Orthotic intervention in forefoot and rearfoot strike running patterns.

OBJECTIVE To compare the differential effect of custom orthoses on the lower extremity mechanics of a forefoot and rearfoot strike pattern. DESIGN Fifteen subjects ran with both a forefoot and a rearfoot strike pattern with and without orthoses. Lower extremity kinematic and kinetic variables were compared between strike pattern and orthotic conditions. BACKGROUND Foot orthoses have been shown to be effective in controlling excessive rearfoot motion in rearfoot strikers. The effect of orthotic intervention on rearfoot motion in forefoot strikers has not been previously reported. METHODS Five trials were collected for each condition. Peak rearfoot eversion, eversion excursion, eversion velocity, peak inversion moment, and inversion work were compared between conditions. Kinematic variables in the sagittal plane of the rearfoot and in the frontal and sagittal plane of the knee were also determined. RESULTS Increased rearfoot excursions and velocities and decreased peak eversion were noted in the forefoot strike pattern compared to the rearfoot strike pattern. Orthotic intervention, however,did not significantly change rearfoot motion in either strike pattern. Reductions in internal rotation and abduction of the knee were noted with orthotic intervention. CONCLUSIONS Foot orthoses do not differentially effect rearfoot motion of a rearfoot strike and a forefoot strike running pattern. Orthotic intervention has a larger and more systematic effect on rearfoot kinetics compared to rearfoot kinematics.