When choosing an orthotic for shock attenuation, what qualities should be considered?
Answer
My main recommendation when looking for othoses is to find someone good to work with who knows the orthoses business. The reason for this is that the properties of the materials are always changing. You need to have a really good orthotist who can help you. Fortunately, there are a lot in the PT field.
There are two types of orthoses. What you look for to address shock attenuation is something similar to what you would use for a diabetic foot - you want to bring the ground up to the foot with forgiving material. You can have arch support, but you don't want something rigid. A hard arch or shell would limit mobility. The orhtotic you will choose is ususally made of some sort of EVA (Ethylene-vinyl acetate) material which is kind of like a memory foam. It distributes the forces nicely as opposed to a biomechanical control orthosis which is going to have a hard shell with a deep heel seat, some type of flare on either side or some type of wedging that is going to be more controlling. You can tell by holding the material what is soft and what is not.
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Lori Bolgla, PT, PHD, MAcc, ATC
Lori A. Bolgla, PT, PhD, MAcc, ATC, is an Associate Professor in the Department of Physical Therapy (formerly the Medical College of Georgia). She received her PhD in Rehabilitation Sciences from the University of Kentucky. She received both her BS in Physical Therapy and an advanced master's degree with an emphasis on the Physical Therapy Management of Knee Dysfunction at the Medical College of Georgia. Ongoing research activities include electromyographic analysis of trunk and lower-extremity muscles during rehabilitation exercises to enhance clinical decision-making for exercise prescription. Dr. Bolgla’s work has been published in The Journal of Orthopaedics and Sports Physical Therapy; the Journal of Sport Rehabilitation; the Journal of Athletic Training; and the Journal of Electromyography and Kinesiology. She has presented at national meetings on electromyography and on numerous sports and orthopedic topics, with an emphasis on lower-extremity dysfunction.
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