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I have gone through a brief training with the Rep from Masai Barefoot Technology (MBT) shoes. http://www.mbt-uk.com (I am new to the arena not sure if this has already been discussed). From what I got out of the training the shoe aims to replicate bare foot walking. It does this using a negative heel system and a rocker style sole.
They claim that this puts the foot on "uneven terrain" thus encouraging the foot and leg muscles to strengthen i.e. no more orthoses required. Their main philosophy seems to be based around decreasing heel height and stride length at contact thus reducing anterior pelvic tilt, lumber lordosis etc. They also make a lot of other claims (all apparently researched) ranging from relief of neck pain to increase blood flow to the pelvis!?
Are any podiatrists using these shoes and if so what results are being found? What implications is this having on orthoses precription?
We have had a lot of that around here in recent times. Those who followed the previous snake oil threads will notice something similar in the patterns of claims made between them and the MBT shoe .... anyone else notice the pattern of thought and types of arguments made by their proponents are so similar to each other and the snake oil salesman of old.
Personally, I have nothing against MBT shoes and accept they may be helpful for some people .... I just do not recommended them purely because of the "snake oil" sales approach taken by supporters of them.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
I like that article on quackery and how to spot it. I am printing it out and putting it up in my waiting room.
The article makes it so simple on how to spot it:
-extraordinary claims
-author hopes to sell you something
-no evidence or references offered
I too was given the MBT sales pitch at a conference and laughed. I also see it what Dr Payne was referring to when he mentions the other threads.
i have seen a number of people (all women) come into my clinic saying they have bought MBT for there back pain heel pain and to reduce cellulite which i think is quite a bold claim. All i have found with them is that more often than not my patients have complained of new injuries often knee pain as a result of wearing these and maybe the fact that there is little heel or delayed heel contact which give them a gait cycle like brains out of thunderbirds might have something to do with it. Out of 6 people i have seen who bought them 5 gave up wearing them and resulted to orthoses to cure them problems
I have briefly worn a pair of the sandals and they felt great to me....yes a real rocker but at my body weight (120kg) they felt very mid foot loading and very squishy dynamic under foot, which I liked for the brief time I had them on, have been intending to by a pair but have not yet got "a round tuit"....
I thought that for young healthy people who need motion enhancement rather than motion limitation they may help....does not mean I believe all the claims.
regards Phill
Yes there have been some ridiculous claims about mbt's. I only believe in the ones that have been proven (see studies at uk site www.mbt-uk.com or any country site at www.swissmasai.com) and more importantly, believe in the ones I have seen.
Remember to understand how they work before you listen to what they do and before you make ill-informed judgements.
I look at proven claims and ones that are plausible. (not everything we believe in has been proven)
Many claims have been made within our profession, most justified and some ridiculous. does this mean we should throw 'podiatry' in the "snake oil" dept?
I do not see any claims on their website that have been "proven". I see studies that show how they change gait etc, but nothing on if that change is proven beneficial or not (I would have thought that increasing muscle activity during gait is a really bad thing). As soon as they made the claim about reducing cellulite, they get placed in the "snake oil" category in my book.
Show me where MBT Footwear has advertised cellulite reduction. This has only been suggested by some users of mbt's and it was picked up by the media for it's shock factor. Again ill-informed by your source. I am sure that some eager sales-people would try and used this advertised claim.(reduces credibility for the company).
Interesting to see that Increasing muscle activity is seen as a bad thing in today's society. Again which muscles are been used more? How can this benefit people? I could explain it more if you would like. Off to work now I'll get back on tonight and see if you want me to explain some concepts and benefits. I agree with you that its sales pitch is off putting in other areas but I think there is some benefits for some patients.
Interesting to see that Increasing muscle activity is seen as a bad thing in today's society
Why is it a good thing? More muscle activity equals inefficient gait - thats a bad thing!!!
Look at this dodgey claim from their website:
Quote:
The MBT functions like an active orthotic rather than static. We do not recommend that you wear them with orthotics, as this will stop the activating of the muscles in your feet.
What a load of BS. WTF does that mean? They have no idea about foot orthoses and muscle function and what MBT's do to intrinsic muscle function. I bet they do not even know at what stage of the gait cyle those muscles fire at.
That makes them snake oil.
Last edited by DaVinci : 16th July 2006 at 04:23 PM.
Your first cellulite quote is not from MBT, it is from FOOT SOLUTIONS. Always look at your source.
Your second cellulite quote is from MBT FAQs but does not claim to reduce cellulite. Read it. Admittedly done in a clever marketing way.
As for more 'muscle activity equals inefficient gait', well ... where do I start. .........
...........
Well more muscle activity means that it is metabollically inefficient but what about biomechanically efficient?? Food for thought as my lunch break finishes.
Do not get me wrong. I don't think MBT's replace the need for orthotics. Not at all. I prescribe orthotics when I feel from previously experiences the patient would benefit. We have no proven predictive tools to know who will benefit from orthoses. I use added paddings to innersoles as my predictive tool and I am sure others use other methods and reasoning from their experiences. However with MBT's I see some applications as a treatment modality in podiatry practice. Remember many physio's , pilates instructors and orthopaedic surgeons and other health professionals (including some podiatrists) are using mbt's as a treatment option or adjunct. I have listed only one of my reasoning for it’s possible application. (too many might be frightful to some)
1) If you ever have worn Mbt's you will notice that it promotes a shorter stride length. If you overstride it is not as comfortable as you land on the rounded heel, so you tend to shorten stride slightly and land slightly forward of heel. Heel strike (in particular) and midstance are relatively short as the sole promotes forward movement. The heel and midfoot are not loaded for long. After considering all the pathologies that are primary caused in these sections of gait, the shoe could be worn as an adjunct. Although the company does prefer orthoses not to be worn with the shoes, I tend to in some cases place some wedging or what ever is required depending on patient. (many things must be considered). Of course I do not suggest these shoes for people with forefoot pathologies or for the fact to all with rearfoot pathologies, I pick out the ones when considering many things including lifestyle.
This is only one simple logical example. Nothing exceptional, just logical for me.
Hi everyone,
I have a pair of MBT'S and have found them great for walking down hill :) much easier.
I have noticed less shock absorption and increased knee discomfort.
I get more tired in the legs after a day on them. I cannot run well in them nor do a gym workout.
They are good if I want a break from my orthoses and am at work or for day to day activities and I will get a pair of sandles for summer to use as i can't wear my orthotics in sandles.
Just my opinion.
Cheers
Simone
Thanks conp...I cant even keep these new Crocs Rx in stock in my clinic... I wear them and they are SO comfortable...not to mention they have significantly reduced my hip and nagging chronic, lower lumbar back pain!
I simply have them displayed in my waiting area and 1/3 patients come in to the room and size themselves ( always go 1 full size down in Crocs Rx versus shoe size in general) and they have ALL given them a 10/10 rating. The best part is they wear them with or without their orthotics and I find they work best without the orthotic versus barefeet and stocking feet or feet with slippers.
It always bothered me when patients loved their orthotics but could not wear them in the house with shoes (as their spouses cursed and swore as the shoes marked up the floors and were hot and heavy). The Crocs Rx are fantastic and I encourage all podiatrists to get the latest Rx type ( which are ONLY sold in medical clinics....about $35-40). Don't worry....everyone won't suddenly cancel their orthotic orders due to less symptoms in their feet, legs, hip, and back while wearing them...they still need their biomechanical correction...these are to be worn when you are spending hours on your feet WITHOUT the orthotics(Beach/cottage/in home/ on tiles and cement/ as a slipper, etc)
The latest sighting of Crocs was Jack Nicholson!!!
Hi,
The crocs look good and correct me if i am wrong but they are still a slip on style shoe.
Doesn't that defeat the purpose of a 'supportive' shoe?
Cheers
Simone
In-shoe pressure distribution in "unstable" (MBT) shoes and flat-bottomed training shoes: A comparative study. Gait Posture. 2006 Aug 8;
Stewart L, Gibson JN, Thomson CE
Quote:
BACKGROUND: Footwear comfort in many clinical situations is dependent on the ability of the 'shoe' to redistribute plantar pressure. Offloading the metatarsal heads may be achieved by fitting an insole, but recently a new design of shoe with a curved under sole (Masai Barefoot Technology((R)) or "MBT shoe") has been advocated. The aim of this study was to directly assess the effect of such shoes on gait pattern.
METHODS: Normal subjects were recruited and asked to walk sequentially in (a) flat-soled training shoes and (b) midfoot bearing shoes (MBT shoe). Mean and peak pressures in four anatomically defined areas of the foot, and the total area of sole contact were measured electronically by an in-shoe system (Pedar Ltd., UK).
PRINCIPAL RESULTS: Standing in the Masai shoes resulted in a 21% lesser peak pressure under the midfoot and an 11% lesser peak pressure under the heel in comparison to the figures found when patients wore their training shoes. There was a 76% compensatory increase in pressure under the toes. In essence there was a significant shift in pressure towards the front of the foot.
Hi All,
This recent study Aug 2006 has reconfirmed what the Edinburgh Pilot Study found previously. Less peak pressure in heel and midfoot areas. http://www.mbt-uk.com/pdf/Edinburgh_Study_final.pdf
I must now declare on this forum that I have just recented invested interest with MBT as I am now employed by MBT Footwear. I have come to an arrangement because I think the shoe has some merit. This is important to declare so you know where I am coming from and I hope all others that have invested interest with any product do the same. However I hope that you will also recognise that I am as objective and logical as possible and will try in future if the need arises to write with no bias.(if possible)
PRINCIPAL RESULTS: Standing in the Masai shoes resulted in a 21% lesser peak pressure under the midfoot and an 11% lesser peak pressure under the heel in comparison to the figures found when patients wore their training shoes. There was a 76% compensatory increase in pressure under the toes. In essence there was a significant shift in pressure towards the front of the foot.
PLUS
Quote:
Originally Posted by MBT FAQ's
6. I have diabetes. Can I wear MBTs?
MBTs can be worn by individuals with both insulin dependent and non-insulin dependent Diabetes Mellitus. Wearing the MBT stimulates blood flow to all muscle groups in the legs. It is also a potent aid to proprioception thereby, stimulating the nerve supply to muscles, joints, ligaments and tendons in the lower limbs. This is of benefit and may help individuals who are prone to develop the neuro-vascular complications of Diabetes Mellitus.
Quote:
Originally Posted by MBT Study
PRINCIPAL RESULTS: Standing in the Masai shoes resulted in a 21% lesser peak pressure under the midfoot and an 11% lesser peak pressure under the heel in comparison to the figures found when patients wore their training shoes. There was a 76% compensatory increase in pressure under the toes. In essence there was a significant shift in pressure towards the front of the foot.
PLUS
Quote:
Originally Posted by MBT FAQ's
6. I have diabetes. Can I wear MBTs?
MBTs can be worn by individuals with both insulin dependent and non-insulin dependent Diabetes Mellitus. Wearing the MBT stimulates blood flow to all muscle groups in the legs. It is also a potent aid to proprioception thereby, stimulating the nerve supply to muscles, joints, ligaments and tendons in the lower limbs. This is of benefit and may help individuals who are prone to develop the neuro-vascular complications of Diabetes Mellitus.
EQUALS.............
EQUALS....... Just don't recommend them for the diabetic (or anyone) at risk to ulcer breakdown in this area. Abit like Ingrown toenail surgery can be performed on most diabetics but is contraindicated for some.
Cheers
Con
Last edited by Admin2 : 28th April 2008 at 06:40 PM.
Reason: fixed quote
I think I see your point Dave. I gather what you are suggesting adding a warning for diabetics to seek professional advice prior to wearing them. Am I correct in stating that?
I also do not like the "proprioception therapy" bit.
Surely the application of the MBT product depends on the needs of the individual and the out come desired presciber. This is indeed the case for every kind of "medical" shoe. A case for litigation can be made against any product that allegedly causes the wearer to fall,trip or what ever, from shoes to socks to foot orthoses.
In short I do not have an issue with the footwear. My concern is that how the product is sold and the how much knowledge the dipenser has of foot pathology, bio mechanics and other issues that relate to the wearing of footwear.
Nigg B, Hintzen S, Reed F, "Effect of an unstable shoe construction (MBT) on lower extremity gait characteristics", Clinical Biomechanics, 2006; 21:82-88
Nigg's small study ( 8 subjects) found that MBT's tested in both standing and walking conditions induced kinematic, kinetic and EMG changes (or "trends" for those that were not statistically significant) when compared to the Adidas Supernova running shoe. He makes the analogy of wobble board training and suggests that MBT's may be advantageous in strengthening LE mscles and improving proprioception. So while the shoes may induce fatigue they may be useful as a training tool.
I have had some good outcomes especially with midfoot OA but the weight, thick midsole and instability are a problem for some.
Replace orthoses with Masai Barefoot Technology (MBT) shoes?
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