EP0350784A2 - Surgical insert for shoes, in particular a sports shoe - Google Patents

Abstract

The invention relates to an insert, particularly for sports shoes, which consists of a truss pad and a foot bed support, the truss pad being formed by two discs with cushions inserted therein for the guidance and support of the ankle of a foot, and these discs being joined via borders which interconnect them and being connectable to one another under the foot bed support and/or to the foot bed support also by means of these borders. <IMAGE>

Description

The invention relates to a medically oriented insert for shoes, esp. Sports shoes, such as tennis shoes, basketball shoes and. a. with a shaft extending over the ankle of the foot and with pads that can be placed on the side of the ankle and at least partially encompassing it, the pads on each side of the ankle being formed by two L-shaped legs and the ankle can be supported vertically on the one hand and on the other hand by the back.

From many studies of human movements, such as walking, running, jumping, among others, it has long been known that the respective foot is subjected to an enormous load, which it usually copes with by adjusting the tread on the one hand and rolling off the foot part on the other. The concept of the foot as such has largely adapted to these movements, and relatively few occur Damage to the foot when the foot, without shoes, is exposed to these movements, especially on natural, soft ground. In today's civilized society with footed movements, it is important to provide the foot with aids with which the foot can follow the peculiar movements without being damaged or damaging the body to be carried.

From the above investigations it is also known that when humans appear, direct pressure contact on the heel bone or on the tendon inserts acting here releases forces which can correspond to 6 times the body weight. On the foot and especially on the sole of the foot, as is known, the dynamic moment of movement of the z. B. moving body converted to a static state, d. H. The sole of the foot sits on the floor or rolls off, which creates shear forces, especially on the heel bone, as a result of this sequence of movements. Such investigations have also shown that the foot, and in particular the rear foot, is exposed to various transverse deformations during these movements. These transverse deformations cause the heel bone to be placed on the ground and lifted off it again when running in an O position (valgus), but that it runs through a kink in the X position (varus) during the rolling phase and consequently also in this movement must be slowed down and accelerated

Accordingly, e.g. B. in the running movement, in the rear foot various problems in the interception of the load sequences of the foot on, which are static-mechanical or static-dynamic origin.

The damping function when the hip occurs Steer, especially when running, no longer experiences a vibration, can be taken over by a soft floor, a soft shoe or by the tendons and muscles in the area of the foot and lower leg.

However, if such movements are used abruptly or if they persist chronically for a longer period of time, they overload the muscle pulls such as B. the Achilles tendon or plantar fascia and lead to persistent complaints such as heel spur complaints, Achillodynia and. a.

Based on many observations and experience, the movement sequences lead to permanent damage to the feet, especially since they are forced into fashion-oriented and less orthopedic shoes and the movement sequences usually take place on hard floors that neither provide the necessary cushioning of the foot nor enable a natural rolling process.

To counteract these problems in one way or another, a variety of orthopedic shoes and / or insoles have been developed for them, most of which are devoted to partial solutions with more or less great success.

For example, from DE-OS 23 38 060 an orthopedic, therapeutic shoe has become known, in which disks are provided on the side of the shoe facing outward with respect to the wearer between the inner lining and the shaft in the region of the ankle, which are essentially oblique run downwards and vertically downwards and can be inserted into the support rods. The support rods in the inserted state, partly in front of and partly behind the ankle on the heel area, stiffen the area of the ankle on the upper of the shoe and there form a stiffening spanning the ankle in the form of an upside down "V". Support rods of this type may provide increased support and thereby give additional support, but they considerably hinder the natural course of movement, in particular the foot rolling process when walking naturally.

These support rods also stiffen the upper of the shoe to such an extent that even in this area there are pressure points which have an adverse effect on the ankle and thus also on the ankle. It has also been found that ankle support should not come from above, the fork of the "V", but from below if the supporting function of the ankle is to be effective.

In order to carry out this supporting function of the ankle from below, an insert for sports shoes has become known from CH-PS 337 751, which consists of two L-shaped legs on each side of the ankle, in the connecting plane of which the ankle is embedded. Both halves of the insert are designed as inflatable parts, and the legs of this insert are arranged relative to one another such that one leg laterally below the ankle and the other leg essentially perpendicular and parallel to the Achilles tendon. The air spaces of the perpendicular legs on both sides of the ankle are connected to one another along the Achilles tendon, and these air spaces are connected to the air spaces that lie below the ankle. A valve runs through the Achilles tendon through which the inflatable cushions can be filled with air.

With such an insert, voids can be filled between the ankle and the inside of the upper of the shoe in order to ensure better contact between the sen manufacture, however, it is considered disadvantageous here that neither the different axial position of the ankle, in terms of its support, is taken into account, nor does the movement of the foot in the shoe dampen. For this reason, this insert is also not suitable for giving the foot the necessary guidance and support, and in particular cushioning, in relation to the footbed.

Furthermore, from DE-AS 1 015 364 an insert for the protection of the ankle and ankle is known, which consists of a U-shaped cushion bead which can be attached to both sides of the ankle and in the rounded, deepest point of which the ankle can be embedded. The legs of this cushion bead are directed vertically or approximately vertically upwards, and this takes into account the position of the articulation axis insofar as the cushion beads on the two sides of the ankle are set differently with their legs. Here, the legs behind the ankle run close to the Achilles tendon on the one hand and, on the other hand, offset from this, and the legs themselves are of different lengths. The upholstery beads themselves are attached to a foot made of a rubber-elastic knitted fabric, which extends from the shaft of the shoe to the arch of the foot, and consist of a highly elastic foam which has a bean-shaped cross section. With this insert, the different position of the ankles is taken into account, but it is not recognized that in addition to the support of the ankle, the ankle itself and the area of the arch of the foot, especially on the plantarapone rose, are supported in a damping manner and the foot both in the longitudinal direction and must be run across this.

DE-PS 855 370 is an orthopedic shoe knows, in which a hole is provided for yielding support of the heel of the foot between the insole of the shoe and its heel. The hole cutout, which covers the predominant surface of the heel except for one edge, is formed by wedge inserts that are inserted between the insole and heel. A certain flexibility of the insole is achieved in the area of the heel, but this is for embedding diseased parts of the heel, e.g. B. the heel spur, of minor importance, because the insole clamped all around the shoe, due to its edge-side, fixed fixation and hardness, hardly yields and thus, for example, the heel spur is hardly embedded in the hole recess. Also, this shoe cannot follow the natural movement of the foot, and in no way does it support the ankle and / or guide the arch of the foot.

In order to give the foot guidance and support in the arch area, acc. DE-PS 900 179 known to insert an insert in the shoe, which consists of two sandwich-like midsoles and a bellows-shaped elevation, i.e. H. Joint insert. This joint insert, the increase of which consists essentially of a material accumulation, is triangular and inserted between the midsoles so that it is transverse to the longitudinal axis of the shoe with one side of the leg and offers the highest point of the ball of the foot there. With this insert, the movement process in the longitudinal direction of the shoe is braked in a damping manner, but this insert cannot take on any other functions with regard to the movement sequence, so that here too there is only one insert that fulfills a very narrow partial function.

Based on these counteracting problems and the realization that when the foot rolls on the floor it goes through a special sequence of movements, which can be described as follows:
- putting on the rear foot in the O-leg position, the heel leg with a pronounced longitudinal arch in the midfoot area,
- Rolling in the X-B setting of the rear foot with flattened longitudinal arch,
- Forefoot load in the heel and final push phases; thereby reshaping the longitudinal vault, such as
- slight turning in the area of the metatarsal joint and return to the O-B position of the rear foot,
the invention is based on the object of developing an insert, in particular for a sports shoe, in such a way that both the tensile forces occurring in the ligament bond between ankle and rear foot (ankle and heel bone) are absorbed by the insert and transmitted into the shoe, as well as the normal movement of the foot, as stated above, is not, at least not significantly, impaired.

This object is achieved according to the invention with an insert of the type mentioned in that the pads are attached to two lobe-shaped pads and these pads are connected to one another at least via an anatomically shaped footbed support, and that this footbed support has one end at the heel of the foot has an elastic bulge that yields to the pressure of the heel.

Through these measures, not only that of the invention basic task solved advantageous, but it will achieve the other advantages below. On the one hand, this insert is due to its special shape with regard to floor and lateral support of the foot and, on the other hand, due to its material composition, able to take over the damper function that is no longer provided by the floor and / or shoe and thus relieves the bony, the band-like as well as muscular structures in the foot and lower leg area have a positive effect.

Another advantage is that the thickening or accumulation of material on the front inner edge of the footbed support springs the so-called whip mechanism of the tension on the sole of the foot. This leads to a temporary change in the direction of the structures of the foot under tension and thus to avoiding local tension peaks in the area of the attachment point on the heel bone and thus also to avoid the so-called heel spur complaints (periostosis, periostosis, insertion tendinosis).

In addition, the resilient recess in the sole of the foot creates a pressure relief at this point of attachment, but at the same time also a massage effect, which has an anti-edematous (decongestant) and circulation-promoting effect and in this connection develops both prophylactic and therapeutic effects.

Pressure and tensile loads also result from the conversion of the dynamic movement of the body into a static element on the sole of the foot, which causes the foot to slide forward in the shoe. Here, too, the medial, front bulge in the sense of a brake and a large-area and more favorable pressure absorption in the sense of an inhibitor counteract the heel bone periostoses.

Overload complaints in the lower ankle or the muscle and tendon structures spanning this joint occur both in the context of the rolling process and the required change position, e.g. B. X-O-X, as well as fatigue when standing for a long time through the then existing X-leg position of the rear foot.

When standing, the insert or orthosis relieves the structurally active structures, while the correct heel adjustment is induced when walking or walking, depending on the wedging in the outer and inner edge of the foot.

With problem feet, with the X leg, with the O leg, with the X rear foot, with the O rear foot, additional wedges on the sole (so-called inner or outer edge elevations) can be applied to the orthosis, which then correct a not ideal heel adjustment. These also help to prevent damage caused by overloading, especially for the athlete, on the Achilles tendon and in the area of the longitudinal arch.

In the case of external ligament damage to the upper ankle - statistically, the most frequently injured, isolated structure in humans - an increase in the outer margins can possibly even in combination with a pelotte-like extension of the orthosis - stabilize or relieve these problem structures.

This insert or orthosis is therefore ideally suited to be used to avoid static complaints in everyday life, and also to avoid overloading complaints in standing professions and in recreational sports. This insert is also very well suited to various sports damages and injuries for competitive athletes counteract.

This insert or orthosis offers further advantages in the treatment of the so-called problem foot with an incorrect position in the rearfoot area. New perspectives for successful treatment also arise in the after-treatment of overload damage or ligament or tendon ruptures to be treated conservatively or surgically and here in particular on the Achilles tendon and outer ligament apparatus on the upper ankle.

An advantageous further development of this insert is characterized in that the pads have a hem on their side facing the footrest, and that these are connected to each other as well as to the shoe via these hems, and that the footrest is connected via these hems to the Footbed is put on.

This connection of the pads under the heel has the advantage that the connecting parts are accommodated there more easily and, moreover, there are no pressure points on the heel which could give rise to new complaints. This connection also has the advantage that the pads supporting the ankles on the pads can hold their position better and, above all, more precisely, so that the ankle, the heel and the foot itself can be placed exactly on the footbed.

Another feature of the invention is to make the upholstery and / or the footrest support from an elastic material (silicone rubber or foam).

This has the advantage that, in contrast to hard padding for the ankle, the heel, among other things, a soft, cushioning and skin-friendly padding or support is created here, which is sufficient for the pressure acting on it. yielding follows and still guarantees the necessary guidance and support of the foot in the shoe. Another advantage of this material is that even after it has been deformed by the support and / or pressure, it returns to its original position and thus ensures the desired function, even after prolonged use.

Another advantageous embodiment of this insert consists in that its parts, consisting of at least the pelotte-shaped pads for the ankle and / or the foot bed support for supporting the foot, are designed as a fixed unit integrated into the shoe and are therefore part of the shoe .

This variant has the advantage that shoes can already be made from the factory that largely meet the orthopedic requirements. The general adaptation of shoes of this type may include some variations that are as narrow as possible, so that most people with feet of different sizes or shapes can be helped. This variant has the advantage that the fashionable aspect can also be taken into account, since the space conditions for accommodating the insert can already be taken into account when manufacturing the shoe.

According to a further advantageous embodiment of the insert, at least the pelotte-shaped pads for the ankle and the disks holding them can be knitted in a form-elastic knitted fabric, and together they can form a unit that can be inserted into a suitable shoe.

Through these measures, the scope of the A was further expanded, since in addition to so-called orthopedic shoes, almost any other can be used. Such an inlay hanging from a knitted fabric can also be used in a rehabilitation phase with changing footwear, as a result of which the foot is guided and supported accordingly, but the footwear can change depending on the application.

Further advantageous further developments can be found, in particular, in the remaining subclaims, for which independent protection is also sought within the framework of the applicable main claim.

• Fig. 1 eine perspektifische Ansicht auf einen Sportschuh mit der am fersenseitigen Ende des Schuhs gestri­chelt dargestellten Einlage,
• Fig. 2 eine perspektifische Ansicht auf die Einlage mit den den Knöchel abstützenden Pelotten und einer von der Ferse bis zum Fußballen reichenden Fuß­bettstütze,
• Fig. 3 einen Längsschnitt durch den Schaft des Sport­schuhs im Bereich der Achillessehne und die Ein­lage mit deren den Knöchel abstützenden Polstern und die Pelotte im Schnitt,
• Fig. 4 eine Seitenansicht einer nur den Bereich der Fer­se erfassenden Fußbettstütze mit je einer, am Fußaußenrand und -innenrand stehenden Aufkeilung,
• Fig. 5 eine Draufsicht auf die Fußbettstütze gemäß Fig. 4,
• Fig. 6 eine Draufsicht auf die Fußbettstütze gemäß Fig. 4, jedoch betrachtend von deren Auflage auf der Brandsohle, mit einer eiförmigen Ausformung für die Aufnahme, z. B. des Fersensporns,
• Fig. 7 einen Schnitt durch die Fußbettstütze in der Ebene VII - VII in Fig. 6,
• Fig. 8 eine Draufsicht auf eine Fußbettstütze, die von der Ferse bis zu den Zehen reicht und mit einer, von deren äußeren Randzone zum Fußballen sich bogenförmig erstreckenden, Aufpolsterung,
• Fig. 9 ein L-förmiges, den inneren Knöchel stützendes Polster und die nur angedeutete, dieses Polster haltende Scheibe bzw. Pelotte,
• Fig. 10 einen Schnitt durch das Polster und dessen Scheibe in der Ebene VIII - VIII gem. Fig. 9,
• Fig. 11 eine Form für das Abgießen der elastischen Pol­ster und hier für die Innenseite des Knöchels, und
• Fig. 12 einen Schnitt durch die Form in der Ebene XII-XII in Fig. 11

In the drawings, an embodiment of the insert, its conception and parts is shown schematically using the example of a sports shoe with a shaft. It shows:

• 1 is a perspective view of a sports shoe with the insert shown in dashed lines at the heel end of the shoe,
• 2 is a perspective view of the insert with the pads supporting the ankle and a foot bed support extending from the heel to the ball of the foot,
• 3 shows a longitudinal section through the shaft of the sports shoe in the area of the Achilles tendon and the insert with the pads supporting the ankle and the pad in section,
• 4 is a side view of a foot bed support which only covers the area of the heel, with a wedge standing on the outer and inner edge of the foot,
• 5 is a plan view of the foot bed support of FIG. 4,
• Fig. 6 is a plan view of the footbed support of FIG. 4, but looking at its support on the insole, with an egg-shaped shape for receiving, z. B. the heel spur,
• 7 shows a section through the footrest support in the plane VII-VII in FIG. 6,
• 8 is a plan view of a footbed support that extends from the heel to the toes and with a padding that extends from the outer edge zone to the ball of the foot,
• 9 shows an L-shaped cushion that supports the inner ankle and the only indicated disc or pad holding this cushion,
• Fig. 10 shows a section through the cushion and its disc in the plane VIII - VIII acc. Fig. 9,
• Fig. 11 shows a mold for the pouring of the elastic pads and here for the inside of the ankle, and
• 12 shows a section through the shape in the plane XII-XII in FIG. 11

The insert 1 acc. The embodiment according to FIGS. 1-3 is essentially formed by a pad 2 with two L-shaped pads 3, 4 integrated therein and a foot bed support 5 provided at least in the area of the heel. The pad 2, which consists of two disks 8, 9 provided on each side of the ankle 6 of a foot 7, is designed in such a way that, on the one hand, these disks are connected to one another via their bottom edge, ie their hem 10, and with this edge opposite end are led out over the area of the ankle in the direction of calf 11. The connection of the two disks 8, 9 can be done via ribbons or hems 10 on the bo Denside edge 11 take place, it being useful to guide these bands under the footrest 5 and / or to connect at the edge. When these disks 8, 9 are connected under the footbed support 5, the hems 10 lie between the latter and the insole 12 of a shoe 13, and the insert 1 can be an integral part of the shoe and thus be integrated therein and can also be designed as a separate insert. The foot bed support 5, which covers at least the area of the heel, is anatomically shaped at least up to the forefoot and corrected in accordance with the course of the foot.

The embodiment according to. 1-3 shows the insert as a unit integrated in the shoe 13. As a result of this integration, the disks 8, 9 with the pads 3, 4 provided on them are preferably inserted behind the lining 14 of the shoe 13, these disks being able to cover almost the entire shaft of the shoe when the shoe is designed as a sports shoe with a shaft 27.

In order to give the ankle 6 the necessary support, the L-shaped pads 3, 4 arranged on the disks 8, 9 are arranged with their one leg 15 approximately parallel to the foot bed support 5 and with their other leg 16 approximately perpendicular to the latter. The corner point, in the area of which the legs 15, 16 are connected to one another, is rounded both inside and outside, the inner rounding 17 being made soft and the curve of which extends around the predominant circumference of the ankle 6. This rounding 17 is designed as an embedding for the ankle 6, so that this, softly damped, comes to lie in this. Analogous to the position of the axis y through the ankle 6, which, as is known, does not run horizontally, the inner roundings 17 of the L-shaped pads 3, 4 of each ankle side are arranged at different heights from the footbed support 5. The upholstery 3, 4 are also with the upholstery padded material so far that they largely fill any cavities around the ankle 6 (Fig. 3) The L-shaped pads 3, 4 can be made of a rigid insert 18 and this enveloping, soft padding material 19, z. B. a skin-friendly silicone rubber or a foam, the legs 15, 16, according to the ankle side, can be padded both of different lengths and to different degrees. The different length of these legs 15, 16 is also necessary because the heel-side and upward leg 16 serves to guide and support the Achilles tendon and this can additionally have a bulge 20 in which this Achilles tendon can be embedded. The panes 8, 9, which, like the cushioning material 19, can be made of silicone rubber, fall sharply with respect to their material accumulation from the pads 3, 4 to their edges 11, so that they have a wall thickness of 0 at their edges. Have 5 to 2 mm. In order to keep the weight of these disks 8, 9 low, another material with similar properties can be used here instead of the silicone rubber, whereby it should be ensured that the material is damping, compliant, but after the damping process in its original Shape declines. Such materials can be foams, for example, insofar as they are dimensionally stable.

The foot bed support 5, which, depending on the type of insert 1, can only grasp the area of the heel or that of the entire sole of the foot, is placed on the insole 12 of the shoe 13 and, if appropriate, there also with the bands or the seams 10 of the disks 8, 9 connected. 4 to 6, the footbed support 5 is designed only as a so-called heel support 21 and is placed on the insole 12 in the shoe 13, in the area of the heel. This heel support 21 has a U-shaped edge 22, 23, wherein the edge 22 facing the inner foot can be higher than the edge 23 facing the outer foot. In addition to these edges 22, 23, this heel support 21 also has a bulge 24 in the region of its circumference on the heel side, which serves in particular to embed the heel spur. According to the example shown here, the indentation 24 is oval, the quality of which corresponds to the longitudinal central section of approximately one egg. Studies have shown that it is advisable for the longitudinal axis Z of this oval bulge 24 to intersect the longitudinal central axis X of the heel support 21, ie the sagittal axis of the foot 7, at an acute angle α.

Analogous to the short foot bed support 5 shown here, this can also be made longer and thus extend from the heel to approximately the toes. Such a footbed support 5 is shown in Fig. 8. This foot bed support 5, which can of course also have the bulge 24, is provided with an edge 25 rising to the inner foot, and from this edge there is a cushion 26 which extends approximately to the ball of the foot. This padding 26, which extends from the edge 25 in an arc shape to the ball of the foot, acts both as a support for the sole of the foot and as a brake for the foot 7, especially when the latter moves forward when walking.

The insert 1 shown here consisting of the padded discs 8, 9 and the respective short or long footbed support 5 is designed as part of a shoe 13, preferably with a shaft 27, and integrated in the shoe so that it lies behind the lining 14 of the shoe . Of course, it can also be designed as a separate insert 1, which is inserted into the respective shoe 13. When executing the same as a separate insert 1, it is advisable to insert it into an elastic knitted fabric knit and pull over foot 7 like a stocking.

In order to better understand the disks 8, 9 and the pads 3, 4 provided on them, reference is made to FIG. 9. In this figure, the disc 8 is shown together with an L-shaped cushion 3 for the inner side of the ankle. The disc 8 is so large that it can accommodate the different lengths of the legs 15, 16 and can also be inserted into the 27 of the shoe 13 itself. The side of the disc 8 facing the shaft 27 can run relatively smoothly downwards, while its side facing the ankle 6 has the padding 19 and consequently outwards, i.e. H. towards the ankle 6, is arched. The upholstery 19 or curvature is shown (FIG. 10) that the section XIII-XIII through the pad 2 leads through the bulge 28 for the ankle 6 and here shows the leg 15 for supporting this ankle 6 in section.

It must be noted here that the L-shaped cushions 3, 4 in the embodiments shown close an angle of approximately 90 ° between their legs 15, 16. This is not absolutely necessary, nor is it usual for the knuckles 6 of all people to lie in the same joint axis y. Here it is necessary to use the most common angle, i.e. H. between 80 and 110 °, and deviations from this can be operated with specially manufactured orthoses or pads 2.

Such a special pad 2 is shown in FIG. 11, which is based on the casting mold 29 for two L-shaped pads 3, 4. The pads 3, 4 are intended to support the outer ankle 6, and the vertical leg 16 here is approximately twice as long as the horizontal one Tavern 15 executed. In this illustration, the horizontal leg 15 is also pulled upwards from its connection with the vertical leg 16, so that the ankle 6 can be embedded in the inner curvature 17 between these legs. Investigations have shown that it is expedient to make the width of the legs 15, 16 at their roots 30, 31 relative to their projecting ends 32, 33 in a ratio of 1: 1, 1 and 1: 1, 3, respectively. The free ends 32, 33 of these legs 15, 16 should open like a fan from their roots 30, 31. In order to also protectively embed the Achilles tendon, the leg 16 assigned to it should have the bulge 20, so that the tendon can rest in this bulge almost without pressure.

Regarding the material-typical damping property (ie the viscoelasticity) z. B. the material of the footrest 5 correspond in its pressure behavior to the damping function of the subcutaneous fat on the sole of the foot with its mattress construction.

REFERENCE SIGN LIST

• 1 insert
• 2 pads
• 3 pads
• 4 pads
• 5 footrest
• 6 ankles
• 7 feet
• 8 disc
• 9 disc
• 10 hem
• 11 margin
• 12 insole
• 13 shoe
• 14 lining
• 15 legs
• 16 legs
• 17 inner rounding
• 18 insert (rigid)
• 19 upholstery material
• 20 bulge
• 21 heel support
• 22 margin
• 23 margin
• 24 bulge
• 25 rand
• 26 padding
• 27 shaft
• 28 bulge
• 29 mold
• 30 root
• 31 root
• 32 cantilevered end
• 33 cantilevered end

Other

y axis (joint axis)
Z longitudinal axis
x longitudinal central axis
α angle

Claims (11)

1. Medically oriented insert for shoes, in particular sports shoes, such as tennis shoes, basketball shoes, etc., with a shaft reaching over the ankle of the foot and with pads that can be placed on the side of the ankle and at least partially encompassing them, the pads on each side of the ankle being separated by two L- Shaped legs are formed to each other and the ankle can be supported vertically on the one hand and backwards on the other, characterized in that the pads (3, 4) are attached to two lobe-shaped pads (2) and these pads are positioned one below the other and / or via an anatomically shaped footbed support ( 5) are connected to each other, and that this footbed support at its end facing the heel of the foot (7) has an elastic bulge (24) which gives way to the pressure of the heel, and that this footbed support in the area of the arch of the foot, on the one hand, has a cushioning which dampens the sagittal thrust (26) and on the other hand between this and the heel leads the outside of the foot rende and supportive support (22, 23) with carding on the edge. 2. Insert according to claim 1, characterized in that the pads (2) on their side facing the footrest (5) have a hem (10), and that these hems both with one another and with the shoe (13), in particular. whose insole (12) are connected, and that the foot bed support is placed over these hems on the foot bed or the insole. 3. Insert according to claim 1, characterized in that the pads (3, 4) and / or the footbed support (5) are made of an elastic material (silicone rubber or foam). 4. Insert according to claim 1, characterized in that the pads (3, 4) consist of an elastic, but incompressible plastic (polyvinyl chloride). 5. Insert according to claim 1, characterized in that the pads (2) are designed as anatomically shaped disks (8, 9) with the L-shaped pads (3, 4) attached to them. 6. Insert according to claim 5, characterized in that the disks (8, 9) outside the ankle (6) supporting area or their pads (3, 4) have a wall thickness between 0.5 and 2 mm. 7. Insert according to claim 1, characterized in that the pads (2) in the region of the support of the ankle (6) have the sink marks of the foot (7) around the ankle filling reinforcements (18, 19). 8. Insert according to claim 1, characterized in that it consists of the pads (3, 4) and pads (2), as well as the heel support (21), which is anatomically shaped and corrected at least up to the forefoot, part of the shoe ( 13) and this insert (1) is incorporated into it. 9. Insert according to claim 1, characterized in that the footbed support (5) is inserted only in the area of the heel of the foot (7) in the shoe (13) and the elastic bulge (24) provided there with its opening the footbed or the insole (12) faces. 10. Insert according to claim 9, characterized in that the bulge (24) has an oval plan, and that the longitudinal axis (7) of this bulge, the longitudinal central axis d. H. intersects the sagittal axis of the foot (7) at an acute angle (α), in particular between 20 and 30 degrees. 11. Insert according to claim 9, characterized in that the bulge (24) has an egg-shaped plan and with its larger diameter in the area of the heel end and with its smaller diameter in the area of the ascending, lateral support (edge 22) of the footbed support (5) .

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