Do orthoses work? Does foot strengthening work?

Two questions for the ages really, and so important to have answers because these two techniques are so ingrained in musculoskeletal medicine.

Two brand new papers have taken a look at two treatment modalities that often seem to have a target on their back, orthoses and foot strengthening.

I believe the situation is much clearer with the use of orthoses for MSK injury, with the overwhelming body of evidence in the literature strongly supporting their efficacy across a very wide range of injury.

The research group out of Melbourne's LaTrobe University, including George Murley, Shannon Munteanu and Dan Bonano had published widely on the topic and has just released yet another paper looking at the issue. 

let's take a look at what they found.

Effectiveness of foot orthoses for the prevention of lower limb overuse injuries in naval recruits: a randomised controlled trial
Daniel R Bonano, George S Murley, Shannon E Munteanu, Karl B Landorf, Hylton B Menz
Br J Sports Med Published Online First: 22 October 2017


To evaluate the effectiveness of prefabricated foot orthoses for the prevention of lower limb overuse injuries in naval recruits.


This study was a participant-blinded and assessor-blinded, parallel-group randomised controlled trial. Three-hundred and six participants aged 17–50 years who undertook 11 weeks of initial defence training at the Royal Australian Navy Recruit School (Cerberus, Australia) were randomised to a control group (flat insoles, n=153) or an intervention group (contoured, prefabricated foot orthoses, n=153). The combined incidence of medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain during the 11-week training period were compared using incidence rate ratios (IRR). Data were analysed using the intention-to-treat principle.

Simon Bartold
Director of Bartold Clinical