I love varus posting for my pronators, and valgus posting for my supinators. Yet, as basic as that seems, it should be used more. This simple, but eloquent article, goes over the findings of when the subjects had to wear varus or inverted wedged insoles (whether they needed it or not unfortunately) I would have done it only in two groups of patients, those with pronation and everted heels to correct and those with significant (+5 degrees) Tibial Varum. They simply varus wedged some insoles and checked the mechanics, whether they need the wedging or not. They still came up with a good bit of telling information. Here were some of the conclusions and discussions.
- In their review, they link flatfoot to plantar fascial pain, ankle pain, and knee pain, and correction of pronation to help these problems.
- The article is loaded with 56 articles to make their points of how valuable treating foot pronation is.
- Wearing the varus wedged insoles reduced the second peak patellofemoral contact force and the peak ankle contact force significantly.
- Wearing the varus wedged insoles also significantly reduced peak ankle eversion angle and ankle eversion moment.
- However, wearing the varus wedged insoles increased the peak adduction moment at the knee (possibly not good) but did not increase the contact pressure of the medial or lateral knee components (very good).
- Their summary was that the reduction of the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower extremity joint problems, despite greater knee adduction moment.
- They have a good discussion on internal moments and you want to see your insert decrease moments of ankle inversion (since the insert is helping to invert) and decrease moments of knee abduction and adduction (which means the knee is working less to stay centered). Increasing knee adduction moments means that their inserts made that area work harder (which happens when the knee is not centered properly). They made no effort to individualize, like we do, what shoe and what insert was utilized for each of their 15 subjects. This is a very common problem with research.
Here is a copy of the insert they used.
Good heel cup, medial arch support and 6 degree forefoot varus posting
