HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ekenman, I. Articles by Burr, D. Search for Related Content PubMed PubMed Citation Articles by Ekenman, I. Articles by Burr, D. Related Collections Fracture Overuse Biomechanics

The Role of Biomechanical Shoe Orthoses in Tibial Stress Fracture Prevention

Ingrid Ekenman, MD^*, Charles Milgrom, MD^,, Aharon Finestone, MD, Michal Begin, MD, Carin Olin, MD^*, Toni Arndt, PhD^* and David Burr, PhD^||

^* Department of Orthopaedics, Huddinge University Hospital, Huddinge, Sweden, Department of Orthopaedics, Hadassah University Hospital, Ein Kerem, Jerusalem, Israel, Department of Orthopaedics, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel, ^|| Department of Anatomy, University of Indiana Medical Center, Indianapolis, Indiana

Address correspondence and reprint requests to Charles Milgrom, MD, Department of Orthopaedics, Hadassah University Hospital, Ein Kerem, POB 12000, Jerusalem, Israel

Background: Biomechanical orthoses have been shown to lower stress fracture incidence in infantry recruits. However, these results may not be applicable to running athletes.

Hypothesis: Training in either running shoes or military boots with custom biomechanical shoe orthoses lessens tibial bone strains and strain rates during walking and running.

Study Design: Randomized controlled laboratory study.

Methods: In vivo strain measurements were made in nine subjects to determine whether the use of biomechanical orthoses lowers tibial strains during both walking and running and whether such lowering depends on the type of shoe worn. Measurements were made during treadmill walking at 5 km/hr and then during serial 2-km treadmill runs at 13 km/hr with running shoes, with and without the orthoses, and during serial 1-km runs with army boots, with and without the orthoses.

Results: When soft or semirigid biomechanical orthoses were worn with boots, the tibial peak-to-peak strains were significantly lowered. Soft orthoses also significantly lowered the tension and compression strain rates when worn with boots. During running, semirigid orthoses significantly increased the compression and tension strain rates when worn with boots.

Conclusions: The use of biomechanical orthoses may be warranted for tibial stress fracture prevention during training in which boots are worn and that mostly involves walking, but they are not warranted for activities that primarily involve running or are performed in running shoes.

This article has been cited by other articles:

				R. J. Butler, I. S. Davis, and J. Hamill Interaction of Arch Type and Footwear on Running Mechanics Am. J. Sports Med., December 1, 2006; 34(12): 1998 - 2005. [Abstract] [Full Text] [PDF]

				R. Hargrove, C. Maclean, and B. Yates Letters to the Editor * Author's Response Am. J. Sports Med., March 1, 2005; 33(3): 463 - 464. [Full Text] [PDF]