some times see Cam/moon boots in here that have an extreme rocker to one foot, the other foot has a mainstream shoe, which helps to stabilise these clients, but they all complain of lower back pain as they fight to stand still when they stop walking.
To get the best evidence based outcome we use inshoe pressure mapping system, Fscan, the information from this system shows us where the force's are and we make adjustments accordingly, to the sole fulcrum and or orthoses. -
Eric -
"Rocker tip shoes"
This is how confusion and miscommunications happen.
People coining their own phrases. I love reading what you write, but it is a "Rocker toe sole" any shoe can have its sole modified, but it hasnt changed the shoe, just the sole. -
Aloha Eric and Boots,
I understand your confusion.
The best way to understand the mechanics is to START working with and personally using composite spring plates in YOUR existing shoes.
Otto Bock and Dr. Jill's have reasonabley priced composite spring plates on their websites.
At this point I agree with Boots " Rocker Tip Shoes??" Is this a term you are using instead of the "toe spring" modification made to the shoe last to "ramp up" the toes at the end of a shoe. Is there a mechanical difference between the two?
As a side you will find that the toe spring in shoes obsolete with carbon fiber systems. They steal the ability to bend the springs as much at the MPJs thus losing power and strength and make them difficult to fit inside the shoe. ref U of Calgary research by Dr.Nigg on composites and MPJ strength.
I will be happy to show you mine if you show me yours. Provide a link to your JAPMA published article or abstract I'll have my hospital librarian get it for me.
https://www.joomag.com/en/newsstand...ugust-2015-vol-47-issue-3/0372767001435716796
My published article-primer on our US Department of Defense grant results was published in Current Pedorthics - Why Cowgirls Wear High Heel Boots. I'll admit only partial testing was completed " (after Dr. Peter Cavanough past director of the American Diabetes Foot Care council hijacked it for himself and has yet to release their Phase 1 or Phase 2 SBIR DoD testing results!)
Come on Peter show us your tech please it is meant to save life lives of our fellow Americans.
Let me know when you have more questions after reading the article. Please.
If we want to prove you are right and me wrong open up your college's testing lab to us and this innovation, that is science.
Mahalo,
Steve
Potential is Action in Limbo. -
Toe spring is not relevant to a rocker sole either.
Toe spring is relevant to the Last.
The Last design has toe spring and the toe spring of a shoe can not be changed by altering the sole.
A sole is where you create a Rocker sole. -
Reduction of peak pressure on the forefoot with a rigid rocker-bottom postoperative shoe.
Fuller E, Schroeder S, Edwards J.
J Am Podiatr Med Assoc. 2001 Nov-Dec;91(10):501-7. -
Also, when I was talking about the benefits of rocker tip shoes, I was talking about force reduction between the foot and the shoe. Your diagram is looking at shoe versus ground forces.
Eric -
Aloha David and Eric,
David in the old days yes you were correct.
"A sole is where you create a Rocker sole."
But when you incorporate a composite lever spring it is the MIDSOLE where you create the rocker.
That is why we do not use EVA or PU mid-sole materials anymore.
Also why is the toe spring added to the last in the first place? I have asked many many folks in our industry and have not found out a single reason that is supported by clinical research.
I think it is a continuation of the declining plane-simple machine which is needed for better passive dynamic gait from midstance to toe-ff at the expense of heel contact when the passive dynamics are worsened by asking the unloaded limb to lift up and load on the shoe each step , on average 22mm.
Would you please do me the favor and watch the "Rocking Video" on this link to our research results?
https://www.kingetics.com/maren/
Eric you are also correct.
"No, this is not the best way to understand the mechanics. The best way to understand the mechanics is free body diagram analysis."
But the best way for you and i to have an open conversation about a new orthotic system is to have us both try it. The proof is in the pudding.
We are currently completing the sponsored orthotic research (from Ameriflax) on the Finite Element Analysis with Dr. Chad Ulven at North Dakota State U.
Once the FEA is complete we can add the data to the free body diagram.
I will admit the FBD becomes a bit tough with this dynamic system though, it just does not sit there like foam.
A hui hou,
Steve
Waiting for Innovation is an invitation to the status quo. -
Toe spring in a Last does two things.
In a ladies tradition court shoe, as weight is taken up the thinner sole loose some of the toe spring and tightens the topline of the shoe increasing its grip on the foot, this is why court shoes have more toe spring than normal heel ptiched shoe. For the less flexible sole, Goodyear welt, the sole will not flex well, it needs toe spring so you dont trip over your own toes -
A rocker at the midfoot does not reduce force on the forefoot. That is from some of the sites in my rocker shoe paper.
Eric -
Aloha David and Eric and anyone else that wants to chip in a their few cents worth,
David, interesting i have not heard this one before but understand and have personally felt this, especially when i first started put flat carbon plates in shoes with foam midsoles.
" the toe spring and tightens the topline of the shoe increasing its grip on the foot".
This may tighten the shoe around the toes but does not translate to the grip of the shoe to the ground, that is a function of the force applied, the surface area that force is applied to and the coefficient of friction of the two materials making contact.
Hey for you students reading this is a good site to review.
http://exploration21.com/3.4/3.4/3.4.2.html
I can understand the reasoning since i play tennis.
Could I also then claim that a significant cause of ingrown toenails is caused by the toe spring when it tightens the topline of the shoe increasing its grip on the foot ??
Please please provide a single published research paper to support this assertion, please. For the Love of Science...
"For the less flexible sole, Goodyear welt, the sole will not flex well, it needs toe spring so you dont trip over your own toes"
Ok Eric now for your comments.
"What is your definition of midsole?"
Can we agree to these definitions?
I agree with old fashioned foam shoes this is correct.
"A rocker at the midfoot does not reduce force on the forefoot. That is from some of the sites in my rocker shoe paper."
Old Fashioned Definition
- in or according to styles or types no longer current or common; not modern.
"an old-fashioned kitchen range"- (of a person or their views) favoring traditional and usually restrictive styles, ideas, or customs.
"she's stuffy and old-fashioned"
synonyms: out of date, outdated, dated, out of fashion, outmoded, unfashionable, passé, démodé, frumpy; More
outworn, old, old-time, behind the times, archaic, obsolescent, downlevel, obsolete, ancient, antiquated, superannuated, defunct;
medieval, prehistoric, antediluvian, old-fogeyish, old-fangled, conservative, backward-looking, quaint, anachronistic, fusty, moth-eaten, old-world, olde-worlde;
informalold hat, square, not with it;
horse-and-buggy, clunky, mossy
"an old-fashioned hairstyle"antonyms: modern, fashionable
- (of a person or their views) favoring traditional and usually restrictive styles, ideas, or customs.
North American
noun: old-fashioned
- 1.
a cocktail consisting chiefly of whiskey, bitters, water, and sugar. May be old fashioned but still is tasty...
Way Important Concept
An important concept of using a spring levered orthotic is that the cradle helps transfer that midstance-midfoot load to the spring plate enough that a noticeable reduction of pressure is felt under the metatarsal heads ( thus personally most of my running calluses have disappeared, and my broken 5th metatarsal Jones fracture remains un-rebroken...)
The stiff cradle is an actuator to help the foot pre-bend and bend the spring plate. Ill admit composite spring plates are hard, harder than concrete so you have to use the cradle arch to help bend the plate.
This would not work the same without having a lever under the spring providing an excursion area for the spring to move in (as opposed to a regular plastic orthotic on top of a flat spring plate.
Trust me i tried this first, many times.
This is the main reason i am adding content to this string.
This concept is enhanced with the use of a longer lever up the leg such as with a modified carbon fiber Ankle Foot Orthotic, Like a stroke brace.
As to our claims
Kingetics LLC “Spring Orthotic Device” Claims
September 15, 2010
Faster-Lighter-Safer
Materials Claims: Advanced Composites (i.e. carbon fiber, Kevlar, fiberglass) with advanced resin systems can be manipulated to increase puncture resistance, blast resistance, heat resistance, electrical resistance or conductivity. Strength to weight ratio is very high.
Biomechanical Claims:
1. Increased energy efficiency during gait, utilizing and spring and cantilever orthotic. Energy from impact is stored in the spring plate and is used to assist heel lift. Energy from the plantar flexing forefoot over a pivot crates a simple lever and mechanical advantage to assist heel lift. Energy from the dorsiflexion of the spring plate at the end of the cradle (MPJ/MTJ) assists thrust at toe off. Increased energy efficiency will decrease water and caloric demands.
2. Stability is increased due to the longer and wider effective foot-ground contact. The force from gait is transferred more proximal (heel) and distal (past toes). The rigidity of composites allows stability of the forefoot over uneven terrain.
3. Decrease of shearing forces. This occurs when the pressure of the metatarsals is transferred distally and under the spring and rotational moment occurs at this location.
4. Increased force amplifier effects. The strength to push foot pedals (gas pedals etc.) is increased.
Medical Claims:
1. Reduction of Impact Diseases. Decreasing the amplitude of the shock wave/longitudinal wave up the kinetic chain will reduce the onset and effects of this negative energy. This would include i.e. plantar fasciitis, achilles tendonitis, OA, lower back pathologies.
2. Reduction of Diabetic and Neuropathic pathologies. Decreasing the shearing forces on the forefoot will reduce the onset and effects of ulcers and shear related wounds.
3. Increased mobility. Utilizing “Spring Orthotic Devices” in conjunction with Ankle Foot Orthotics (AFO), braces, prosthetics, and crutches will increase the effective force to ambulate making the less ambled more ambled…
A hui hou,
Steve
Life is Where You Awake It - in or according to styles or types no longer current or common; not modern.
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Why?
As scientist we are often asked to poke and prod.
"If you can concisely state the claims that you are making for your product and then describe how the device brings about the effects that you say it does, then we can have an open conversation without me actually wearing the device. "
Has the past post fulfilled your requests enough for you to take the next step inside of pair of newly fashioned shoes?
Otherwise you may end up suffering from the dreaded blind wise man disease.
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Toe spring does not tighten the area around the toes at all.
It tightens the topline....the topline is no where near the toes.
Next time you put your high heels on note how the slip on easily, but when you stand and walk they dont slip at the heel, thats because the topline has tightened, its not the toes that has tightened.
l cant believe how little you really know about footwear...and l mean the basics.
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