June 2006

Research validates use of orthotics by chiropractors

by Dr. Terry A. Rondberg

The hottest topic in chiropractic today is evidenced‑based research. Before we do anything in our practices, we have to ask: "Does the evidence support this?" Or, put another way, "Where's the proof?"

Thousands of chiropractors recommend orthotics for their patients, in order to correct postural defects that can cause vertebral subluxations. Is there any proof, however, that those devices really do any good?

Fortunately, for these doctors and their patients, a great deal of research has been done on the adverse affect of postural problems on health, as well as the benefits of proper orthotics to correct these problems.

According to one research study, published in Practical Research Studies, at least 75% of the population has some degree of leg length inequality, caused either by an anatomical defect such as a bone fracture or surgery, or by excessive and/or asymmetrical pronation. [1]

Another study showed that excessive foot pronation in either one of both feet can cause pathology throughout the musculoskeletal system. [2]

In 1999, research published in Clinical Biomechanics demonstrated that "there are small, but important, intersegmental movements of the spine during gait." [3]

Other studies supply addition support for these conclusions, making it easy to see how foot problems are linked to spinal abnormalities and vertebral subluxations. For this reason, chiropractors have a legitimate reason for dealing with orthotics, as well as postural rehabilitation.

Research has indicated that orthotics can help reduce or eliminate many of the foot and gait problems we see in chiropractic patients. The overall effectiveness of orthotic devices is extremely high.

According to a Canadian study of the use of orthotics, there was an average improvement in condition for all diagnostic categories of 75.27% and a average total patient satisfaction for all diagnostic categories of 80.23%. [4]

One study ‑‑ specifically focusing on runners using orthotics for plantar fasciitis ‑‑ showed that 74% reported a significant improvement of symptoms and 90% continued to use orthotics even after resolution of symptoms. [5]

It's important to note, too, that orthotics are appreciated by patients and can actually increase their level of satisfaction with chiropractic care. This is undoubtedly based, at least in part, on their realization that orthotics is a way to help them prevent subluxations and possibly reduce their need for adjustments.

Research published in the Spring 2004 issue of The Journal of Chiropractic Education noted that 79% of patients were satisfied with their orthotics and 73% would recommend orthotics to a friend. Naturally, if they obtained their orthotics from you, that's where they'll send their friends. Can you imagine what it would do for your practice growth if 73% of your patients referred their friends to your office?

So, it's clear that orthotics is a powerful tool not only to help patients but to increase practice revenue in an ethical and relatively easy manner. Given these facts, I still can't understand why so many doctors don't bring up the topic of orthotics with every patient who walks through their door, why they insist on ignoring this "secret weapon" in the battle against subluxations.

My own orthotics are made by Footlevelers. I chose that company for several reasons. First of all, my personal research led me to the conclusion that their product is superior, and the procedure for fitting is quick and simple. Secondly, I recognize the tremendous contributions Footlevelers ‑‑ and both Monte and Kent Greenawalt ‑‑ have made to this profession. It's like knowing that a portion of every dollar I spend on these products will go back to making chiropractic stronger and more prosperous.

I urge all DCs to contact Footlevelers for more information on its line of orthotics, and strongly consider offering this valuable service to your patients.

References

1. Yochum TR. "The short leg," (revised). Practical Research Studies 1994; 4(5):4.

2. Hyland JK. "Recurring subluxations linked to pronation." Practical Research Studies 2003; 13(4):1.

3. Sychewska M, Oberg T, Karlsson D. "Segmental movements of the spine during treadmill walking with normal speed." Clin Biomech 1999;14:384‑388.

4. English, E, et. al. "An Analysis of Orthotic Function and Patient Satisfaction," April 2, 1997 ‑‑ Toronto.

5. Gross ML, Davlin LB, Evanski PM. "Effectiveness of orthotic shoe inserts in the long‑distance runner." Am J Sports Med 1991;19:409‑12.

(Dr. Terry Rondberg is president of the World Chiropractic Alliance and publisher of The Chiropractic Journal and the Journal of Vertebral Subluxation Research. A popular speaker at chiropractic conferences and seminars, Dr. Rondberg is also a frequent guest on TV and radio shows. He has written numerous articles on chiropractic for the profession and the public, as well as several best‑selling books, including "Chiropractic First," "Under the Influence of Modern Medicine," and, with Timothy J. Feuling, the "CBS Malpractice Prevention Program," and "Chiropractic: Compassion and Expectation.")