Do I need orthotics or special running shoes???

An age old question from so many runners, walkers, athletes, and those who work on their feet.  In hopes of catching the blog up, this along with others, will be old posts that I often find myself discussing with patients and colleagues.

Read NY Times Blog Post below:

http://well.blogs.nytimes.com/2010/07/21/phys-ed-do-certain-types-of-sneakers-prevent-injuries/

While not a definitive study, it appears to have debunked the idea that so many people need ‘motion control’ shoes due to foot problems.  The original idea was that a ‘motion control shoe’ reduces pronation and would subsequently reduce injury in those pronators who wear them.  I suspect that more often pronation is the end-result of another issue  and should not be our main focus.  While in a small number of cases pronation may be solely a foot issue, it is likely that it is the result of a problem farther up the chain (most likely the hip; with delayed onset or weakness of the gluteus medius or lateral rotators).  My estimation is that as we fix pronation with a ‘motion control’ shoe, the compensation for the hip issue is eliminated.  This prevents energy leakage from the system and as energy remains during each step it overloads a different tissue/structure/joint leading to the increased rates of injury noted in the article.  Further study is needed, but we need to be aware of these sacred cows and exercise myths.  Look for future posts on strengthening the foot (foot drills & short foot exercises) as well as hip stability exercises.