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Running orthoses Prescription

Discussion in 'Biomechanics, Sports and Foot orthoses' started by bren11, Sep 16, 2010.

  1. bren11

    bren11 Member

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    Hi All,

    I was wondering from the cohort what orthers prescribe in the way of orthoses for runners.

    And how much would the recreational runner differ from the marathon runner?

    And would you put a sprinter in spikes a 3/4 v full length?

    I have heard pods have the 3/4 vs full length discussion.

    Others i hear use carbon only with 220 eva arch fill, full length poron + neoprene covers.

    I have heard 2-3mm poly with 150 eva arch fill + heel posts with lunasoft +1.5mm poron tops.

    Personally I use a combination depending on the patients' needs.

    Though I seek others to express their views. and prescription variables

    Thank you in Advance

    Last edited: Sep 16, 2010
  2. Bren it depends what your trying to achieve.

    But striking pattern will be important.

    ie not a great deal of point having rearfoot control when the patient is Forefoot striking.

    But it´s alittle how long a peice of string - but I would think the best thing to do is not get stuck in patterns of treatment plans, but deal with each case specifically.
  3. JPod

    JPod Member

    Does the runner need orthotics?

    What is their foot strike pattern?

    What are you trying to achieve?

    Most good distance runners have got to being good due to having decent biomechanics - getting them into an appropriate shoe and doing plenty of strengthening work is in most cases far more effective than an orthotic, IMO.

    Finally, does the runner need orthotics? (Argh)
  4. Phil Wells

    Phil Wells Active Member


    I agree with you that good runners and orthoses don't often mix however it worth thinking along the ZOOS concept and how insole may 'tweak' internal foot moments.
    We see a few elite athletes who have never needed insoles but suddenly start having foot pain. We have prescribed very soft bespoke PU insoles into there sport specific shoes and had excellent results.

    Sometimes a little goes a long way.

  5. bren11

    bren11 Member


    does that mean that only good runners have good biomechanics? and have no pathologies?

    functionally I agree technique can alter compensation patterns and muscle inbalance.
    what about Jo average? cannot he benefit and HAS benefited from orthoses and strengthening rehab?
    I dont believe orthoses as being a magic pill, though strongly believe in its place within our practice

    I mearly would like to hear about orthoses prescription
    3/4 v full length orthoses, shell thickness and materials used.
    Thought it could be a good forum to discuss the different prescription habbits.

    and the thoughts on shell thickness so tha
  6. CraigT

    CraigT Well-Known Member

    Some interesting thoughts in this discussion...

    I think the most significant thing to consider is what you want to achieve with the orthoses- this is much more important that the material on it's own.
    I know Pods who treat runners who will only use EVA orthoses, but I also see elite runners and almost always use a 3/4 poly shell with no cushioning. I personally find that doing this will flag any potential problems quite quickly- ie: if the orthosis is going to cause a problem, it is obvious very quickly (it will feel hard or not natural). I might make the same deice out of carbon fibre for spikes or racing flats.
    It is up to the practitioner to decide which is best to achieve their aims.

    No. While it is true that elite runners rarely have grossly 'poor' mechanics, they also do not have to have much wrong to have problems. In addition it is more rare to not have pathologies.
    A small problem for someone who trains 160km a week is often significant. The same problem may be insignificant to a recreational runner.
    Elite African runners are often cited as being ideal, but an alarming number do not compete at their top level past their mid 20's. I have seen a few who have quite poor mechanics and this has never previously been addressed.

    Need is a very definite word.
    I prefer to look at how much of a benefit for the athlete there would be. For example- I had a runner who was training up to 120km a week, but would break down with Achilles and knee pain if she did any more than this. An assessment revealed some potential areas which could be improved- orthoses allowed us to address some of these in a very short period of time. She was happy as she could then increase her mileage to 150km+ without the previous problems.
    She did not 'need' orthoses, but had a clear benefit from them.

    I don't entirely agree with this.
    Perhaps if you have a forefoot striker who never loads their heel, however I think this is quite rare. Midfoot and forefoot strikers often will have some heel load, so rearfoot support still may have a benefit.
    Interestingly, even sprinters can derive benefit from rearfoot supporting orthoses as they also spend a large period of time walking around in spikes, and doing other exercises where they are not sprinting. I also think there may be some flow on postural effect from being in the orthoses if they have classic pes planus/ medially deviated STJ axis feet.

    Just a few random thoughts on the subject...

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