Current Pedorthics | May-June 2018 | Vol.50, Issue 3 | Page 46

ROCKER SOLE REVOLUTION extremity of the body – uses more energy. This well accepted physiological effect by itself has nothing to do with the rocker sole concept. Walking with a rucksack full of rocks on your back will also result in greater caloric output, muscle activity and corresponding loss of body weight. The further and faster you walk – the greater the effect. It is also interesting to note that although all of the physiological benefits of MBT’s rocker soles are equated and credited to the African Masai peoples – they don’t actually wear shoes to achieve these benefits. Such is marketing logic. (Fig. 4) With the help of attractive female models with shapely abs, butts and legs “toning shoes,” as they are now called, represent a sizable shoe market segment. It’s a market driven by a customer base that is 90% women, accord- ing to an industry spokesman. There is little doubt that the destabilizing rocker affect on the body created by toning shoes does change the wearer’s gait pattern and posture when walk- ing and standing. However, like other footwear trends there are a growing number of practitio- ners that have come to the realization that not all radical biomechanical concepts are suited to every patient or wearer. Toning shoes create their advertised benefit by destabilizing how a person walks thus forcing the core muscles of the body to rebalance. This affect generates more muscle activity in the gluteus maximus muscles and upper thigh muscle groups. It is only a short marketing leap away to therefore claim that the wearer is burning more calories, fighting cellulite, improving their posture and circulation while also reducing knee stress. However, that instability can result in sprained ankles and strained Achilles tendons. These 44 Pedorthic Footcare Association | www.pedorthics.org types of unstable soles may also cause particular problems for older wearers or those who have difficulty keeping their balance. ROCK STEADY A pedorthic rocker sole, as stated, is basically used for off-loading pressure on the forefoot or heel. It facilitates easier heel-to-toe gait and reduce the motion of the foot and ankle. A SACH heel rocker is particularly useful for patients with ankle osteoarthritis or those who have had an ankle fusion. This common shoe modification is usually accomplished by creat- ing a fulcrum at the heel or across the shoe sole medially to laterally. It affects the sagittal plane and helps to rock the shoe forward from heel to toe without bending the shoe. Of late, a growing number of clinicians are advising wearers that toning shoes do not deliver on their marketing promises created by their advertisers as benefits. Worse, some are warning that unstable rocker sole shoes could cause injuries, such as strained Achilles tendons and ankle sprains by destabilizing how a person walks and forces a change of gait pattern. Claims that toning shoes can significantly con- tribute to a person’s fitness are “utter nonsense,” according to Barbara de Lateur, a professor of Physical Medicine and rehabilitation at Johns Hopkins University of Medicine in Baltimore. Another warning comes from Bryan Mar- kinson DPM, chief of Podiatric Medicine at Mount Sinai School of Medicine in New York. Markinson says some of his patients who are “not in the greatest of shape” have inflamed their Achilles tendons while wearing toning shoes. People thinking of buying them, he says should begin an “active stretching program” or else risk injury.