EP0386173A4 - Pronatary insert for high-heeled shoes - Google Patents

Pronatary insert for high-heeled shoes

Info

Publication number
EP0386173A4
EP0386173A4 EP19890906291 EP89906291A EP0386173A4 EP 0386173 A4 EP0386173 A4 EP 0386173A4 EP 19890906291 EP19890906291 EP 19890906291 EP 89906291 A EP89906291 A EP 89906291A EP 0386173 A4 EP0386173 A4 EP 0386173A4
Authority
EP
European Patent Office
Prior art keywords
metatarsal
orthotic
thickness
inch
pad
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP19890906291
Other languages
English (en)
French (fr)
Other versions
EP0386173A1 (en
Inventor
Lee S. Cohen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dr Cohen Group Inc
Original Assignee
Dr Cohen Group Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dr Cohen Group Inc filed Critical Dr Cohen Group Inc
Publication of EP0386173A1 publication Critical patent/EP0386173A1/en
Publication of EP0386173A4 publication Critical patent/EP0386173A4/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A43FOOTWEAR
    • A43BCHARACTERISTIC FEATURES OF FOOTWEAR; PARTS OF FOOTWEAR
    • A43B13/00Soles; Sole-and-heel integral units
    • A43B13/38Built-in insoles joined to uppers during the manufacturing process, e.g. structural insoles; Insoles glued to shoes during the manufacturing process
    • AHUMAN NECESSITIES
    • A43FOOTWEAR
    • A43BCHARACTERISTIC FEATURES OF FOOTWEAR; PARTS OF FOOTWEAR
    • A43B7/00Footwear with health or hygienic arrangements
    • A43B7/14Footwear with health or hygienic arrangements with foot-supporting parts
    • A43B7/1405Footwear with health or hygienic arrangements with foot-supporting parts with pads or holes on one or more locations, or having an anatomical or curved form
    • A43B7/141Footwear with health or hygienic arrangements with foot-supporting parts with pads or holes on one or more locations, or having an anatomical or curved form having an anatomical or curved form
    • AHUMAN NECESSITIES
    • A43FOOTWEAR
    • A43BCHARACTERISTIC FEATURES OF FOOTWEAR; PARTS OF FOOTWEAR
    • A43B17/00Insoles for insertion, e.g. footbeds or inlays, for attachment to the shoe after the upper has been joined
    • A43B17/02Insoles for insertion, e.g. footbeds or inlays, for attachment to the shoe after the upper has been joined wedge-like or resilient
    • AHUMAN NECESSITIES
    • A43FOOTWEAR
    • A43BCHARACTERISTIC FEATURES OF FOOTWEAR; PARTS OF FOOTWEAR
    • A43B7/00Footwear with health or hygienic arrangements
    • A43B7/14Footwear with health or hygienic arrangements with foot-supporting parts
    • A43B7/1405Footwear with health or hygienic arrangements with foot-supporting parts with pads or holes on one or more locations, or having an anatomical or curved form
    • A43B7/1415Footwear with health or hygienic arrangements with foot-supporting parts with pads or holes on one or more locations, or having an anatomical or curved form characterised by the location under the foot

Definitions

  • This invention relates to a pronatary, resilient wedge shoe insert, and, more particularly, to a compensatory, protective biomechanically designed cushioned insert composed of a closed cell foam material for use with high-heeled shoes.
  • high heeled means shoes with heels exceeding 1 _ inches (3.3 cm) in length.
  • the anterior is forward (toes)
  • the posterior is rearward (the heel)
  • the interior is medial (instep)
  • the outside is lateral
  • the bottom is plantar.
  • the bones are designated, in order from the anterior to posterior, as phalanges (toes) , metatarsals, cuneiforms, navicular, tali and calcaneus (heel) while first means medial and fifth means lateral (see Figure 1) .
  • the first phalange is the medial most phalange bone (big toe) .
  • Plantar flexion describes the foot position where the foot is pointed in a downward direction, with the toes parallel to the floor. When in this position, the foot is unnaturally rigid thereby causing forces normally directed to the heel, to shift to the ball of the foot.
  • Locomotion basically, involves a two-phase cycle; a weight bearing and nonweight bearing.
  • rigidity as noted above, can produce potentially damaging, forced stretching of the plantar fascia and possible development of heel spurs.
  • the foot When the foot is held in a plantar flexed (supinated position as described in the literature) , it does not allow the body to properly absorb the impact shock generated by contact of the foot with the ground. Due to the absence of shock absorbing ability, the impact force is passed to the body from the foot through the ankle, leg, knee, up the spinal column and, ultimately, to the neck. Hence, the entire vertical skeletal system and associated musculature is affected. More specifically, the shock energy is not physiologically damped as it is in a normal heel-to-toe gait. - With the impact force being concentrated on the anterior metatarsal area (ball) , the foot often sustains enhanced trauma which is evidenced by a substantial increase of injuries to anterior metatarsal area.
  • the plantar flexion creates indirect physiological complications.
  • increased shock impact forces cause the calf muscles to compensate for the diminished impact damping of the foot by tightening.
  • the tightening and increased strain on the front part of the lower leg are symptomatic of anterior shin splints (inflammation of the front, lower leg) which develop from such muscle strain.
  • the body attempts to decrease strain on the legs by increasing strain on the knees, which in turn, tend to flex.
  • the hips also then, flex from the knee flexion.
  • these reactions cause the body's center of gravity to move forward whereby the buttocks protrude and the back arches to balance the center of gravity and to maintain a standing position. It is readily appreciated that once the back arches, the entire spinal cord extending to the neck, is affected and the chest and buttocks are caused to compensate even more.
  • locomotion in high- heeled shoes creates dynamic, impact deforming forces on the body.
  • Forefoot deformity (see Figure 2) is generally results in abnormal subtalar joint pronation (greater than 7° forefoot varus). Plantar flexion and increased median arch height are the deforming characteristics caused by wear of high-heeled shoes. Accordingly, when combined, the problems of forefoot deformity are exacerbated where the foot is maintained in an overly rigid configuration and a constant abnormal attitude of propulsion. Thus, the lever-mobile adapter sequence of the normal gait cycle is disrupted.
  • the normal foot provides a lever mobile adapter sequence for the gait cycle which provides for normal locomotion, shock impact damping and is compatible with natural skeletal and muscle structure.
  • a normal foot is exposed to high-heeled shoes, it should be readily appreciated from the foregoing that the plantar flexion coupled with increased median arch height results. Hence, a sufficient degree of pronation, necessary to effect proper weight distribution and shock dissipation, is prevented. This, in turn, causes the discomfort and injury prone conditions of high-heeled shoes.
  • rearfoot deformity causes abnormal subtalar pronation.
  • the forefoot valgus at the metatarsal heads (greater than 5° subtalar eversion or inversion) causes the forefoot to turn towards the medial axis (pronation) .
  • the forefoot valgus is approximately 3° and extends from the lateral aspect to the.medial aspect along the metatarsal parabola (the curved line defined by the metatarsal phalangeal articulation) and imparts a normal degree of pronation.
  • Brown 4,688,3308 describes a laminated orthotic for high-heeled shoes. Brown's approach is to provide a multilayered structure of resin impregnated graphite fiber layers where the different layers possess differential geometric orientations relative to the longitudinal axis of the foot. The identified purpose of the structure is to offer a rigid platform resistive to the forces associated with high-heeled shoe wear.
  • Brody 3,068,872 a stiff foot supporting device for a curved elliptical high- heeled (court) shoe is described. That device includes an arch portion for better supporting the arch during locomotion.
  • Yet another object of this invention is to provide a pronation inducing orthotic insert structured to overcome the detrimental effects of plantar flexion.
  • a pronatary orthosis for use with high-heeled shoes comprising a pad having a surface dimensioned to underlie the plantar fascia and heel of a foot.
  • the pad is composed of a compressible and resilient material which has a load deflection of between 1-2 kg/cm 2 , adapted to compress during the weight-bearing portion of the gait cycle and catapults the foot into the next weight-bearing portion.
  • the orthotic incorporates an anterior pad portion for underlying the plantar fascia and metatarsal parabola, said portion defining a first transverse wedge of diminishing thickness from the lateral to medial sides and extending thereacross, a second longitudinal wedge of increasing thickness from the metatarsal parabola to the posterior line defined by the metatarsal-cuneiform articulation, where said pad resists plantar flexion by inducing pronation by stretching the plantar fascia and raising the height of the metatarsal heads to decrease the height of the median arch.
  • the crux of the instant invention is to provide a structure minicking rearfoot deformity, aid the foot in pronating to increase shock absorption and to catapult the foot' into its next step without further excessive shock to the metatarsal area.
  • This invention introduces a biomechanically configured orthotic intended to artificially induce rearfoot deformity (pronation) and thereby minimize the adverse biomechanical effects caused by the wear of high-heeled shoes.
  • the orthotic incorporates a flared wedge-shaped mass of resilient cushioning material extending on the anterior- posterior axis approximately 1 inch (2.2 cm) which diminishes in thickness from the posterior to the anterior direction and terminates just posterior to the metatarsal parabola.
  • the wedge provides resistive force that is resolvable into vertical and horizontal components.
  • the horizontal component acts to stretch the plantar fascia and the vertical component acts to raise the metatarsal bones.
  • the orthosis of this invention is constructed from a compressible, resilient, cushioning material which resists automatic return of the foot to the plantar flexed condition.
  • a springing action similar to a catapulting effect, exerted in the plantar fascia and median arch.
  • the combined effects of the forefoot valgus and the spring loading of the plantar fascia and median arch are intended to produce increased pronation.
  • This increase in pronation more closely mimics normal pronation and, in turn, provides more normal weight distribution and shock dissipation within the foot.
  • the orthosis relieves the discomfort and injury caused to the entire body by high-heeled shoes.
  • Figure 1 is a diagram of the skeletal structure of the foot.
  • Figure 2 is a representation of a forefoot varus deformity.
  • Figure 3 is a representation of normal foot positioning.
  • Figure 4 is a representation of rearfoot deformity.
  • Figure 5 is a perspective view of the invention.
  • Figure 6 is a sectional view of an orthotic according to the invention.
  • Figure 7 is a schematic representation of the effect of the invention on locomotion forces.
  • Figure 8 is a schematic of the force redistributio .
  • Orthotic device 10 is specifically designed to compensate for foot deformity occasioned by the use of high-heeled shoes. Orthotic 10 is dimensioned to conform to the interior platform of a high-heeled shoe. Preliminarily, it should be noted that the drawings and description address an insert adapted for a right foot. Clearly, the same principals apply to the left but as a mirror image.
  • anterior surface 11, underlying the toes, has a thickness of approximately 1/8 inch (.3 cm) and is adapted to fit into the toe portion of the shoe.
  • Line 12 represents the posterior boundary of surface 11 and defines the anterior border of middle wedge portion 14 and corresponds to the metatarsal parabola.
  • Orthotic 10 rises at an angle of 40° from line 12 to posterior heel section 16.
  • Posterior portion 16 contains shallow, meniscus shaped heel cup 18 (of lesser thickness than the surrounding structure) adapted to accommodate the heel of the foot comfortably and stabilize the posterior portion of orthotic 10 within a shoe.
  • middle wedge portion 14 it extends rearwardly from line 12 the metatarsal parabola to the metatarsal- cuneiform articulation defined by line 19 (anterior of heel cup 18) .
  • Middle wedge portion 14 defines forefoot valgus wedge 20 (exaggerated for purposes of illustration) .
  • the lateral aspect of forefoot valgus wedge 20 has a thickness of 3/16 inch which gradually diminishes to 1/8 inch at the medial aspect underlying the second metatarsal head.
  • the thickness of the orthotic remains constant at 1/8 inch from the second metatarsal head across the first metatarsal head and to the medial boundary.
  • the substantially uniform slope of the wedge diminishing in thickness by l/16th inch between fifth and second metatarsal head provides a slope of approximately 3 ° , thereby establishing an artificial forefoot valgus which contributes to a cumulative lowering of the median arch and stretching of the plantar fascia.
  • middle wedge portion 14 The longitudinal configuration of middle wedge portion 14 is described with reference to lines 22 and 24.
  • Line 22 corresponds to and underlies the second metatarsal bone and is approximately 1 inch (2.2 cm) in length.
  • the thickness of portion 14 along line 22 gradually diminishes from 1/4 inch (.55 cm) at line 19 to 1/8 inch (.27 cm) at line 12.
  • Line 24, corresponding to and underlying the fifth metatarsal has a thickness of 1/4 inch (.55 cm) at line 19 which gradually diminishes to 3/16 inch (41 cm) at line 12 and ultimately to 1/8 inch in anterior portion 11.
  • this wedge structure establishes a forefoot valgus posterior of the metatarsal parabola and also provides additional cushioning for the plantar fascia.
  • the material to be employed is critical.
  • the present invention requires particular cushioning and resilience properties.
  • the material must possess structural integrity so as to withstand the repeated forces generated during locomotion.
  • One material found acceptable is a closed cell foamed plastic with thermosetting properties. It is "Plastizote P078", available from United Foam Plastics of Georgetown, Massachusetts.
  • Plastizote P078 has an original (non- thermoset) density of 4.4 lb/ft 3 (120 gm/cm 3 )
  • Alternative to the "Plastizote” is "Trocellan JV500” produced by Rogers Foam Corp. of Somerville, MA, having an original density of 6.5 lb/ft 3 and a thermoset (50%) density of 8 lb/ft 3 (220 gm/cm 3 ) .
  • thermoset 50% density of 8 lb/ft 3 (220 gm/cm 3
  • a typical technique for producing orthotic 10 from such materials includes placing a sheet of ⁇ inch thick "Plastizote P078" in a convection oven with both top and bottom heating elements which is preheated to a temperature of between 340° and 400 ⁇ F (170-205 C°). Once the desired thermosetting temperature is achieved, the sheet is removed from the oven and placed in a mold corresponding to the desired contours of the insert. The mold is closed and pressure ranging from 5-10 lb/in 2 (.35-.70 kg/cm 2 ) , preferably 7 lb/in 2 (.5 kg/cm 2 at a closing speed between 40 and 400 inches per minute is applied. The mold is kept closed and then the inserts are permitted to cool for between 2 and 6 minutes prior to removal.
  • An alternative method contemplates heat molding.
  • the "Plastizote" sheet is placed directly into the mold and heated to where upon a closing pressure of up to 40 lb/m ⁇ (2.8 kg/cur) is employed. Once the molding has been completed the finished insert, as above, is removed and excess material is trimmed.
  • Figures 7 and 8 are provided to illustrate the effect of the longitudinal wedge of the invention on force distribution relative to the foot.
  • transverse wedge 20 is not depicted.
  • Figure 7 schematically represents longitudinal wedge 42 relative to the foot.
  • Line 30 represents the bottom of a foot.
  • the anterior (phalangeal) portion is represented by line 32, the middle portion (plantar fascia) by line 34 and the heel by line 36.
  • Line 38 defines the metatarsal bone which corresponds to a portion of the plantar fascia (line 34) .
  • the locus of resistive force 50 is located where the bisectors of the wedge sides intersect.
  • Vertical force vector component 52 and horizontal component 54 are designated by arrows 52 and 54, respectively.
  • Figure 8 schematically illustrates a foot with the invention and the resulting resistive forces.
  • wedge 42 is not illustrated.
  • Angle 40 represents the median arch. Irrespective of the artificial height increase and catapulting effect of wedge 42 relative to the metatarsal bones (line 38) , elementary biomechanical and geometric force vector analysis clearly indicates the effect of the force redistribution provided by the invention. It is noteworthy to mention that wedge 20 (the forefoot valgus) is not described with particularity here because as a practical matter, the first and second me atarsals more greatly influence the median arch and plantar fascia than do the third through fifth metatarsals.
  • a standardized insert for use with high-heeled shoes is provided with features a wedge structure intended to induce pronation and mimic the effects of rearfoot deformity while also providing a longitudinal wedge which contributes to beneficial force redistribu ion.
  • the insert may be modified to include conventional characteristics. For example, it may be coated or combined with a textile or fabric layer on its upper surface for comfort and cosmetic reasons. Other such variations or known techniques and materials may be used to improve or modify the basic invention as should now be apparent from the foregoing. Such variations and modifications now being evident to the skilled artisan, are contemplated to fall within the intent and scope of the invention now defined by the following claims.

Landscapes

  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Footwear And Its Accessory, Manufacturing Method And Apparatuses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
EP19890906291 1988-05-02 1989-05-01 Pronatary insert for high-heeled shoes Withdrawn EP0386173A4 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US18912688A 1988-05-02 1988-05-02
US189126 1988-05-02

Publications (2)

Publication Number Publication Date
EP0386173A1 EP0386173A1 (en) 1990-09-12
EP0386173A4 true EP0386173A4 (en) 1992-01-02

Family

ID=22696042

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19890906291 Withdrawn EP0386173A4 (en) 1988-05-02 1989-05-01 Pronatary insert for high-heeled shoes

Country Status (5)

Country Link
EP (1) EP0386173A4 (ko)
KR (1) KR900700029A (ko)
AU (1) AU3732989A (ko)
BR (1) BR8907414A (ko)
WO (1) WO1989010708A1 (ko)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2808977B1 (fr) * 2000-05-22 2002-07-19 Guy Sparacca Orthese dynamique bifonctionnelle pour chaussures

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2458674A1 (de) * 1973-12-14 1975-06-26 Ernst Meier Verfahren zum herstellen eines schuhes
WO1981003112A1 (en) * 1980-05-06 1981-11-12 J Stubblefield Shoe sole construction
DE8419408U1 (de) * 1984-06-28 1985-08-01 Doron, Paul, 4930 Detmold Orthopädische Einlegesohle und mit dieser Einlegesohle versehenes Schuhwerk

Family Cites Families (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2216630A (en) * 1937-12-23 1940-10-01 Thompson Bros Shoe Co Corrective shoe
US2237945A (en) * 1939-07-24 1941-04-08 Dorothy C Minor Overcorrective shoe for talipes varus
US2345820A (en) * 1940-12-16 1944-04-04 Jules J Kohn Foot correction
US4266553A (en) * 1979-10-22 1981-05-12 Faiella Joseph V Footgear embodying podiatric sole
US4320558A (en) * 1980-05-08 1982-03-23 Teepak, Inc. Continuous shirring and spinning machine for casings
US4620376A (en) * 1985-01-22 1986-11-04 Talarico Ii Louis C Forefoot valgus compensated footwear
US4631841A (en) * 1985-03-14 1986-12-30 Hickey John L Shoe insert device
US4688338A (en) * 1985-04-03 1987-08-25 Northwest Podiatric Laboratories, Inc. Orthotic insert for high heeled shoes
US4702255A (en) * 1985-06-17 1987-10-27 Schenkl Joseph L Orthopedic apparatus
US4747410A (en) * 1985-11-26 1988-05-31 Cohen Lee S Cushioned anti-pronation insert
US4759357A (en) * 1987-01-28 1988-07-26 Gerard Allart Podiatric orthesis for orientation of the calcaneus and subtalar bones

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2458674A1 (de) * 1973-12-14 1975-06-26 Ernst Meier Verfahren zum herstellen eines schuhes
WO1981003112A1 (en) * 1980-05-06 1981-11-12 J Stubblefield Shoe sole construction
DE8419408U1 (de) * 1984-06-28 1985-08-01 Doron, Paul, 4930 Detmold Orthopädische Einlegesohle und mit dieser Einlegesohle versehenes Schuhwerk

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO8910708A1 *

Also Published As

Publication number Publication date
WO1989010708A1 (en) 1989-11-16
KR900700029A (ko) 1990-08-11
EP0386173A1 (en) 1990-09-12
BR8907414A (pt) 1991-05-07
AU3732989A (en) 1989-11-29

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