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Proven to reduce low back pain

Balance Improvement: Club-Head Velocity Improvement with Custom Orthotics

Effects of Orthotic Intervention and Nine Holes of Simulated Golf on Club-Head Velocity in Experienced Golfers
David E. Stude, DC, and Jeff Gullickson, DC

The scientific literature supports the premise that the function of one body region influences the performance of another, that structural changes in one region of the body can promote compensatory changes in another1-4 and that the human body functions as a whole unit rather than functioning regionally.5-8 In addition, there are studies that demonstrate the global effects of such regional influences.9, 10

Because the spine and lower extremity represent a closed kinetic chain in the upright posture, there is considerable potential for the foundation (i.e., foot and ankle) to influence the function of other regions. There is also evidence to show that shoe selection affects balance performance11-13 and may be very important in reducing the likelihood of overuse injuries, minimizing performance loss from fatigue and impact force from heel strike14 and potentially increasing sports performance capabilities.

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Vertical Leap

The Effect of Custom Orthotics on the Vertical Leap of Athletes in a Sport Demanding Jumping
William M. Austin, D.C., C.C.S.P., C.C.R.D., Dennis Nosco, Ph.D., Nosco Consulting, and Jeffrey D. Olsen, D.C.

The chiropractic literature is almost devoid of any studies related to vertical leap. In fact, scientific literature, in general, is devoid of any reference to orthotics affecting vertical leap. A number of companies have attempted to produce noncustom shoe insoles or shoe-related devices designed to improve vertical leap in jumping sports (i.e., basketball, volleyball, track and field jumping events). The current pilot project attempts to gather the first data on whether the use of custom orthotics in athletic shoes of a jump sport team can positively affect the vertical leap in a controlled, blinded study.

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Decreased Q-Angle

Immediate Changes in the Quadriceps Femoris Angle After Insertion of an Orthotic Device
D. Robert Kuhn, DC, Terry R. Yochum, DC, Anton R. Cherry, and Sean S. Rodgers


Hyperpronation of the foot causes many different stresses on the lower extremity joints and soft tissues.1 This changes the quadriceps femoris angle (Q-angle), which has been associated with chondromalacia patella and lateral displacement of the patella.1 The Q-angle has been defined as the angle formed by the line connecting the anterior superior iliac spine (ASIS) with the center of the patella and the line connecting the tibial tuberosity to the center of the patella.1,2

Normal mean values for the Q-angle are 13.5˚ ± 4.5˚ in healthy subjects between 18 and 35 years of age.1 Comparatively, women have a larger mean Q-angle of 15.8˚ ± 4.5˚ than men (11.2˚ ± 4.5˚).1

There have been a number of studies regarding the Q-angle and its relationship to anterior knee pain, standing and supine measurements, force on the patella in the frontal plane, shin splints, and others.2

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Football Injuries

The Effectiveness of Custom Orthotics at Reducing Injuries in a College Football Team
Brian Jensen, DC1, William Austin1, DC, J. Nathan Wilder2, MS, ATC, CSCS, Brent A. Ungar3, DC, CCSP, John Zhang4, MD, PhD, Dennis L. Nosco5, PhD, Mark Mandell1, DC, MBA

1-Foot Levelers, 2- Waynesburg College, 3- Private Practice, 4- Logan College of Chiropractic, 5- Nosco Consulting
Contribution from Foot Levelers Inc., Roanoke, VA


American football is a violent sport involving high velocity directional changes and high velocity impact. The sport is performed by athletes of above-average strength, speed and, in many cases, weight. Lower body half (defined as from the lumbar spine down) injuries are common in football. While a number of studies have been published discussing ankle, knee, neck and mouth injuries and devices to make football safer, the incorporation of custom-made orthotics into football shoes to help prevent lower body-half injuries has, of yet, not been studied.

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Prolonged Standing

Chiropractic Adjustments Plus Orthotics Reduced Symptoms for Workers Standing Six Hours Daily
John Zhang, Ph.D., M.D. and Joe Zhou, D.C. Logan College of Chiropractic


Foot pain and discomfort due to weight bearing are common in workers whose jobs require them to stand many hours a day on their feet.1 It has been reported that approximately three-fourths of Americans experience foot problems in their life.2 Foot pain and discomfort often lead to other complications above the level of the foot. The most common problems associated with foot pain and discomfort are ankle, leg, knee, hip and spinal disorders in people who spend many hours standing.3, 4 Foot orthotics have been used as a non-invasive treatment for conditions involving the feet and other parts of lower extremities.

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Treatment of Chronic Low Back Pain

Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Pilot Study
Jerrilyn A. Cambron, DC, PhD, Manuel Duarte, DC, Jennifer Dexheimer, BS, LMT, and Thomas Solecki, DC


The purpose of this pilot study was to investigate the feasibility of a randomized clinical trial of shoe orthotics for chronic low back pain.

The study recruited 50 patients with chronic low back pain through media advertising in a midwestern suburban area. Medical history and a low back examination were completed at a chiropractic clinic. Subjects were randomized to either a treatment group receiving custom-made shoe orthotics or a wait-list control group. After 6 weeks, the wait-list control group also received custom-made orthotics.

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Foot Scanner Reliability

The Reliability of the Associate Platinum Digital Foot Scanner in Measuring Previously Developed Footprint Characteristics: A Technical Note
M. Owen Papuga, MS, and Jeanmarie R. Burke, PhD


An ink pad and paper, pressure-sensitive platforms, and photography have previously been used to collect footprint data used in clinical assessment. Digital scanners have been widely used more recently to collect such data. The purpose of this study was to evaluate the intra- and interrater reliability of a flatbed digital image scanning technology to capture footprint data.

This study used a repeated-measures design on 32 (16 male 16 female) healthy subjects. The following measured indices of footprint were recorded from 2-dimensional images of the plantar surface of the foot recorded with an Associate Platinum (Foot Levelers Inc, Roanoke, VA) digital foot scanner: Staheli index, Chippaux-Smirak index, arch angle, and arch index. Intraclass correlation coefficient (ICC) values were calculated to evaluate intrarater, interday, and interclinician reliability.

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Comfort to Workers

The Effectiveness of Custom-made Orthotics in a Standing Work Environment
Jeffrey D. Olsent, DC, Samuel A. Rowan, DC, William M. Austin, DC, CCSP, CCRD, Dennis L. Nosco, PhD.


Extended standing on hard surfaces has been related to many physical ailments including venous insufficiency, cumulative stress trauma, and complications with pregnancy. Although some published studies exist regarding orthotics use in work settings, no specific studies were found that addressed orthotics use with workers who worked continuously on concrete surfaces. The current study was designed to look at such workers working in warehouses at 3 companies.

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Low Leg Pain: Abstract

Shin Splints with Underlying Posterior Tibial Tendinitis: A Case Report
William M. Austin, DC, CCSP, CCRD

To discuss treatment protocols for a recreational middle-distance runner who suffered from anterior shin splints complicated by an underlying posterior tibial tendinitis, who was unable to train to his full capacities, and who turned to chiropractic care when standard medical protocols proved ineffective.

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