From the Guidelines
For supination, lateral posting is the best orthotic approach. This involves adding material to the lateral (outer) edge of the orthotic to create a wedge that tilts the foot inward, counteracting the excessive outward roll of supination. Typically, a 3-5 degree lateral wedge is used initially, though this can be adjusted based on individual response. Look for orthotics made with firm but supportive materials like polypropylene or carbon fiber for durability and proper biomechanical control. The posting should extend from the heel through the midfoot for optimal control, and may be combined with a deep heel cup for additional stability. This approach works by altering the ground reaction forces on the foot, effectively redistributing pressure away from the lateral border and encouraging more even weight distribution across the foot. For best results, these orthotics should be worn in supportive shoes with adequate depth and width to accommodate the device without compromising fit.
Key Considerations
- The use of orthotics and braces, such as shoe orthotics, can be valuable in correcting biomechanical problems, including excessive foot supination 1.
- While there is limited data to support definitive conclusions regarding the effectiveness of orthotics for supination, they are widely used and often helpful in reducing symptoms and improving function 1.
- It is essential to select orthotics made from materials that provide adequate support and durability, such as polypropylene or carbon fiber.
- The design of the orthotic, including the degree of lateral posting and the extension of the posting, should be individualized based on the patient's specific needs and response to treatment.
Clinical Application
In clinical practice, the use of lateral posting orthotics for supination can be an effective way to reduce symptoms and improve function. By redistributing pressure away from the lateral border of the foot, these orthotics can help to alleviate pain and discomfort associated with supination. It is crucial to work with a healthcare professional to determine the best course of treatment and to ensure proper fitting and use of the orthotics.
From the Research
Orthotic Posting for Supination
To address supination, the focus is often on reducing the supination moment or controlling excessive pronation, as direct posting for supination is less common. The goal is to stabilize the foot and improve the biomechanical alignment.
- The medial heel skive technique is a method used to enhance pronation control in foot orthoses, which indirectly can help in managing issues related to supination by improving the overall foot mechanics [ 2 ].
- This technique involves modifying the foot orthosis to create a varus wedging effect within the heel cup, which can lead to improved pronation control and, by extension, may help in conditions where supination is a concern.
- The application of such techniques is based on the specific needs of the patient, including the type of foot deformity or dysfunction, such as pediatric flexible flat feet or posterior tibial dysfunction [ 2 ].