Feet

Think twice before using cushioning

A lot of our patients request us to make insoles with “extra” cushioning or insoles that are ultra soft as they perceive them to protect the foot and provide comfort. And not just with our patients, it’s common perception when we go to a shoe store that we want footwear that has a highly cushioned foot bed. A lot of runners feel that they are protected from injuries if they use expensive shoes with high levels of cushion.

Today, we will shed some light on the importance of cushioning under the plantar surface or the sole of your foot. The human foot has natural cushioning on the sole in the form of fat pad. This fat pad gets worn out for a lot of people with time due to reasons like ill-fitting or ill-designed footwear, walking or running on hard surfaces, aging and related wear and tear, diabetic foot neuropathy, etc. When this fat pad under the heels and the metatarsal heads (the ball of the foot region) gets worn out, it is important to compensate for the same by using artificial cushioning in your footwear in order to protect the bones, tissues, ligaments and nerve endings of your feet from getting damaged on impact with the ground.

However, when the fat pad is intact or adequate, there’s no need to use excessive cushioning in your footwear. It can cause you more damage than you might realize. Too much cushioning between your feet and the ground reduces the proprioceptive function of the foot. The sole of your foot has thousands of nerve endings which sense the ground or the terrain and send signals to the brain that send signals back to the foot so that it can manouver efficiently over the ground without getting injured. This function of the foot is called proprioception and it’s these signals sensed by the nerve endings and send to the brain that help the foot act as a stabilizer, shock absorber, booster and providing balance to the body. With excessive cushioning, the nerve endings cannot sense the ground level signals and they start losing their functionality over a period of time.

We had a patient who visited us and insisted on silicon insoles as he’d been advised by his doctor to use only these. He had severe pain from plantar fasciitis and on evaluation, his fat pad was intact. We advised him to get custom insoles made to change his foot mechanics but he left since he wanted to silicon insoles only. After six months, he visited again. He said he purchased silicon insoles from the market and they didn’t make any difference to the pain. On the contrary, he started getting numbness in the soles of his feet. We made him a pair of orthotics, custom designed for his complaint, and he had relief from pain in less than three weeks. Also, his numbness disappeared as well within a month of discarding his silicon insoles.

There are several researches documented on many running websites that have proved that having increased cushioning in your footwear does not reduce the risk of injury. That’s why, cushioning should be used judiciously, with a lot of discretion, on a case to case basis. At Podiapro, we pride ourselves with the range of technical materials in our repository. For cushioning, on a case to case basis, we use different materials for eg. most of our sports insoles have Noene, a patented Swiss rubber that is not a cushion, but a highly effective shock absorber. This reduces the peak plantar pressure on the sole of your foot. Next, for those sports people that have reduced fat pad, the Sidas proprietory Podiane + is highly effective cushion that also provides shock absorption. For patients having diabetic feet complaints, we use a diabetic grade poron to provide cushioning and for those who have heel pain but are not actively into sports, Poron XRD has proved to be very useful.

So the next time you are tempted to buy a pair of ultra soft and highly cushioned footwear, think again if you really need them.

Rushabh

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