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 Researchers analyzed data from 11 trials of foot orthotics and seven
studies of shock-absorbing insoles that, combined, included more
than 3,200 people.
Overall, foot orthotics were tied to a 28 percent lower risk of
injuries and a 41 percent lower risk of stress fractures, the study
found. Shock-absorbing insoles, however, were not linked to a
statistically meaningful reduction in injuries or stress fractures.
“By pooling the results of all available trials on this topic we
found that foot orthotics were effective for preventing shin pain
and some stress fractures of the foot and leg (metatarsals, tibia
and femur) as per previous studies, but we also found that overall
injuries were reduced,” said lead study author Daniel Bonanno of La
Trobe University in Melbourne, Australia.
Athletes often use orthotics and insoles to help prevent and manage
a range of muscle and bone problems such as stress fractures and
injuries to the tendons, muscles and joints.
Typically, foot orthotics have a contoured profile and are used with
the intention of optimizing foot function. These inserts can help
shift weight distribution and pressure as the foot strikes the
ground and alter muscle activity and running mechanics.
Shock-absorbing insoles, by contrast, tend to be relatively flat and
are predominately used to reduce the force of impact when the foot
strikes the ground, potentially warding off damage to muscles,
tendons and bones.
While the benefits of orthotics appeared clearer, the study found
mixed results for both products, researchers report in the British
Journal of Sports Medicine.
One trial of shock-absorbing insoles actually showed an increased
risk of injuries associated with these products, though the other
trials in the analysis simply found no benefit.
The authors cautioned against reading too much into the study
results, though, because most of the trials in their analysis were
done in military settings where typical physical activities may not
look much like the experiences of civilian joggers and weekend
warriors.
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Another limitation of the study is that most of the trials in the
analysis allowed participants, therapists and researchers to know
the goals of the experiments and what treatments were delivered.
This makes the results low-quality because the way people rate the
effectiveness of treatments can be biased when they know what
treatment they got, the authors of the current study note.
Still, it may make sense for some athletes to use orthotics, said
Dr. Selene Parekh, a researcher at Duke University in Durham, North
Carolina, who wasn’t involved in the study.
“Stiff or hard orthotics seem to help redistribute the force going
through the bones thereby shielding the bones,” Parekh said by
email. “But, orthotics – soft or hard – do not change the way the
foot and ankle are moving, therefore, there is no benefit to the
soft tissues.”
The best way to know if orthotics can help, and that they won’t make
matters worse, is to check with a doctor first.
“For athletes, and anyone in general, you need to rely on the health
care professional to evaluate and decide if you are a candidate for
an orthotic,” Parekh said. “The right fitting orthotic can allow
athletes to continue to participate in sports activities through
some injuries, such as a fifth metatarsal stress fracture or turf
toe injury, but a bad orthotic can worsen symptoms of an injury.”
SOURCE: http://bit.ly/2hwDIUq British Journal of Sports Medicine,
online December 5, 2016.
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