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Two recent patients have shown me full length moulded othotics/insoles constructed of a single layer of stiffened fibre glass like material without any postings that they have had made for them on a visit to a shop in London called Profeet. They were both very pleased with their 'inserts' that fit very snugly into their running shoes and appeared to have been made by taking weightbearing impressions in the shop and the product was provided within an hour - and they had reportedly 'cured ' their symptoms (plantar fasciitis and anterior knee pain respectively). Initially I was very sceptical of their actual clinical value - believing in the value of 'non weight bearing casting that does not capture the abnormal compensations' concept but I am now becoming much more questioning of every perceived wisdom - especially the concept that the more complicated the device is in terms of posts/additions skives the more clinically effective it must be! I must keep an open mind!

My questions are:
1.Has anyone else seen these products and/or made and used them with patients?
2.If so what is your impression of them and their clinical value - Have they got a role?
3.Are these products similar to those made for ski boots in many ski shops(which you do not actually walk in) and that are so popular?
4. Who makes the hardware? Is it / similar to the Podiatech offering advertised in Podiatry Journals - vacuum with thermo moulding?

Any information/debate appreciated.

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At the recent Australsian podiatry conference Karl Langdorf presented a meta analysis on the effectiveness of prefabricated devices on the treatment of plantar faciitis cf customised devices, and found that while they both decreased pain, there was no substantive short term differnce between the devices, so it would be expected that a semi-customised device would give similar results.

Karl's take home message was that given the cost difference b/w prefabs and custom devices, a prefab should be considered as the inital treatment for painful plantar faciitis.

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Stephen Tucker
Calvary Health Care

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Hello Penny,

From what I have seen on Profeet website http://www.profeet.co.uk/, they use "Conform'able" pre-custom insoles from Sidas (the same French company who produces Podiatech products).

The orthotic shell is made of polyester resins. For further information about why these devices works you can check the thread on this website:"Foot orthoses and the placebo effect"

Regards,

Javier

I have used Sidas products for almost 20yrs, used to have two ski shops, we made all sorts of devices using a variety of materials and processes.
Sidas have used various materials...this sounds like something new maybe...is it cadcam tooled or still a thermplastic blank with a weighted image taken and then finished by hand?
Regards Phill Carter

Having read the site it does not look any different to what we have been doing for up to 18 yrs...well presented though

I am surprised its not more widespread....

The technology exists to do this: Imagine going into the shopping mall; going up to a ATM looking like device in the wall; standing in front of it on a pressure plate/scanner unit; putting your credit card details in; enter some other informaton; and then wait a few minutes while a pair of orthostics are milled ...

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Craig Payne
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Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

I doubt it would be accepted by the public. Everybody loves to tell his/her problems to another soul. How would you feel complaining about your foot problems to a machine? :)

We will be necessary as long as general public have the need for socializing!

This thread is pertinent:
Doctors Say Salespeople Can't Diagnose, Treat Problems

it about Good Feet Stores

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you have gathered that the product used is by conformable / sidas / podiatec it is made weightbearing on a bag filled with silicon sand with the air removed by vaccuum, the product has been around for some 20 years the verion they are using is the latest generation with a flexible forefoot to allow normal gait, having worked with this product for several years (and other systems, direct to foot but non-weightbearing) it works for some people but is not effective for others, the same product is available form a lot of ski / outdoor shops for 1/2 the price (without their logo on it.
have a look at the Superfeet product range www.anatom.co.uk it offers superior contol and cushioning for a similar price, the custom versions are direct to foot and non-weight bearing

Having also worked with conform'able orthotics in a ski shop for five years, I find it an immediate cure for foot alignment problems in a ski boot. The problem is that untrained boot fitters - commonly seen at places like Snow and Rock in the UK are using the equipment too. In a ski boot if you don't neutralise the client's foot, the client is spending money on fresh air since their orthotic will not prevent the foot from collapsing into the side of the hard ski boot shell.
Hole in the wall orthotics would have this effect too, as a client would simply weight bear in a pronated position - - Money for old rope!

Hi

My experience with these insoles:

I work with Sidas conformable insoles for about 7 years ( http://www.sidas.com/b/s/307/fiches/...2099719988.pdf ), as a part of my fitting protocol.

My point of view:

A) I always tell to costumers that these insoles are not real orthotic devices, only insoles to help plantar pressure distribution and improve fit (and ok stability ).

b) I never do any kind of post or correction to the insole (and belive me many costumers ask to do so, like ie: leg length discrepancys.

c) During the sale, if any pathology is detected to the costumer he/she is referred to a podiatric professional.

D) I use these insoles (apart from the actually sale) to "educate" , costumers to the value of a real orthotic device if needed, and to go to the podiatric practitioner if needed.

E) Finally these are great to "custom-fit", a shoe made in Indonesia/China, etc, in mass prodution.



(Old Foto in Lisbon's half Marathon Expo)

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Paulo Silva-MSSF
www.calcadodesportivo.com (Portuguese)
Member of the Society of Shoe Fitters
www.shoefitters-uk.org
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