Why Not Orthotics?

As a practicing Podiatric Physician and researcher for over 40 years, I have had a passion for understanding the link between foot mechanics and overall body health. I can still remember my professor in biomechanics saying ‘the patient’s manner of walking not only affects the overall health of the feet, but also the overall health of the body’. At that time I did not fully appreciate how prophetic his statement was. 

How the foot functions, referred to as biomechanics, is a major determinant in the overall wellness of the patient. From an engineering point of view, this is easy to understand. An unstable foundation can produce problems in the entire building. Likewise, an unstable (pronated) foot can produce problems in the entire body.

For years I attempted to stabilize foot mechanics by using a supportive type insoles (orthoses). These orthoses typically incorporated an arch support with forefoot posting (wedging). They were very effective for controlling foot, knee and low back pain, but at a very high price. Over the years, it became apparent to me that by supporting the foot I was weakening it (e.g., inner arch collapsed more and more). As long as my patients wore their orthoses, their body pain was less. However, their pain quickly returned when the orthoses were not worn. It appeared I was addicting my patients to their orthoses!

The link between foot function and musculoskeletal health can not be overstated. However, I recently discovered another important link between the foot and the body: Posture. My research indicates that a weak and unstable foot can and often results in postural distortions (poor posture). And these postural distortions occur in young children. It also became clear that postural distortions are a harbinger in the development of chronic body pain. The child with poor posture is the adult with chronic body pain. 

In my pursuit to reverse and correct these postural distortions, I continued to use orthotics.  The long term results were less then desirable: These orthotics definitely improved posture. However, when the orthoses were not worn, the postural gains were quickly lost. And alarmingly, in many cases, the posture appeared even worse when compared to pre-therapy photos. This suggested a disturbing link between supporting the foot and weakening the posture. 

Obviously, a different approach in therapy was needed!

Proprioceptive Insoles

In 1995 I invented a non-supportive type foot insole which incorporates a form of acupressure therapy.    These insoles, now referred to as Rothbart Proprioceptive Insoles, apply a tactile stimulation to the bottom of the foot. In theory, this tactile stimulation transmits a signal to the cerebellum (the balance center of the brain). Acting on this signal, the cerebellum initiates a postural correction affecting the entire body.  The posture shifts from a forward, inward position to a straighter more upright position. Postural photos visualize the immediate and far reaching impact proprioceptive insoles have on the body.

Published studies confirm the link between improving posture and reducing or eliminating chronic musculoskeletal problems. While both proprioceptive insoles and orthoses improve posture, unlike orthoses, proprioceptive insoles do not weaken the foot. In fact, many of our patients find that they are able to use their proprioceptive insoles less and less and still maintain their level of wellness (a process referred to as engramming).