Orthotics and Rehabilitative Exercise
narrow scope of practice to a multi-faceted
management strategy, to get the best result for
our clients in the shortest amount of time and
attempt to prevent any re-injury or secondary
may be played on. Tennis and other racquet
sports provide similar issue to the practitioner
and patient, as do running shoes!
a strength and conditioning program tailored Your safest options when prescribing shoes
for the purpose of injury prevention is to make
sure the shoe is designed for the activity in
mind, that the shoe is of adequate length and
width for the individual and that the outsole
is designed for the surface it is to be used on.
Other than that, it’s all about comfort, comfort,
comfort!
to their chosen activity. ORTHOTICS / OFFLOADING
injury as a result of detraining.
When trying to prevent injury a practitioner
should aim to offload structures identified as
being under high loads of stress, satisfactorily
rehabilitate previous injury, educate the patient
on appropriate footwear choices and refer for
FOOTWEAR
Athletic attire has transformed the sporting
world over the last seventy years or so –
especially in the footwear category. From
waffle-iron pressed rubber to 3D printed one
piece uppers, the athletic footwear enterprise
encompasses scientific evidence, fashion trends
and at times bizarre additions that look like
they’re out of a sci-fi movie.
The evidence available for footwear’s impact
of injury prevention is very limited, most
circulates around debate of high top vs low
cut basketball shoes and lateral ankle sprains—
spoiler alert—low cut wins. Using footwear as
an injury prevention strategy primarily comes
down to taking an accurate patient history
and analysis of the movement patterns and
demands of their chosen sport. Football cleats
have a variety of sports they are useful for
whether it be football, rugby or soccer, each of
which also has a variety of surface types they
The use of orthotic therapy as a way of
preventing injury has always been a hotly
debated topic, with the key argument against
the use of orthotics being “if the tissues are
able to tolerate the stressors being placed
upon them, why would you look to redirect or
attenuate those forces?” in other words “if it’s
not broke, why fix it?”.
That argument now seems to hold less
weight with the release of a systematic review
and meta-analysis identifying the benefits of
orthotics in reducing the presence of common
lower limb injury.
Bonanno et al 2016, looked at 16 trials (11
custom orthotics, 7 shock absorbing insoles)
in the prevention of lower limb injury. Their
findings indicted that the use of custom
orthotic devices in the prevention of lower
limb injuries was effective in the case of stress
fractures and overall injury rate, however,
was not effective in the prevention of soft
Current Pedorthics May/June 2017
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