Orthotics Function Like Horseshoes

By: Brian Jensen, DC

Some members of my family and I once visited a living history museum that re-enacts life as it was on the plains of Nebraska in the late 1800’s. When we stopped by the blacksmith’s shop, I got a lesson in structural biomechanics that we would all do well to take heed of.

My niece asked the blacksmith to make a horseshoe. He proceeded to heat and hammer a steel bar into the classic horseshoe shape (complete with nail holes) while explaining that, in those days, a blacksmith was too busy repairing farm equipment to make horseshoes. A farrier was the specialist responsible for shoeing all of the horses. My first thought was that the blacksmith was too skilled to bother with such a simple device; but as he continued to paint the picture of all that was involved, I soon realized that the farrier was quite possibly the more skilled of the two.

Nailed-On Custom Support

The blacksmith told us that the farrier would first watch the horse walk, analyzing its gait. If any abnormality in the gait was detected, he could alter it by manipulating the shape of the shoe. Weight could be added to a point on the periphery of the shoe, or a short extension piece could be placed on the lateral aspect to rotate the leg out on contact with the ground to correct “toe in.” The farrier could actually alter the growth plates of the leg bones, correcting structural imbalances during a horse’s first three years of life.

I wanted to shout out, “That’s bone remodeling, osteoblastic and osteoclastic activity!” But the sheriff’s office and jail were next door, and I didn’t want to push my luck. Prairie justice can be swift if they think you’ve spent too much time in the saloon. I also learned that horseshoes can be specifically made to train the horse to have a high-stepping gait or trot. The variations are seemingly endless, but the bottom line was this: every horse is different and has specific structural needs.

Horseshoes are custom orthotics! It is apparent to me that the long-term health of a horse can be directly related to the quality of analysis of its gait, how it bears its weight, and the quality of the shoe that it wears. It’s the small details that make all of the difference.

Orthotics for All Ages, Needs

It is also apparent to me that, when it comes to our weightbearing structures, we humans deserve at least the same considerations that a horse gets. I was reminded that we need to be more diligent in examining children because of the influence that orthotics could have on their structures during the early years of their development. With older patients, it is obvious when the structure has started breaking down, but it’s not too late to do something about it.

Fortunately, I am not recommending that we seek the advice or services of a farrier for ourselves or our patients. Foot Levelers, Inc. has already more than filled that position. The 3D BodyView® imaging system gives you the detailed analysis of the foot in the weightbearing position. Sixteen individual measurements of each foot take into account the complexity of the biomechanics of the foot’s three arches, the 26 bones of the foot and ankle—and of the foot’s relationship with the knee, hip, and pelvic complex.

Shock absorption, structural support, and proprioceptive influence are key features of Foot Levelers’ custom-made, functional orthotics. This translates into having a positive influence on growth plates in young patients and slowing down degenerative changes in adults that result from Wolfe’s Law. Balance in the gait cycle also deactivates the compensatory mechanisms that cause muscles to reflexively contract, which cause trigger points and myofascial tension and pain.

The bottom line is this: every patient is biomechanically different and has specific structural needs. Genetics, occupation, trauma, shoe type, age, height, weight, and recreational activities are all factors that contribute to our structural uniqueness. There is no such thing as “off-the-shelf” horseshoes, because the results would be inadequate to accommodate all of the differences not only between horses but in all four hoofs of one horse. In the same way, off-the shelf arch supports or cushions cannot take into account all the variations of feet that exist. Most people possess some variation between their right and left feet which makes the custom-made orthotics that Foot Levelers provides superior.

Fine Tune Fit, Function

It is also important to remember that the original correction in a horseshoe needs to be altered once the correction has been accomplished. The body adapts and retrains the musculature and proprioceptive reflexes to the more favorable function. The same is true for our patients.

We are constantly adapting and changing, so it is important to follow up with patients who have received orthotics in the past. If a corrective medial heel wedge and rehabilitative exercises were necessary to address hyperpronation, the wedge may not be necessary after the body has adapted. I have had cases where a new scan or cast has resulted in a change in the prescription.

Don’t miss the opportunity to fine tune the fit and function of the custom-made orthotic. When the prescription changes it reinforces in the patient’s mind that the long-term correction we told them about is actually taking place. They have better balance because of the proprioceptive input into the cerebellum. Ultimately they are less likely to suffer a fall in their later years because function is being preserved.

Another benefit of replacing older orthotics is to update their shock-absorbing properties. It just makes sense that if they have been absorbing the shock forces of walking and running for a couple of years, it is a good idea to update them so the orthotics are efficiently absorbing those forces, not the knees, hips, and spine. Broken down, arthritic joints are sure to occur if the forces of gravity have not been managed properly. That reason alone is enough to recommend orthotics to a patient.

The ramifications of structural wear and tear in a horse are often the cause of its ultimate demise. A horse will not be allowed to suffer from degenerative conditions. Humans, on the other hand, often spend many years suffering from degenerative changes that could have been prevented—if only we would take a lesson from the farrier.

Dr. Brian Jensen

Dr. Jensen is a graduate of the Palmer College of Chiropractic and has practiced in Nebraska for 17 years. He is currently Assistant Director of Professional Education for Foot Levelers.