Shoe insert explained

A removable shoe insert, otherwise known as a foot orthosis, insole or inner sole, accomplishes many purposes, including daily wear comfort, height enhancement, plantar fasciitis treatment, arch support, foot and joint pain relief from arthritis, overuse, injuries, leg length discrepancy, and other causes such as orthopedic correction and athletic performance.

Medical use of foot orthoses has been criticized as lacking evidence of benefit, and practice is very inconsistent: reputed podiatrists prescribe completely different orthoses for a single patient.^{[1] [2] [3]} Further, effect of a given design of orthosis varies significantly by patient,^[4] and standard practice to personalize prescription is not available.^[5] However, evidence is mixed: patients often report at least short-term improvements in comfort, and other studies have found effectiveness.^[6]

Fitting patients

There are three standard methods for fitting patients: plaster casts, foam box impressions, or three-dimensional computer imaging. None are very accurate: all produce proper fit under 80% of the time.^[7]

Traditionally they were created from plaster casts made from the patient's foot. These casts were made by wrapping dipped plaster or fiberglass strips around the foot to capture the form, then letting it dry and harden. Once the cast was hardened, the doctor would carefully remove it from the patient's foot and ship it, along with a prescription, to an orthotics lab which would use the negative of the cast to create an orthopedic insert.

Recently, several companies have developed digital foot scanners that use specialized software to scan a patient's foot and create a "virtual" cast. These scans are made by having the patient place the foot onto a specialized flat image scanner that uses light and software to capture and create a 3D model. This 3D model is then electronically submitted (along with a prescription) to an orthotics lab, where it is used to program a CNC machine that will ultimately produce the orthopedic insert.

Diabetic shoes

See main article: Diabetic shoe. Diabetic shoes, sometimes referred to as extra depth, therapeutic shoes or Sugar Shoes, are specially designed shoes, intended to reduce the risk of skin breakdown in diabetics with co-existing foot disease.

See also

• Comparison of orthotics
• Orthotics
• Podiatry

Further reading

• Razeghi . Mohsen . Batt . Mark Edward . Biomechanical analysis of the effect of orthotic shoe inserts . Sports Medicine . 29 . 6 . 2000 . 425–38 . 10870868 . 10.2165/00007256-200029060-00005. 19959986 .
• Landorf . K.B. . Keenan . A.M. . 23374568 . Efficacy of foot orthoses. What does the literature tell us? . Journal of the American Podiatric Medical Association . 90 . 3 . 2000 . 149–58 . 10740997 . 10.7547/87507315-90-3-149.
• Christovão. TC. Neto. HP. Grecco. LA. Ferreira. LA. Franco de Moura. RC. Eliege de Souza. M. Franco de Oliveira. LV. Oliveira. CS. Effect of different shoe inserts on postural balance: a systematic review.. Journal of Physical Therapy Science. Oct 2013. 25. 10. 1353–6. 24259792. 10.1589/jpts.25.1353. 3820199.
• Penny. P. Geere, J . Smith, TO . A systematic review investigating the efficacy of laterally wedged shoe inserts for medial knee osteoarthritis.. Rheumatology International. Oct 2013. 33. 10. 2529–38. 23612781. 10.1007/s00296-013-2760-x. 20664287.

Notes and References

1. Chevalier, T.L. and Chockalingam, N., 2012. Effects of foot orthoses: how important is the practitioner?. Gait & posture, 35(3), pp.383-388.https://doi.org/10.1016/j.gaitpost.2011.10.356
2. Book: Nigg, Benno M. . Biomechanics of Sports Shoes . 2011.
3. News: Close Look at Orthotics Raises a Welter of Doubts . The New York Times . Gina . Kolata . January 17, 2011.
4. Chevalier, T.L. and Chockalingam, N., 2011. Foot orthoses: a review focusing on kinematics. Journal of the American Podiatric Medical Association, 101(4), pp.341-348.https://doi.org/10.7547/1010341
5. Medicine & Science in Sports & Exercise. 2003. 35. 2. 314–319. 10.1249/01.MSS.0000048828.02268.79. 12569222. Effect of Shoe Inserts on Kinematics, Center of Pressure, and Leg Joint Moments during Running. Nigg. Benno M.. Stergiou. PRO. Cole. Gerald. Stefanyshyn. Darren. m??Ndermann. Anne. Humble. Neil.
6. Gross, M. L. . Davlin, L. B. . Ebanski, P. M. . Effectiveness of orthotic shoe inserts in the long-distance runner . American Journal of Sports Medicine . 1991 . 19 . 4 . 409–412 . 10.1177/036354659101900416 . 1897659. 23550947 .
7. Telfer S. . Gibson KS . Hennessy K . Steultjens MP . Woodburn J. . Computer-aided design of customized foot orthoses: reproducibility and effect of method used to obtain foot shape . Arch Phys Med Rehabil . 2012 . 93 . 5 . 863–70 . 22541310 . 10.1016/j.apmr.2011.12.019.