Running Myth 6 – Do Orthotics Prevent and Treat Overuse Injuries to the Lower Limb by Correcting Abnormal Biomechanics?

MYTH

Orthotics prevent and treat overuse injuries to the lower limb by correcting abnormal biomechanics.

REALITY

Orthotics are useful in the treatment of certain acute foot pathologies, but the absence of good quality scientific studies makes it hard to clearly demonstrate the effect of orthotics in the treatment and prevention of lower limb injuries in runners.

ELABORATION

There is no consensus among scientists regarding orthotics as treatment of common running injuries. The results from studies are often unclear and confused with other treatment methods. When someone is prescribed othotics together with other various forms of treatment it is hard to establish a cause-and-effect relationship.

Abnormal biomechanics is not typically the primary concern when it comes to preventing running injuries, read our previous posts on anatomical abnormalities  and the cause of running injuries for more details. Correcting an anatomical abnormality; such as pronation or flat feet, does not necessarily decrease your risk of injury. It can even have a negative effect on oxygen consumption due to the extra weight, and the neurophysiological mechanisms of absorption and propulsion due to the continuous contact of the orthotics with the plantar surface.

EXCEPTIONS

There is a difference between biomechanical orthotics and support orthotics. The former being designed to correct a biomechanical abnormality, and the latter being designed to support the foot by evenly distributing the load or relieving pressure from certain areas of the foot. A support orthotic can be helpful in the acute stage of overload injuries, such as; metatarsalgia, sesamoiditis, some stress fractures and pain in the ankle or heel, or in the case of an acute new onset of altered biomechanics. Supporting and unloading the painful tissue gives the body a greater chance to heal in the same way that supportive tape would.

BOTTOM LINE

Before you go get yourself a pair of orthotics, make sure that you have a health professional assess you to form a complete picture of your situation. Depending on your specific concern, it may be more beneficial for you to focus on;

  • Running technique
  • Proper training progression
  • Muscular strength and function

Each individual and pathology is unique and there is no one answer that fits all. While orthotics have their place in the acute stage of certain pathologies, it should not be a standard go-to, and they may not be the best investment for you to prevent a running injury. Find all the pieces of the puzzle and think bigger!

 

Stay tuned for #TeamJina’s next post by @jeanlewispt next Tuesday where she will discuss the role of flexibility in the prevention of running injuries.

For more Physio related information, stay updated by following @jeanlewispt and @linaenglundpt on Twitter.

References: “New Trends in the Prevention of Running Injuries” – Blaise Dubois BScPT; based on several scientific publications available on demand.

 

 

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