Summit Chiropractic offers custom fit orthotics to help improve balance, posture and gait.These orthotics are a leather 2-piece device with sorbethane ( an eraser–type rubber ) inserted in between the leather appliance. We make various kinds of orthotics adaptable to all sports and lifestyles.
testimonial

Othotics and Golf

Chiropractic and orthotics benefit golfers by improving their posture, stance, and mobility; therefore, enhancing performance on the green! We invite you to explore the possibilities of a better game.

research studies
survey results
Pronation studies

In 1997, Drs. David Stude and Danielle Brink had peer-reviewed research published in the Journal of Manipulative and Physiological Therapeutics (JMPT), which proved that Foot Levelers' flexible, custom orthotics help experienced golfers improve both their balance and proprioception. In 2000, JMPT published a paper by Drs. Stude and Jeff Gullickson, showing that Foot Levelers' orthotics help improve a golfer's club-head velocity. Now, in another landmark study scheduled to be published by JMPT, Drs. Stude and Gullickson, showing that Foot Levelers' orthotics "influenced the parameters associated with gait and reduced the effect(s) of fatigue associated with nine holes of simulated golf."

Background

The lower extremity and the spine represent a closed kinetic chain in the upright posture. The premise that the function of one region of the body can influence the function of another region has been supported. The foot and ankle, as part of this kinetic chain, have considerable potential for influencing the function of the rest of the kinetic chain.
There is also evidence that shoe selection affects balance performance, suggesting that foot function can influence whole-person activities.

The Current Investigation

Participants.

Stude and Gullickson evaluated a group of golfers to determine the effects of orthotic intervention on gait patterns and fatigue associated with nine holes of simulated golf. The 12 research participants (11 men and one woman) picked were experienced golfers with a reported handicap of ten or less (some of these golfers were teaching or touring professionals). Nine of the twelve were able to return for subsequent data collection two months later. This sample was chosen to control for the effects of experience and skill as much as possible (experienced golfers tend to have a more consistent swing).

Method.

Gait was assessed before and after treadmill walking, utilizing video freeze-frame analysis. Each participant was videotaped while walking on the treadmill for two minutes, following a two-minute warm-up. Measures included pelvic rotation and stride length.
Fatigue was introduced by having participants complete a nine-hole round of golf, before and after wearing custom made, flexible orthotics for six weeks. This required the subjects to walk the distance typical of nine holes of golf and required them to wait for those ahead of them, typical of real course situations. By measuring the outcomes described earlier, namely, pelvic rotation and stride length, before and after completing a nine-hole round of golf, fatigue was assessed.

Parameters associated with gait (i.e. stride length and pelvic rotation) were measured in all subjects, before and after wearing custom-fit, flexible orthotics for six weeks and before and after completing nine holes of simulated golf.

Orthotics

Subjects wore Foot Levelers' custom made, flexible orthotics daily for six weeks and then gait was reassessed using the same objective measurement parameters. Two specific types of orthotics were provided to research participants, one full-length (for recreational shoes) and one three-quarter-length design (for dress and/or oxford shoes). The men received a pair of full length FirmFlex Plus and a pair of Sir Energy Plus orthotics. The women received a pair of full length FirmFlex Plus and a pair of Ms. Energy Plus orthotics.

Results and Conclusions

Stude's and Gullickson's data indicate that the use of Foot Levelers' custom-fit, flexible orthotics used in this study, for six weeks, by experienced golfers, influenced the parameters associated with gait and reduced the effect(s) of fatigue associated with nine holes of simulated golf.
Drs. Stude and Gullickson concluded that the "use of the custom-fit, flexible orthotics used in this study had a significant influence on the elements of gait measured in this study, specifically, pelvic rotation and stride length. There was an average increase in pelvic range of motion between 29% and 36% and associated changes in stride length in subjects after they had worn orthotics for six weeks. Additionally, the use of these custom [orthotics] reduced the effects of fatigue associated with playing nine holes of golf and so could potentially improve the likelihood for more consistent performance, possibly as a result of a more efficient gait pattern"

SURVEY RESULTS

Results are in from a recent survey of both professional and recreational golfers who wore Foot Levelers' ParFlex Plus orthotics while golfing. The results show that 96% of the survey respondents would recommend the custom-made orthotics to a fellow golfer. Other data collected show that an overwhelming majority of golfers surveyed (87%) got used to their ParFlex Plus in three days or less, and they were nearly unanimous (92%) in judging the orthotics to be "comfortable" at the end of the trial period. And almost three-fourths of the respondents (71%) felt that they had better balance while wearing ParFlex Plus.

Preliminary Study of Golfers

Foot Levelers' ParaFlex Plus survey was undertaken as a follow-up to a research study published in 1997 by Drs. David E. Stude and Danielle K. Brink. Their study measured the effects of orthotic intervention and nine holes of simulated golf on balance and proprioception in experienced golfers. Stude and Brink selected Foot Levelers' Full Length FirmFlex Plus® orthotics for their subjects' recreational shoes (ParFlex Plus were not available when the Stude/Brink study was undertaken), and Sir Energy Plus or Ms. Energy Plus for dress shoes. The Stude/Brink study came to the following conclusion: "The data trends associated with the use of these specific, custom made, flexible orthotics suggest a positive influence on balance, proprioception and proprioceptive symmetry in a small population of experienced golfers. This influence seem to be most strongly correlated with measured changes in proprioception, compared with general balance ability. However, the the effect of fatigue on proprioception was less consistent. Improvement of proprioceptive function may potentially enhance performance ability and influence injury potential."

ParFlex Plus Survey

In 1998, Foot Levelers' introduced ParFlex Plus, the custom-made orthotic designed specifically for golfers. Full-length ParFlex Plus provides flexible support for lateral weight shifts, increased forefoot stability during follow-through, and it also offers magnetic therapy. Prior to its general release, ParFlex Plus orthotics were given to a group of professional and recreational golfers. This group was asked to wear the orthotics while they were golfing. After five weeks, the golfers were asked to complete a questionnaire regarding the comfort level and perceived effectiveness of the ParFlex Plus on their game. Here is what the survey participants concluded on these two subjects:

Comfort

When asked, "How long did it take you to get used to wearing your orthotics?" 87% of respondents overall indicated three days or less, and 100% had adjusted to ParFlex Plus by the end of the fifth day. Regarding fatigue, 79% of the wearers stated that their feet felt "less tired" while wearing ParFlex Plus, and a third (33%) reported their feet perspired less with the orthotics in their shoes! And at the end of five weeks, 100% felt they had good support in their shoes, thanks to ParFlex Plus.

Effectiveness.

When asked about balance, 71% felt that their balance was improved while wearing ParFlex Plus. Could ParFlex Plus help them hit the ball farther? An impressive 29% thought they could; and half (50%) felt they were hitting the ball well more consistently. And as to improving their score, 38% overall reported shooting a lower golf score with ParFlex Plus in their shoes.

And so, after wearing ParFlex Plus for five weeks, would the golfers in the survey recommend these orthotics to a fellow golfer? The answer was a unanimous "yes" from the professionals, and a 96% positive response overall.

Individual Comments

Here are just some of the comments that survey participants wrote about ParFlex Plus on their questionnaires:

"I would suggest orthotics to others if they were having problems." - female professional golfer

"Very comfortable. Helped lower back pain." - male recreational golfer

"If playing 36 holes in one day, I believe they [ParFlex Plus] would help fatigue on the last 9 holes." - female professional golfer

"Seemed to help [my chronic back pain] while golfing and walking." - female recreational golfer

Two Research Studies of Pronation During Running and Walking

I. NIKE Research

A project conducted at the NIKE Sport Research Laboratory studied the effects of soft and semi-rigid orthotics on rear foot movement in running. Nine well-trained runners who wore orthotics were chosen as subjects. After an examination by one of the podiatrists participating in the study, each subject received individually prescribed soft and semi-rigid orthotics. Both devices for each subject were identically posted.
After a six-week adjustment period, any necessary modifications to the orthotics were made and the testing began. The athletes ran in a specially constructed test shoe: curved-lasted, slip-lasted in the forefoot, and board-lasted in the heel, with a midsole of a typical hardness and a neutral flat outsole. Three conditions were studied; control (no orthotics), soft orthotics, and semi-rigid orthotics.
After a short warn-up, the subjects were presented with each condition in a random order. The subjects ran on a treadmill for two minutes in each condition at seven minutes per mile pace. At the end of the two minute run, high speed film (200fps) was taken of the subjects from behind. In a manner common to the evaluation of rear foot movement, markers on the calf and Achilles tendon represented the axis of the lower leg. Reference markers placed vertically on the rear of the shoe indicated the position of the rear foot within the shoe.
Using these markers to identify the angle between the lower leg and the foot, the film was analyzed and the three conditions compared. (See Table 1.)

Significant differences in maximum pronation were detected between the control and either the soft or the semi-rigid conditions. The maximum velocity of pronation was also significantly reduced in both orthotic conditions as compared to the control. No statistical difference was noted between the soft and semi-rigid orthotic conditions.
It should be noted that low correlations were found between the various clinical measurements of ranges of the foot, ankle and leg motion and the maximum pronation exhibited in the control condition. This indicates that clinical measurements are not good predictors of the actual degree of pronation exhibited as a subject runs. Film analysis of a subject's gait is the preferred method.
The results of the study indicated that both soft and semi-rigid orthotics reduced rear foot movement by roughly one degree or approximately nine percent of the amount found in the control condition. The average reduction of the maximum velocity of pronation was fifteen percent. Thus it appears that orthotics have a greater effect on the velocity of pronation than they do on the amount of pronation.

II. Q-Angle Research

This is a discussion of the quadriceps angle (Q-angle). Figure 1 demonstrates the typical increase in the female vs. male Q-angle due to the wider pelvis. The standard landmarks and procedure of measuring the Q-angle includes:
1. Have the patient stand with feet together.
2. The resultant angle of measurement is an insertion from:
a. ASIS through the center of the patella, and
b. Tibial tubercle center and the center of the patella.
This angle when measuring between 15 and 20 degrees suggests possible patellar instability and irregular patellofemoral biomechanics. Measurements above 20 degrees may result in severe patellar instability. Figure 2 demonstrates the resultant increase of the Q-angle as a result of excessive pronation of the foot. Measurements and examination of all the knee conditions should also include determination of foot pronation. Thus, it can be appreciated the effect the foot has on knee biomechanics.

Pronation

During running, the Q-angle reaches serious levels of measurement. During walking, figure 3 demonstrates that the pronation phase of gait comprises only 27 percent of the stance phase. Prolonged pronation is a common biomechanical fault seen in a wide variety of athletics. Figure 4 demonstrates the pronation and leg rotation motion during running. The overall effect of a pronated foot on the knee joint will be to increase the Q-angle to abnormal levels. The result will be knee pain due to the altered biomechanics of the foot.

Improvement

A previous study demonstrated the use of the Mekel 300 Camera filming motion at 300 frames per second. With the aid of this camera and the Polaroid Instant Analysis System, one is able to measure the Q-angle during running. Our current research has analyzed 40 cases of excessive Q-angle. Each of the Q-angle measurements was beyond 20 degrees at the limits of knee rotation and foot pronation. In each case no orthotics were being worn. After casting for Spinal Pelvic Stabilizers and re-filming occurred, the results were tabulated as found in Figure 5. Thus, measurable improvements with the Spinal Pelvic Stabilizers can be proven.
Biomechanical stability of the knees can be controlled and improved with customized Spinal Pelvic Stabilizers. Knee pain and discomfort can be successfully managed.

Testimonial

Orthotics

I had been in a motorcycle accident about 5 years prior (had broken my left leg) and had been diagnosed by the M.D.'s as having an anatomically short leg which had developed into a limp and a few months later hip pain and lower back pain. They told me that I would have to live with the problem and the only solution was medication and maybe bracing.

I went into see Dr. Carlomagno and he re diagnosed me after an exam to detect my true leg length as having an anatomically short leg! He said that he could help my short leg and the condition that had evolved through the use of orthotics. He built up a ½ inch higher orthotic for my left foot of which both orthotics fit comfortably in both shoes. He re measured my leg length which at this point became equal. I noticed immediately that I could stand up straighter and in a week my lower back, hip pain diminished. I am really grateful for the simple correction I needed.

D.H. Marketer