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Hi all,
This is my first attempt at submitting a thread - being new to the arena, so forgive my shortcomings - please?
Having recently been on the receiving end of some hard pressure salesmanship regarding MBT's (and I was only looking at the stand whilst my husband paid for his shoes!) I was wondering what the general consensus was on these ridiculous looking canoes? The salesman added to his spiel by informing me that 80% of his staff were wearing them, one of whom said she wouldn't be without them, only wasn't wearing them that day because she couldn't wear them two days in a row, and sometimes couldn't wear them for more than a couple of hours. I can see that they would have benefits for certain patients, but this is also coupled with a deep mistrust of people who are desperately trying to sell me something I didn't ask about. If anyone has some first hand experience that puts them in a better light than the sales assistant I would welcome the responses.
In anticipation - Jacqui

Hi Jacqui:

They are getting popular.

Frankly, as has been stated previously here (somewhere) salespeople are just that, sales people. Few if any have any clue about the function of the shoe or the foot for that matter. They are just doing their job, which is selling a product.

I have worn MBT (in store) and they do shift weight to the heel and off the metaheads. My take is a slightly proximally located rocker bottom with a soft heel depression.

Now, I'm not sure what exactly this has to do with the african tribe - (who walk barefoot) - that the shoe is named after.

I'm sure the biomechanical members can explain the biomechanics.

Steve

Hi, thanks for the reply,
It is probably the name that is adding to my concerns, I can appreciate that a rocker bottom shoe would help certain patients, but it is the promotional stuff that makes me question the research - I understand the concept was that they are based on the predominance of a rocker bottom foot in Masai tribesmen, who reportedly do not have back problems, but having been to Kenya wondered who they would take their back problems to and how they would pay for it once there? Hospitals and clinics not being something that predominates in the Mara! Saying that, how did you actually find they worked for you, and would you recommend them?
Thanks, Jacqui

Jacqui:

The Masai Barefoot Technology (MBT) shoe is popular in some areas of the US. There is a lot of promotional advertising for this shoe which makes no sense and has no research to back it up so your initial impressions that the salesman was giving you a sales pitch filled with bunch of horse manure were probably true.

The MBT has a rearfoot midsole wedge that is of a low durometer material that seems to absorb heel strike shock and also has a rocker soled design. I have walked in a pair of these shoes that were given to me but, after 10 minutes, decided I didn't like the feel of them since they were making my legs hurt. I have, however, had many patients that swear by them and some seem to think it helps their plantar heel pain and other pathologies. Other patients have found them to be an expensive pair of shoes ($200.00+) that work no better than the running shoes that they can get at Costco (a large discount warehouse chain in the US) for $20.00.

I believe we did have a discussion on these shoes some time ago on Podiatry Arena. You may want to check the archives. Hope this helps.

__________________
Sincerely,

Kevin

**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
**************************************************

Jacqui

I believe the Masai reference in the name has been used to represent the postural changes (improvements?) that the manufacturers claim they have made.

I have sold these shoes, prior to studying podiatry, and have heard some very positive feedback from customers who have used these, (Please note I am not presenting this as an argument for the shoes, as evidence this is probably worse than useless) and some less positive feedback from those who haven't got on with them.

They are certainly very unstable, and customers are given an introduction when they buy where they are advised on the best "way to walk," in the shoes (short stride length, heel strike, avoid allowing the foot to excessively to pronate / supinate, keeping their head up and back straight] I did hear some concerns that they can encourage some genu vecuvatum due to the creation of a functional equinus (Nigg et al 2006 certainly report increased ankle dorsiflexion during the first half of stance phase) and I feel that an unstable foot would be allowed to move more in the frontal plane in MBT rather than most other footwear.

Supported by the supplier the store are very careful when recommending the shoes, and any customer who has a musculoskeletal disorder (that they are aware of) is recommended to go back to their treatment provider for advice before the shoes are purchased.

Ultimately there is a difference between the sales person who has some training in a product but has a product to sell rather than a health professional who's decisions and recommendations should be evidence based.

There has been some research published into the effects of the shoes, although some of this was supported by MBT, there are others but here are 3;

Nigg, B.M., Emery, C., and Hiemstra, L.A. (2006) Unstable Shoe Construction and Reduction of Pain in Osteoarthritis Patients. . Sci. Sports Exerc. Vol 38(10)

Nigg, B,. Hibtzen, S. and Ferber, R. (2005) Effect if Unstable Shoe Construction on Lower Extremity Gait Characteristics. Clinical Biomechanics Vol 21

Stewart, L.m Gibson, J.N.A., and Thomson, C.E. (2007) In-Shoe Pressure Distribution in "Unstable" (MBT) shoes and Flat-Bottomed Training Shoes: A Comparative Study. Gait & Posture Vol (25)

Hope this is of some use.
Euan

Kevin:
What pathologies specifically do you think the MBT may help with?
Steve

__________________
DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Green Bay, Wisconsin, USA

Steve:

The only pathology that I have ever seen MBT shoes work for were proximal plantar fasciitis (i.e. plantar heel pain).

__________________
Sincerely,

Kevin

**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
**************************************************

See:
MBT physiological footwear
MBTs and windlass mechanism
MBT rocker sole footwear, for hallux limitus?
MBTs
Rocker bottom shoes for diabetics
MBT'S - Are they suitable footwear from a health and safety point of view for nurses
Replace orthoses with Masai Barefoot Technology (MBT) shoes?
Masai Barfuss Technology shoes
Shoe Claims to Reduce Cellulite
Other threads tagged with MBTs

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Interesting thread ! Cant comment on the shoes but imagine like any rocker bottom soles can be very useful on some people.

Can comment on the Masai we met in Kenya, they were not barefoot but wore the tread from tyres that were cut to size and strapped to the feet. The ground they walk over was very hard and rocky and the tyre treads certainly gave them plenty off bounce and perhaps had a degree of natural rocker sole .

I'm another who sold them in a shop for a few days and at a retirement expo.
I was given a pair ($369.oo in Aussie dollars) and have worn them off and on for 6 months. They do alliviate heel pain,(which I had suffered for a year, since I trod on a large stone a year previously) and are really good if you stand for long periods. Walking not so good. I am tall, 171cm, and they add some 5 cms and make me stand up straight, but they drag for want of a better word. The idea is good, and to some extent, yes, it helps. I want to make the same model in softer, lighter weight material, like Crocs.
Into my second year of Pod at Uni of Newcastle. Passed all my exams. Been working for a top sports pod during the summer holidays. Yeah! Having fun.
Carole

MBT's seem to be a purely personal choice but they do look like orthopaedic footwear, and I understand the wearer has to be trained to walk in them - why?

Has anyone had experience of Earth negative heel footwear? They're supposed to burn off extra calories and I can see they would encourage stretching of the calf muscles. Does any non hippy out there wear them?

P.S Does anyone know where the venue is for the Birmingham Biomechanics boot camp is in February?

Having formerly worked in biomechanics I was frequently asked what I thought of MBT's. Until recently,like the most, I had no experience of them and therefore no opinion and wouldn't recommend as they are rather expensive to try out. However, I met Joshua Wies, their chief physiotherapist in the UK, and asked him if these shoes had been cased on patients with conditions such as Ankylosing Spondylitis. My husband has this condition and Joshua kindly offered to supply a pair of shoes in return for our feedback. I have to say my husband loves them. They reduce pain in his feet and enable him to be mobile for longer periods than in "regular" shoes or trainers. You must wear them in gradually as with orthotic devices and extra care with those suffering tight TA's as the heel strike is deeper with the rocker sole. It is also good for painful Hallux joint movement as the joint is rested in these shoes. They are not the thing for everyone but I suggest to my patients that they walk around the shop for half an hour before buying. I also like that they make my shortie hubby a wee bit taller!

I was wondering what they did with all the Earth Shoes of the 1970's that didn't sell. You should try walking up a steep San Francisco hill in them.

Clever rebranding!

Cheers

Frederick

"I was wondering what they did with all the Earth Shoes of the 1970's that didn't sell"

Hi Fred:

Wait til you hear this!

I had a patient in on Tuesday; 6 weeks post op Achilles debridement/retrocalcaneal exostectomy. He was all excited that he might be getting back into a regular shoe soon and he told me he was going shopping and wanted to get a pair of EARTH shoes!!!!!!!

I didn't know quite what to say...... maybe he knew a bit more than I gave him credit for and was joking with me. But no, he was being truthful.

I told him that if, in fact, he did get some Earth shoes and it ruined my "good work" that I'd consider putting his bone spurs back in! lol

Steve

Hi Steve

I didn't know they still made them. The line was that the inventor was walking on the beach and noticed that his heels were sinking deeper in the wet sand.

When I was in pod school, they were great for clinical experience.

Cheers

Frederick

I had some MBT's, bought them to try and correct my terrible posture, but I have rheumatoid arthritis with quite large nodules on the plantar aspect, the insoles DID NOT HELP! in fact they were really painful. I did follow the instructions fully, then tried my cleron insoles which only helped a little (they usually releive all problems I have with harder soled shoes.)
Take the removeable insoles out of a pair and have a look at the sole underneath I think it's made of mdf!
So they may help some people but they don't help all!
jane

I had also been asked about MBT's by clients and thought the best research I could do was to try then myself. I followed the guidelines given by the sales team accurately. By the time I could enjoy a walk without contstant leg and foot correction, they were seriously affecting my tendonitis. However, a friend who purchased them at the same time for aid with a spinal injury, can't take them off. He finds them so helpful that I saw him the other night wearing a tuxedo and MBTs. The client will only find out the pro's and cons by wearing them I'm afraid. And it is a costly excercise to find out that they don't suit you

we sell them in the company that I work for and I have to agree with Tricia, it is a very individual experience, but a costly one. I wear them. At first, they hurt my feet and my lower back, but this may have been due to wearing them all day before "breaking them in." Now, I can't wear ordinary shoes as they donit provide the rocker soles and the heel strike from my shoes are too stark. They really do help with my lower back, plus I have Hallux limitus. I don't find that it has made any changes to my stomach muscles, (still a bit flabby!!) All in all, I am very happy with them. Out of curiosity, have the Masai people been given any accreditation for this design, off their intuition? (ie royalties..monies..

Not yet tried these myself - thinking "Gimmic" to be an appropriate response. Had about four pts try them; end result = knee pain. It seems that they cannot control their pronation (differing levels of control for these 4 people) suitably and follwing this all suffered from posterior knee pain and some visible swelling. Now about 18 months on from this NONE of them wear the damn things. I do not know if they followed any advice or whether any was given at time of purchase. As they all paid silly $ for this it is now the "subject we don't talk about' and they are all now back in their orthotics and runners, doing well.

I do however have one woundcare pt doing well with this. She didn't like the post-op healing shoes provided, does very little walking so not really able to comment on their overall effectiveness.

When standing on a rocker that is in the middle of your foot you can choose to put your weight forward (increased Achilles tension weight on forefoot), you can choose to try to balance on the rocker point (Mental effort and constant muscle activity, but level) Or you can put your weight on your heel (Ankle dorsiflexed, possible AT muscle activity) Sometimes, one of these balance choices will relieve symptoms, other times they will make them worse.

Regards,

Eric

Thanks Eric, I appreciate the lesson.

Begs the question: if you have to think that much about how you are walking then are you not straining something else in the process? Why not buy a healing sandal with defined purpose to offload and therefore acheive what you are intending rather than hoping your pt will "get it" not not cause some other injury such as hyperextending the knee.

After some distance/time most people's brain sends them back to their "normal". One of my mentioned pts was brain damaged in a RTA, another has balance issues.

I'm not intending to argue; jsut points to ponder. Hrrrmmmmmmmmmm.

Fraoch

Thanks Eric, I appreciate the lesson.

Begs the question: if you have to think that much about how you are walking then are you not straining something else in the process? Why not buy a healing sandal with defined purpose to offload and therefore acheive what you are intending rather than hoping your pt will "get it" not not cause some other injury such as hyperextending the knee.

After some distance/time most people's brain sends them back to their "normal". One of my mentioned pts was brain damaged in a RTA, another has balance issues.

I'm not intending to argue; just points to ponder. Hrrrmmmmmmmmmm.

Fraoch

Orthotics were dispensed for many years because they increased "stability" without regard to stress on specific tissues. A lot of the time they worked. You pays your money and you takes your chances. I prefer to design a device to relieve stress on what hurts.

Any rocker can be a problem for patient's with balance issues. A rocker shoe effectively decreases the amount of contact with ground. More specifically it decrease the distance your center of pressure can travel while staying under your center of mass. If you center of mass "sways" more than this distance then you have to take a step to prevent from falling over.

Regards,
Eric

Hi, they seem to be Ok for those with 1st MPJ pain/hallux rigidus...I suppose doing the job of the good old rocker bottom that a cobbler used to fit.

Patient of mine had them, and they now sit in a box (not the pt).

They caused him grief in his achilles tendons, and posterior knee joint capsule.#

Oh, and when my pt with atherosclerosis told his vascular consultant, the consultant did his nut!

The hard sell always makes me concerned to keep my hands firmly deep in my pockets.

__________________
“Body: A thing of shreds and patches, borrowed unequally from good and bad ancestors and a misfit from the start”

Ralph Waldo Emerson

I was a DVA footwear prescriber/supplier for over 10 years and in that time I recommended rocker bottom soled footwear for only specific complaints.

In Australia you can get rocker bottom soled footwear from Gadeans, P.W Minor, Homy Ped, MBT, Rockport and Orthopaedic footwear makers

Care must be taken, if a person does not need this type footwear then they should not be prescribed.

Don Scott

Don,

Couldn't agree more. The problem with commercial shoe retailers is that they will recommend their shoe for absolutely anything and never inform of the foot type/morphology which could precipitate pathology in a given person.

__________________
“Body: A thing of shreds and patches, borrowed unequally from good and bad ancestors and a misfit from the start”

Ralph Waldo Emerson

Absolutely agree with you meet; overprescription whereprescriber knows naff all/ not enough about what they are doing.

However I love the quote in post #23 re orthotics " you pays your money and takes your chances" ???????? Not my my bloody clinic you don't. Well thought out, well prescribed and oh by Jimminy... they actually work! If I say so myself.

I spend a lot of time lecturing pts on their footwear, pleading them to discard the nasties ; otherwise what's the point? It''s all got to work together man, like one big happy world dude.

Due to the nature of the MBTs there are various applications.

Some people love MBTs for just comfort or plantar heel pain relief or hallux limitus pain relief or improved posture or balance training. Some people feel they don't make any difference at all.

HOWEVER as health professionals I believe it would remiss of us not to direct the OA ankle pts to MBTs. This one is a 'no-brainer' to me now, after my experiences with MBTs

What other effective treatments do we have for them. Orthoses? AFOs? Fusion/s? Shoe modifications?

You will find that these people have a new lease of life with them. The only reason I am involved in some capacity with this footwear is because the positive feedback I get with these pt's is very fulfilling. Whether it is pre or post ankle surgery this type of pt will improve dramatically with MBTs.

Some are fortunate to have immediate relief but most require up to 5 -6 weeks of acclimatising before significant relief is experienced.

I am not talking about any other symptoms except OA ankle pain that requires careful consideration of MBTs.

Best Regards and Best Intentions,
Con

Con:

Rocker soled soles have been a standard shoe sole modification for probably a half-century or more for people with ankle osteoarthritis (OA) and ankle arthodesis. These modifications may be added to many styles of shoes at approximately one half the cost of purchasing an MBT shoe. Why would a podiatrist first recommend an MBT shoe, as you suggest, since rocker soled shoes seem to also help patients with this pathology, at half the cost? Have you compared a standard rocker soled shoe addition to an MBT shoe clinically to see which is more effective on your own patients with ankle OA?

__________________
Sincerely,

Kevin

**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
**************************************************