Orthotics for the Olympics

Orthotics for the Olympics

By: John K. Hyland, DC, DACBR, DABCO, CSCS

With very few exceptions, the sports competitions held during the Winter Olympics are dependent on the function and stability of the feet. This goes for the various types of skiing (alpine, cross-country, and freestyle), skating (figure, dance, speed, hockey), and snowboarding. Participation in these events requires consistent and dependable support from the feet, and the athletes must have very efficient function, in addition to a solid foundation.

Many Olympic athletes who wear skates and boots during their winter sports have found that custom-fitted orthotics are a vital part of their equipment. However, fitting these athletes with orthotics is a challenge for two reasons. First, it is often difficult or impossible to use standard sport orthotics in these specially-fitted boots, because of the construction, materials, fit, and design of the footgear. And then, the sport activity itself places unique requirements on the biomechanics of the foot and ankle. Most off-the-shelf and generic foot orthotics simply cannot be customized sufficiently to provide the level of biomechanical control necessary for these specialized sport activities.

Olympic competitors in all of the various winter disciplines (whether on ice or snow) have similar concerns, both in the fit of their special boots, and in the biomechanical requirements of their feet and ankles. Recreational participants in these sports face the same challenges. In fact, all of these athletes can be considered together when discussing the benefits of an orthotic, the type of orthotic required, and methods for ensuring a good fit.

How Do Orthotics Improve Performance?

Both recreational and competitive skiers, skaters, and snowboarders mention improved performance and injury prevention as the most important reasons for using orthotics. Needless to say, better performances and fewer injuries are hugely important to everyone participating in these sports. Four critical factors are enhanced when their boots contain properly-fitted custom orthotics: edge control, boot fit, biomechanical alignment, and shock dispersion.

Better edge control. Skiing and skating both depend on rapid and decisive movements from one edge to the other. These medial to lateral (and lateral to medial) movements are used to change direction and control speed. When a foot slides in the boot, or if an arch moves into a collapsed position (especially during excessive pronation), there is a lag time in getting onto the skate or ski edge, which hampers good performance. When the foot is supported by a custom orthotic, however, even small movements are quickly transmitted from the foot to the boot, and then to the edge of the ski or skate. The better control of the edges immediately improves performance in Olympic sports such as figure skating, hockey competition, and slalom ski racing.1

Tight boot fit. Many skaters and skiers try to improve their performance by tightening down the laces or buckles of their boots. While this makes the boot more “responsive” and decreases the time lag somewhat when going from one edge to the other, the improvement comes at the expense of foot comfort and health. When the boot is worn too tightly, the entire foot is compressed, which interferes with circulation, proprioception, and normal function. This can cause a variety of symptoms, and has been named “ski boot compression syndrome.”Very tight boots are also one of the causes of progressive arch collapse, which then makes edge control even harder to achieve. As you can see, this can easily become a downward spiral, with the skier or skater trying to get the boots ever tighter, but squashing the arches and making the feet more uncomfortable and dysfunctional. A properly fitted custom orthotic allows for a tight, yet tolerable fit of the upper part of the boot. This ensures a rapid boot response, while preventing many injuries and foot compression problems. Since the bases of skate boots and ski boots are completely rigid, an orthotic can be made of flexible materials, and yet still provide substantial stability. A non-rigid orthotic is not only more comfortable, but the flexibility permits easier placement inside the tight boot. Rigid orthotics are uncomfortable, difficult to fit in boots, and have been known to cut through the leather of some skates.An additional benefit of flexible orthotics is the ability to trim them with sharp scissors. This is sometimes necessary, particularly in the forefoot, where boot shape and design can vary.

Lower extremity alignment. The various disciplines that engage in skating and skiing rely heavily on the coordination, strength, and balance of the lower extremities. An athlete’s subtle leg and ankle misalignments and asymmetries become magnified when fitted into a skate or ski boot. One of the most important factors is the alignment of the calcaneus during weightbearing competition. A perpendicular or slightly valgus (2–4˚) calcaneus is desirable. Measurements outside this range indicate the need for an orthotic with a varus wedge ( a “pronation correction”) built into the heel. When all three arches receive the appropriate amount of support, the base of the foot functions as the “plantar vault.”This normalizes the pedal structural alignment,providing balanced support for the structures above. When the foot, ankle, and leg are in their strongest and most powerful configuration, performance improves significantly.

Another important biomechanical imbalance that can be corrected when using orthotics is leg length discrepancy. Reviewers sponsored by Ski Magazine were amazed to find that “nearly half of our subjects had one short leg. The largest length discrepancy was ½ inch. We found that without correctly lifting the short leg, ideal stance alignment was not possible. As little as a 1/8 inch discrepancy can affect balance.”Of course, this is not surprising to doctors of Chiropractic, who deal with this every day in their practices. Some skiing and skating athletes need heel lifts for an anatomical leg length discrepancy, while many with functional short legs are corrected by the orthotics. This emphasizes the value of having ski and skating orthotics fitted by doctors of Chiropractic, who can make these expert determinations regarding lower extremity biomechanics, and build in the appropriate corrections when the orthotics are ordered.

Shock absorption. Ski boots, snowboard boots, and ice skates are built without any shock-absorbing materials. And yet, the surfaces that skiers and skaters deal with are mostly unyielding and can easily cause injuries. Ice skaters and hockey players spend hours on ice, which is a very hard surface. While skiers and snowboarders are occasionally in powder snow, their competitions are on hard-packed courses and icy slopes, which are quite unyielding. And skiing through mogul fields (the “bumps”) can send large pressure waves from the feet into the legs and spine. In fact, skiers and skaters can both benefit from a reduction in the forces that are transmitted up through the lower extremities to the spine. Many of the injuries and symptoms of soreness produced in these sports are secondary to the significant repetitive stress from the rigid sport surfaces. By ensuring good biomechanical alignment and providing additional shock absorption, orthotics can decrease these forces substantially. Orthotics built with advanced shock-absorbing MPAX™ technology—such as Foot Levelers’ XP3™ (Fig. 1)—and 3-arch support from 3 Arch Advantage™ will reduce these abnormal forces and prevent overuse and stress injuries. In fact, the amount of soreness after skiing or skating can be lessened when shock-absorbent materials are used under the heel.7

Foot Levelers’ XP3™ with MPAX™.

Figure 1. Foot Levelers’ XP3™ with MPAX™.

Conclusion

While watching the Winter Olympics, think about the forces and stresses the athletes are putting on their bodies. And realize that most of them are using some form of specially fitted inserts in their skates or boots. Quite a few may be wearing orthotics from Foot Levelers, such as XP3, in order to ensure top-level performance. A well-fitted custom orthotic can improve performance and prevent injuries in many athletic activities. Skiers and skaters can probably benefit more than most, since their specially fitted boots create a particularly difficult environment for arch and foot function. Foot Levelers custom-made orthotics support the 3 arches of the feet with 3 Arch Advantage and provide shock absorption will enhance edge control, improve boot fit and response, align the foot and lower leg, and disperse excessive shock stress.

References

1. Santoro JP et al. Effect of the orthosis on performance in alpine skiing. J Am Podiatr Med Assoc 1989; 79:93-99.

2. Rich J. Ski boot compression syndrome. Biomechanics 1995; 2(1):36-41.

3. Edwards AR. Orthotic designs vary according to athletes’ needs. Biomechanics 1998; 5(3):23-31.

4. Kapandji IA. Physiology of the Joints: Lower Limb (2nd ed.). New York: Churchill Livingstone, 1981:196-204.

5. Kuhn DR, Shibley NJ, Austin WM, Yochum TR. Radiographic evaluation of weightbearing orthotics and their effect on flexible pes planus. J Manip Physiol Ther 1999; 22:221-226.

6. Rich JS, Hoffman G. Ski boot dynamics and custom orthoses. Biomechanics 1996; 3(10):47-48,55.

7. Faunø P et al. Soreness in lower extremities and back is reduced by use of shock absorbing heel inserts. Int J Sports Med 1993; 14:288-290.

About the Author

After running a full-service Chiropractic practice for twelve years in Colorado, Dr. John Hyland began to specialize in the active rehabilitation of Chiropractic patients. In addition to his DC degree (with honors) from Logan College of Chiropractic, and specialty board certifications as a Chiropractic radiologist (DACBR) and Chiropractic orthopedist (DABCO), Dr. Hyland is also a Certified Strength and Conditioning Specialist (CSCS). He has been the director of several Chiropractic rehabilitation practices over the past seven years, and he now consults, advises, and trains Chiropractors in the concepts of spinal rehabilitation. His past experience includes working with the United States Figure Skating Association to evaluate and improve the performance of skaters headed for Olympic competition.