Orthotics and Rehabilitative Exercise
tissue injuries. Furthermore, the use of shock
absorbing insoles was not found to be effective
in the prevention of injury.
e of
s
u
e
h
"T
erapy
h
t
c
i
t
or tho y of
a
as a w g injur y
tin
preven ys been
wa
has al ebated
d
a hotly
"
topic...
A previously published systematic review
without meta-analysis concluded that custom
orthotics were effective in the prevention of
lower limb stress fractures and shin splints
but not effective in the prevention soft tissue
injuries or back pain.
So what does this actually mean for us
clinically?
Well, one thing that becomes clear from
the research is there is no proven reason
for why orthotics work in the prevention of
injury. We have an abundance of theories and
mechanisms toward their prescription and
manufacturing but yet no definite agreement
amongst professionals.
I take the approach that the orthotic is only
one piece of the puzzle. I use the orthotics or
similar devices to offload areas of increased
pressure or repetitive stress and move on to
other modalities to provide the best outcome
for a patient, such as exercise prescription.
STRENGTH AND CONDITIONING
When studying at University the concept of
strength and conditioning was not a topic or
subject that seemed to be largely taught, or at
least not in depth. Despite the over whelming
amount of evidence available describing
well prescribed and executed exercise
programs as being effective in the prevention
26
Pedorthic Footcare Association www.pedorthics.org
Tomashevska
thing
e
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o
"Well, omes
c
that be
rom
clear f
arch
e
s
e
r
the
is
is there n
ve
no pro r
fo
reason otics
th
why or he
t
work in n of
tio
preven
injur y."