Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review.

Del Duchetto, Francis; Dussault-Picard, Cloé; Gagnon, Martine; Dixon, Philippe; Cherni, Yosra

Background: Running is a widely practiced sport worldwide associated with a host of benefits on cardiovascular, metabolic, musculoskeletal, and mental health, but often leads to musculoskeletal overuse injuries. The prescription of a foot orthosis (FO) is common to manage musculoskeletal impairments during physical activity or functional tasks. Although FOs are frequently prescribed by clinicians for symptomatic populations of runners, the existing literature supporting the prescription of FOs in runners has predominantly focused on either uninjured individuals or a mix of uninjured and symptomatic populations. Thus, the effects of FOs on the treatment and/or prevention of overuse running injuries need to be investigated to guide future research and assist clinicians in their decision-making process. Main body: This scoping review aimed to evaluate the immediate and long-term effects of FOs on lower limb biomechanics, neuromuscular parameters, and pain and disability in symptomatic runners, and to identify factors that may influence the effects of FOs. Five databases (CINAHL, SPORTDiscus, MEDLINE, Embase, and Web of Science) were searched, resulting in 2536 studies. A total of 30 studies, published between 1992 and 2023 (730 symptomatic runners), were included following the removal of duplicates and the screening process. Wearing FOs while running is related to an immediate and a long-term decrease in pain and symptoms of overuse running injuries. Also, wearing FOs while running decreases eversion at the foot/ankle complex, leads to a more lateral plantar pressure at the heel and forefoot, and may change running motor control strategies. Finally, the effectiveness of FOs is influenced by its added features. Conclusions: This study provides recommendations for future research such as the need for standardized methods in describing FOs, considering participant characteristics such as foot morphology, and comparing different types of FOs. Also, this scoping review provides valuable insights for guiding the prescription and design of FOs, and suggests that integrating FOs into a comprehensive treatment plan may yield better results than standalone first-line treatments. Nonetheless, this scoping review highlights the need for future research to explore the optimal integration of FOs into injury-specific treatment plans. Key Points: Foot orthoses may redistribute loads onto non-injured structures, thereby resulting in an immediate decrease in pain and potentially contributing to the treatment of injuries. A rearfoot medial wedge decreases rearfoot and/or calcaneal eversion motion and moments in injured runners. A foot orthosis integrated into a comprehensive treatment plan may yield better results compared to standalone first-line treatments. The use of sham/flat insoles as a control/blinding condition is crucial in evaluating the effect of a foot orthosis.

ANKLE physiology; PREVENTION of overuse injuries; FOOT physiology; BIOMECHANICS; MEDICAL information storage & retrieval systems; HEEL (Anatomy); OVERUSE injuries; RESEARCH funding; RUNNING; CINAHL database; FOOT; FUNCTIONAL status; DESCRIPTIVE statistics; SYSTEMATIC reviews; MEDLINE; PAIN; FOOT orthoses; BODY movement; PHYSICAL activity

Sports Medicine - Open, 2024, Vol 10, Issue 1, p1

2199-1170

Academic Journal

10.1186/s40798-024-00774-w