Shock-Absorbing Insoles Probably Don’t Prevent Injuries Interview with:
Daniel Bonanno

Lecturer & 3rd Year Podiatry Co-ordinator
Discipline of Podiatry, College of Science, Health, and Engineering
La Trobe University
Victoria Australia What is the background for this study? What are the main findings?

Response: Foot orthoses and shock-absorbing insoles are commonly used for the prevention of many musculoskeletal disorders of the lower extremity, so this review summarized the findings of existing clinical trials that evaluated their effectiveness for preventing such injuries.

The main findings of our review were that foot orthoses were found to be effective for preventing overall injuries and stress fractures, but not soft-tissue injuries.

Regarding shock-absorbing insoles, there is no evidence to date to support their use for the prevention of injury. What should readers take away from your report?

Response: Readers should be aware that foot orthoses may be effective for preventing injury, while shock-absorbing insoles appear to not prevent injury. Readers also need to be aware that the majority of studies on this topic, which have informed these conclusions, haven’t been well-designed trials so it is difficult to say whether the shoe inserts in question do indeed prevent or not prevent injuries. More work is needed to confirm this. What recommendations do you have for future research as a result of this study?

Response: Future research that evaluates foot orthoses and shock-absorbing insoles for the prevention of injury should use the best available methods so they contribute additional scientific evidence of the highest possible quality. Specifically, future trials should try and improve on the quality of existing trials – this could include ensuring that participants are appropriately randomized to receiving or not receiving the shoe insert being evaluated, use an appropriate control intervention for people not receiving the shoe insert being evaluated, ensure the allocation of shoe inserts is blinded, and try to ensure that study participants and assessors are blinded where possible. Is there anything else you would like to add?

Response: The majority of participants in the trials to date have been defense force personnel who are unlikely to be representative of the general population due to their age, footwear, gender balance, living arrangements and tightly regulated exercise patterns. As such, whenever we apply findings from military research to the broader population we need to consider these factors. Thank you for your contribution to the community.


Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis
Daniel R Bonanno,Karl B Landorf,Shannon E Munteanu,George S Murley,Hylton B Menz
Br J Sports Med bjsports-2016-096671Published Online First: 5 December 2016 doi:10.1136/bjsports-2016-096671

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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