From the 2nd edition of
Evidence-Based Sports Medicine:
Landorf KB and Keenan A-M. Do foot orthoses prevent injury? In McCauley D and Best T (Eds.),
Evidence-based Sports Medicine (2nd ed.); Pages 73-92. Blackwell Publishing: Malden Massachusetts.
This book chapter presents the findings from a systematic review of the literature. Using rigorous systematic review methodology the authors attempted to answer the question “Do foot orthoses prevent injury?” All trials identified in the review were rated for methodological quality using a validated quality index (the PEDro scale) and a summary of the evidence is provided. The following are the Conclusion and Summary from this book chapter.
Conclusion
Twelve randomized or quasi-randomized trials were identified in this systematic review, of which six related to shock-absorbing orthoses and six to motion-controlling orthoses. The trials mostly used large sample sizes, but their quality ratings were generally low. The evidence suggests (i) that shock-absorbing insoles and heel pads do not prevent injury, and (ii) that motion-controlling foot orthoses decrease the incidence of stress fractures (particularly femoral stress fractures) and shin splints. Better-quality trials are required in order to confirm or refute the evidence to date. Future trials should attempt to evaluate commonly used orthoses; should use consistent outcome measures to assist with pooling results for meta-analysis; and the findings should be reported using the CONSORT guidelines to ensure greater transparency.
Summary
• Foot orthoses are widely used to treat and prevent injury.
• Although a considerable amount is known about the biomechanical/functional effects of foot orthoses, less is known about their effectiveness for preventing injury.
• Most trials that have evaluated whether they prevent injury have used military recruits during basic training.
• Although most of these trials have included large sample sizes, they are generally methodologically poor.
• This limited evidence suggests that shock-absorbing insoles and heel pads do not prevent injury.
• Limited evidence suggests that motion-controlling (biomechanical) foot orthoses decrease the incidence of stress fractures (particularly femoral stress fractures) and shin splints.
• Better-quality randomized trials are required in order to provide more precise estimates of the effect of foot orthoses when used to prevent injury.
Do foot orthoses prevent injury?
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