article archive
September 2005
Orthotics in the sports chiropractic
practice
by Dr. Terry A. Rondberg
In recent decades, we've learned a great deal about the impact
of subluxation on the entire human musculoskeletal and neurologic
system. It's no wonder, then, that chiropractors are quickly
becoming a primary health resource for both professional
and amateur athletes.
Being a great ball player means more than
having a strong pitching arm. Excelling at tennis requires
more than quick reflexes. Swimming competitively takes more
than exceptional lung capacity. For each of these sports ‑‑ in
fact, for ANY sport ‑‑ the entire body must be
able to perform at its optimum capacity. For that to happen,
the person should be subluxation‑free.
That is the primary
goal of the chiropractor, and the only service a DC can offer
that can't be obtained from some other type of health care
provider. Yet, is it enough to ensure that interference to
the nerve flow is eliminated? For most chiropractors, particularly
those who specialize in sports chiropractic, the answer is
no.
That's because, particularly for athletes, adjustments don't
address the root cause of many subluxations. Unlike most
other patients, athletes engage in sports activities that
put unique stresses on their bodies. These repeated stresses
make it almost certain that they'll trigger subluxations
repeatedly, unless the DC goes beyond correction and directs
attention to subluxation prevention.
To do this, it's important
to focus on the feet. After all, as Lou Pack, DPM, Director
of Certification, Functional Foot Orthotics, Division of Enhanced
Performance, United States Sports Academy, puts it, "all
function, in every single sport, begins with the foot."
Pack also notes that, "there is no perfect foot, no
more than any other part of our body is perfect... any degree
of abnormality increases the risks of injury and decreases
performance." The chiropractor might well add that any
degree of abnormality increases the risk of subluxation.
In
addition to helping to prevent subluxations, addressing foot
problems will mean helping to prevent sports injuries, many
of which are caused by over‑ or under‑pronation
of the foot.
"A range of common and apparently unrelated sports
injuries can be triggered by the same mechanical fault ‑‑ a
tendency of one or both feet to pronate to an abnormal extent," explained
British sports chiropractor Cherye Roche in Peak Performance
magazine.
Controlling the pronation and the gait can vastly
improve the athlete's health ‑‑ and performance.
The way to control that motion of the foot is with orthotics.
"The key is to have that excessive amount of motion
controlled as precisely as possible. That can often make
the difference in winning ... most athletes can improve their
performance and decrease injuries with a precisely made orthotic.
Symptoms often disappear and optimal function is created;
again, just like a pair of prescription eyeglasses. Most
importantly, for the competitive athlete, a good set of orthotics
can take a negative mechanical influence and make it a performance
advantage," states Pack.
The American Orthopaedic Foot & Ankle
Society gives the following examples of the uses of orthotics
in various sports:
*** Runners and joggers wear orthotics to
absorb shock at heel contact, provide control and set up the
forefoot for pushoff.
*** Sprinters wear orthotics to control
the movement of the forefoot.
*** Cyclists have a limited need
for orthotics and wear them primarily to control the internal
and external rotation of the lower leg.
*** Skiers wear orthotics
to stabilize their foot in neutral and inhibit motion within
the ski boot.
*** Tennis players wear orthotics to provide lateral
support, to decrease shear factors, to absorb shock (especially
in the forefoot) and to allow subtalar motion.
*** Basketball
players wear orthotics to control the forefoot during jumping,
to control the rearfoot during running and to control excessive
inversion.
Although there are many different orthotic products
available today ‑‑ from generic "off the rack" shoe
inserts to high‑end custom made products.
According to
Mark N. Charrette, DC, an NCAA All‑American
who went on to become a chiropractor and an expert in orthotics,
spinal and extremity adjusting: "The best orthotic for
an athlete is one which will improve the function of the
foot and ankle during complex and strenuous sports endeavors.
This means controlling the amount of pronation, supporting
the arches, and preventing excessive ankle and calcaneus
eversion. Additionally, the orthotic should help improve
gait, knee alignment, and both balance and the proprioceptive
feedback system. The entire foot, ankle, and lower extremity
must have excellent mobility to respond immediately to changes
in posture and alignment."
Dr. Charrette, a featured speaker in the Foot Levelers'
Seminar Series, also notes: "An orthotic used during
sports must be supportive, yet flexible. It has to provide
guidance for the foot and ankle, but must not hinder the
natural biomechanical performance. Torsional rigidity (the
ability of the orthotic to resist twisting) combined with
longitudinal flexibility (especially at the forefoot) are
major indicators of a good sports orthotic. I would characterize
such an insert as a firm‑yet‑flexible orthotic."
Fortunately for chiropractors and their patients, tools
are available that allow DCs to detect pronation and other
gait problems and to help athletes obtain the best in customized
orthotics. Foot Levelers, Inc., the company that has worked
closely with doctors of chiropractic for years, makes it
easy to provide information to patients, and even fit them
for orthotics. Patients simply stand in a foam "mold," which
the doctor sends to Foot Levelers. They do the rest, by making
the orthotic to fit the patient's foot. Foot Levelers has
become the most successful orthotics company in chiropractic
since it has the top‑rated product line as well as
the most complete customer support.
For more information about
orthotics in sports chiropractic, contact Foot Levelers at
800‑553‑4860 or visit
www.footlevelers.com.
(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.")