Biomechanical analysis of the effect of orthotic shoe inserts - A review of the literature

Physical activity is increasingly recognised as an important component of p rimary disease prevention. Overuse injuries are common sequelae of exercise and sporting activities in general, and of running in particular frequentl y resulting in cessation of activity. It has been proposed that there is a link between foot shape, foot function and the occurrence of injury. As a m eans of treatment and prevention of further injury, orthoses and shoe inser ts are widely prescribed in the belief that they can alter the pattern of l ower extremity joints' alignment and movement. Although this is an assumpti on widely made in the treatment of many joint conditions, the manner throug h which this treatment could be effective is not clear. This article aims to examine the literature to gain an improved understandi ng of the present state of knowledge regarding the effect of foot shape and orthotic use on foot kinematic and plantar pressure characteristics. The effects of foot type on the occurrence of lower limb injury during spor ting activities and different aspects of biomechanics are reviewed, and the effects of applying orthoses on injury treatment and prevention and on var ious aspects of biomechanics of the lower limb joints are discussed. Further research is required, firstly to establish the casual effect of foo t type and function on the risk of lower extremity overuse injury, and seco ndly to document the specific effect of orthotic therapy on injury treatmen t and prevention. Specifically, more prospective studies are necessary to i nvestigate the long term effect of orthotic intervention.