When choosing an orthotic for shock attenuation, what qualities should be considered?
Answer
My main recommendation when looking for othoses is to find someone good to work with who knows the orthoses business. The reason for this is that the properties of the materials are always changing. You need to have a really good orthotist who can help you. Fortunately, there are a lot in the PT field.
There are two types of orthoses. What you look for to address shock attenuation is something similar to what you would use for a diabetic foot - you want to bring the ground up to the foot with forgiving material. You can have arch support, but you don't want something rigid. A hard arch or shell would limit mobility. The orhtotic you will choose is ususally made of some sort of EVA (Ethylene-vinyl acetate) material which is kind of like a memory foam. It distributes the forces nicely as opposed to a biomechanical control orthosis which is going to have a hard shell with a deep heel seat, some type of flare on either side or some type of wedging that is going to be more controlling. You can tell by holding the material what is soft and what is not.
Lori Bolgla, PT, PhD, ATC
Lori A. Bolgla, PT, PhD, ATC is an Associate Professor in the Department of Physical Therapy at the Georgia Health Sciences University (formerly the Medical College of Georgia). She received her Ph.D. in Rehabilitation Sciences from the University of Kentucky. She has advanced knowledge of kinesiological EMG and its application to the assessment of patients diagnosed with patellofemoral pain syndrome. Dr. Bolgla has devoted a substantial amount of time over the past 10 years reviewing evidence-based literature and conducting research pertinent to the management of patients with patellofemoral pain syndrome. She also has published and presented in this area at local, national, and international venues.
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