Research: Orthotics may be helpful in short-term

Benno M. Nigg has become a leading researcher on orthotics, those shoe inserts that many athletes use to try to prevent injuries. And what he has found is not very reassuring, according to a story in the New York Times.

Do they help or harm athletes who use them? And is the huge orthotics industry — from customized shoe inserts costing hundreds of dollars to over-the-counter ones sold at every drugstore — based on science or on wishful thinking?

His overall conclusion: Shoe inserts or orthotics may be helpful as a short-term solution, preventing injuries in some athletes. But it is not clear how to make inserts that work. The idea that they are supposed to correct mechanical-alignment problems does not hold up.

Joseph Hamill, who studies lower-limb biomechanics at the University of Massachusetts in Amherst, agreed.

“We have found many of the same results,” said Dr. Hamill, professor of kinesiology and the director of the university’s biomechanics laboratory. “I guess the main thing to note is that, as biomechanists, we really do not know how orthotics work.”

Orthotists say Dr. Nigg’s sweeping statement does not take into account the benefits their patients perceive.

The key measure of success, said Jeffrey P. Wensman, director of clinical and technical services at the Orthotics and Prosthetics Center at the University of Michigan, is that patients feel better.

“The vast majority of our patients are happier having them than not,” he said about orthotics that are inserted in shoes.

Seamus Kennedy, president and co-owner of Hersco Ortho Labs in New York, said there was an abundance of evidence — hundreds of published papers — that orthotics can treat and prevent “mechanically induced foot problems,” leading to common injuries like knee pain, shinsplints and pain along the bottom of the foot.

“Orthotics do work,” Mr. Kennedy said. “But choosing the right one requires a great deal of care.”

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