Put up your hand if you have ever had a patient return for an orthotic review, heaping praise on you for the miracle you have performed, only for you to find out they are wearing the devices the wrong way around....
Worse, I had a patient with simples once who had them in back to front!
Simon gave a good definition of how orthotics work on another thread but as we are presently arguing, there are elements of how orthotics work we don't fully understand! Not least the placebo effect!
Something I played with a while back was something I called Iatrogenic Malignant Hypertonia. I noticed that some patients, particularly the "chronic pain" types had abberactions to ANY kind of orthotic. They would tense up all their intrinsic muscles and find walking painful as a consequence. I have had patients for whom a 3mm poron sheet with a cavity for a corn was "to harsh" and which caused tibialis pain.
I wonder if their is a reverse of that, a mechanism by which people relax more and walk more fluidly if they THINK that a problem has been fixed.
There is probably a funky experiment using an F scan and hypnosis there! Does background muscle tone affect gait? Any volunteers?