There is evidence in the medical literature that using custom
orthotics can reduce the chance of injury to the anterior cruciate
ligament of the knee.
A very interesting study was performed over a 13 year period and
published in 2008. In this study, researchers followed a particular
women’s college basketball team.
In the first part of the study, which lasted for 4 years, the team did
not use foot orthotics. For the next 9 years every member of the team
was given foot orthotics. Then the number of knee ligament injuries
divided by the number of games and practices, was figured out.
Results
The results were very interesting. ACL injuries were 7.14 times more
likely for players who were not wearing orthoses.
Why do orthotics help prevent ACL injuries?
A number of studies show that as the foot pronates (flattens), the leg
rotates in toward the other leg. As this occurs tension is increased on
the ACL – leading to an increased chance of injury.
So, who should wear orthotics to prevent ACL injuries?
This is hard to say – certainly we don’t think everyone needs to be in
orthotics to prevent ACL injuries. Given the results of this study, it
does make sense that anyone with a history of ACL injury should wear
orthotics. Also, women are much more likely to injure their ACL so it
might be beneficial for women who participate in sports that have a high
number of ACL injuries (basketball, soccer) to wear foot orthotics. In
particular those women who have feet that pronate excessively. Make an
appointment to see us in our Seattle clinic and we can discuss whether
it might be beneficial for you.
Figure 1 - ACL injury
What kind of orthotics?
Our goal when prescribing orthotics to prevent ACL injury is to limit
rotation of the leg that puts tension on the ACL ligament. In order to
do this we must limit foot pronation as much as possible. It takes a
very specialized orthosis to do this well. We will usually use a
total
contact orthotic with several features designed to increase the control.
To be evaluated for orthotics, call today to make an appointment in our
Seattle foot and ankle clinic.
References: Foot orthotics and ACL Injury
• Jenkins WL, Raedeke SG, Williams III DSB:The relationship between the
use of foot orthoses and knee ligament injury in female collegiate
basketball players. J Am Podiatr Med Assoc Vol 98, No3 May/June 2008
• Beckett ME, Massie DL, Bowers KD, et al: Incidence of hyperpronation
in the ACL injured knee: a clinical perspective. J Athl Train 27:58,
1992
• Loudon JK, Jenkins WL, Loudon KL: The relationship between static
posture and ACL injury in female athletes. J Orthop Sports Phys Ther
24:91, 1996
• Woodford-Rogers B, Cyphert L, Denegar CR: Risk factors for anterior
cruciate ligament injury in high school and college athletes. J Athl
Train 29:343, 1994
• MacLean CL, Davis IS, Hamill J: Short and long-term influences of a
custom foot orthotic intervention on lower extremity dynamics. Clin J
Sport Med. 2008 Jul;18(4) 338-43
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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
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