Athletic Footwear and Orthoses in Sports Medicine (eBook)

Foreword 6
Preface 8
Acknowledgments 10
Contents 12
Contributors 16
Part I Fundamentals of Athletic Footwear and Orthoses 18
1 Evolution of Athletic Footwear 19
History of the Running Shoe 19
Ancient History 19
The Running Shoe Revolution 20
Reebok Begins the Race 20
The Amazing Dassler Brothers 21
Tiger Shoes and ASICS Join the Chase 21
New Balance and Intelligent Design 21
The Modest Beginnings of the Nike Shoe Empire 22
Breakthrough by Brooks 22
Key Contributors in Athletic Shoe Development 22
Early Research on Athletic Shoes 26
Running Shoe Anatomy: Past and Present 27
The Upper 28
Upper Materials: Past and Present 28
The Bottom 29
Materials: Past and Present 29
Wedges 30
Outsole 30
Insole and Sockliner 31
Putting It All Together 31
References 32
2 Evolution of Foot Orthoses in Sports 34
Definition of Foot Orthoses 34
Historical Evolution of Foot Orthoses 35
Research and Theory on Orthosis Function 35
Research on Therapeutic Effectiveness of Orthoses 36
Theories of Foot Orthosis Function 37
Research on Biomechanical Effects of Foot Orthoses 43
Foot Orthoses Alter Foot and Lower Extremity Kinematics and Kinetics 44
Foot Orthoses Alter Contractile Activity of Lower Extremity Muscles 45
Foot Orthoses Improve Postural Stability 45
Foot Orthoses Reduce Plantar Forces and Pressures 46
Conclusion 47
References 47
3 Athletic Foot Types and Deformities 51
Normal Foot Motion and Biomechanics During Gait 51
Foot Types 52
Functional Foot Disorders 53
Examples of Foot Deformities in Athletes 53
Lower Extremity Pathology 54
Calcaneal Apophysitis 54
Kohler's Disease 54
Freiberg's Disease 55
Heel Spur Syndrome or Plantar Fasciitis 55
Sesamoiditis 56
Stress Fracture 56
Ankle Sprains 56
Patellofemoral Dysfunction 58
Interdigital Neuroma 58
Achilles Tendonitis 58
Posterior Tibial Tendonitis 58
Hallux Abducto Valgus 58
Hammer Toe Deformity 59
Tailor's Bunion 59
Treatment 60
References 60
4 Clinical Gait Evaluation of the Athlete 61
Technology 62
Digital Video Analysis: 3D Analysis 62
Digital Video Analysis: 2D Analysis 63
Pressure Analysis 63
Methodology 64
Video Analysis Methodology 65
In-Shoe Pressure Methodology 66
Conclusion 67
References 68
5 Athletic Shoe Evaluation 69
Anatomy of an Athletic Shoe 69
Last 70
Toe Box 70
Vamp 70
Balmoral Versus Blucher 70
Outer Sole 70
Midsole 71
Upper 71
Heel Counter 71
Function of Athletic Shoes 71
Clinical Assessment of Athletic Shoes 73
Fit 73
Insoles 73
Forefoot Flexibility 74
Midfoot Sagittal Stability 74
Midfoot Frontal Stability 74
Lateral Midsole Heel Cushion 75
Medial Midsole Heel Density 75
Heel Counter 75
Outsole Surface Area 76
Conclusion 76
6 Athletic Shoe Fit and Modifications 77
Shoe Fitting 77
Size 77
Shape 78
Stability 78
Style 79
Athletic Shoe Modifications 80
Shoe Stretching 81
Conclusion 81
7 Athletic Socks 82
Historical Background 82
Basic Sock Design and Construction 82
Fiber Composition 84
Moisture Management 84
Fibers Used for Athletic Socks 85
Clinical Benefits of Athletic Socks 87
Impact and Pressure Reduction 87
Friction Blisters 88
Potential Clinical Benefits 89
Conclusion and Recommendations 89
References 90
8 Athletic Shoe Lacing in Sports Medicine 92
Athletic Shoelace Materials 92
Athletic Shoelace Shapes 92
Athletic Shoelace Lacing Techniques 93
Standard Crisscross Lacing Pattern 93
Non-crossing, Parallel Lacing Pattern 94
Outside-Eyelet, Crisscross Lacing Pattern 95
Inside-Eyelet, Crisscross Lacing Pattern 96
Distal--Medial Eyelet Lacing Technique 97
Heel Lock Lacing Modification 97
Open Distal Eyelet Lacing Technique 98
Open Eyelet Lacing Technique 98
Athletic Shoelace Technology 98
Athletic Shoelace Specialized Systems 99
Athletic Shoelace Lengths 100
Summary 100
9 Prefabricated Insoles and Modifications in Sports Medicine 101
Definitions 101
Benefits of Insoles 102
Summary 106
References 106
10 Orthodigital Devices in Sports Medicine 107
Guidelines for Fabrication of an Orthodigital Device 108
Step-by-Step Process for Fabricating an Orthodigital Device 108
Summary 112
References 113
11 Evidence-Based Orthotic Therapy 114
Evidence for Orthotic Therapy 115
Plantar Fasciitis 116
Functional Hallux Limitus 118
Tarsal Tunnel Syndrome 119
Knee Pain 120
Summary 120
References 121
12 Custom Foot Orthoses 123
Material and Flexibility 124
Correction and Positive Balancing 125
Orthosis Extensions and Additions 127
References 128
13 Ankle Foot Orthoses for the Athlete 129
Terminology 129
Types of Ankle Braces and Ankle Foot Orthoses 129
Treatment Effects of Ankle Braces and Ankle Foot Orthoses 133
Studies of Kinetics and Kinematics of Ankle Braces 133
Studies of Kinetics and Kinematics of Ankle Foot Orthoses 136
Effects of Ankle Bracing on Sports Performance 137
Balance and Proprioception 138
Prevention of Injury 139
Treatment of Injury 140
Summary 141
14 Prescribing Athletic Footwear and Orthoses: The Game Plan 143
The Guidelines for a Customized Footwear Prescription 143
Determine the Foot Type 144
Determine the Foot's Function During Gait 144
Consider Any Foot Pathology 145
Consider the Size and Weight of the Athlete 145
Consider the Athlete's Demands from the Sport 145
Assess Key Features of the Athletic Shoe 146
Athletic Shoes 146
Athletic Socks 149
Athletic Shoe Laces and Lacing Techniques 149
Pre-fabricated Athletic Shoe Insoles 149
Athletic Shoe Modifications 149
Referral for Custom Foot or Ankle Orthoses 149
Prescribe Athletic Custom Foot Orthoses and Modifications 150
Prescribe Athletic Ankle Foot Orthoses and Modifications 150
Follow-Up Re-assessment for Possible Modifications After Wear-Testing 150
Summary 150
Part II Sport-Specific Recommendations 151
15 Walking and Running 152
Gait Biomechanics: Walking vs. Running 152
Classification of Running Foot Types 153
The Neutral Foot 153
The Pronated Foot 153
The Cavus Foot 153
Classification and Selection of a Running Athletic Shoe 153
Normal Arch 154
Flatfoot Arch 154
High Arch 154
Types of Running Shoes 155
Running Socks 156
Custom Running Orthoses 157
Injuries That Influence Running Shoe Selection 158
Functional Hallux Limitus 158
Plantar Fasciitis 158
Achilles Tendonitis 158
Anterior Shin Splints 159
Posterior Shin Splints 159
Runner's Knee 159
References 159
16 Racing, Cross-Country, and Track and Field 160
Purpose of Specialized Shoes 160
Types of Racing Shoes 161
Lightweight Trainer 161
Road Racing Flat 161
Spike Plate 161
Cross-Country 162
Track and Field 163
Sprints 163
Middle and Long Distance 163
Jumps 164
Throws 165
Putting It All Together 165
Spikes 166
Training 166
Skin Issues 167
Support 167
17 Triathlon and Duathlon 170
Overuse Injuries 171
The Act of Running: Single Support and Double Float (Swing) 172
The Act of Cycling: Spinning Through Power and Recovery Phases 175
Biomechanic Role of the Foot 176
Anatomy of a Triathletes Running and Cycling Shoes 178
The Running Shoe 178
The Cycling Shoe 181
Classifying Running Shoes 183
Finding the Perfect Triathlon Shoe 184
Pedal and Cleat Systems 187
Socks for the Triathlete 187
Foot Orthoses Success 189
The Athlete and Overuse Injuries 198
The Older-Aged Triathlete 198
18 Cycling 201
Cycling Biomechanics and Considerations 201
The Pedal Cycle 202
Pedaling Technique 203
Pedaling Forces 204
Cycling Injuries and Risk Factors 204
Cycling Footwear 205
Cycling Shoe Fit 206
Cycling Shoe Construction 206
Road Cycling Shoe Construction 206
Sport Cycling Shoe Construction 209
Mountain Biking Shoe Construction 210
Cycling Cleats 211
Pedals 213
Foot Position on the Pedal 214
Cycling Insoles 214
Cycling Orthoses 215
Socks 216
Footwear Recommendations and Modifications for Prevention and Treatment of Injury 216
Knee Pain 216
Iliotibial Band Syndrome 217
Limb Length Inequality 217
Achilles Tendon and Posterior Heel Pain 218
Plantar Fasciitis 218
Forefoot Pain and Injuries 218
The Future of Cycling Footwear 219
References 219
19 Racquet Sports: Tennis, Badminton, Squash, Racquetball, and Handball 222
Court Design and Surfaces 222
Biomechanical Demands of Racquet Sports 223
Common Injuries 223
Racquet Shoe Design 224
Injury Prevention 225
Performance 226
Comfort 227
Desirable Features of A Court Shoe 228
Orthoses 228
Summary 229
References 229
20 Football 231
Foot Structure as It Relates Specifically to Football 234
The Rectus Foot Type 234
The Pronated Foot Type 234
The Supinated Foot Type 235
Footwear Recommendations 237
Historical Background 237
Cleat Selection 238
Materials 238
Lacing Techniques 239
Ankle Spatting 239
Ankle Bracing 239
Orthoses 239
Sock Selection 240
Footwear Recommendations for Common Football Pathologies 240
Turf Toe 240
Sesamoiditis 240
Neuroma 241
Metatarsalgia 241
Lateral Ankle Sprains 242
Syndesmotic Ankle Sprains 242
References 242
21 Soccer 244
Lower Extremity Biomechanics and Considerations of Soccer 244
General Footwear Recommendations 245
Anatomy of a Soccer Shoe 245
Upper Materials 245
Outsole Materials 246
Molded Shoes 246
Detachable Cleats 246
Turfs 247
Hybrid 247
Indoor 248
Midsole 248
Lacing 248
Shin Guards 248
Orthoses 248
Common Injuries and Preventions 249
Apophysitis 249
Plantar Fasciitis 249
Achilles Tendonitis 250
Soccer Toe 250
Inversion Injuries 250
Conclusion 250
References 251
22 Skating 252
Hockey Skate Boots 252
Goalie Skates 254
In-Line Skates 255
Figure Skates 255
Speed Skates 257
Biomechanics 257
Clinical Injury Perspective 258
Clinical Biomechanical Balance 259
Step 1: Foot Balance Within Boot-Custom Foot Orthosis 259
Step 2: Blade Balance 261
Case 1: Moderate Pronation 265
Case 2: Moderate--Severe Pronation 266
Case 3: Supinated Pes Cavus Foot Type 268
Conclusion 269
References 270
23 Skiing and Snowboarding 272
Downhill Skiing 272
Tibial Varum 274
Tibial Valgum 274
Forefoot Varus 275
Snowboarding 276
Cross-Country Skiing 277
References 278
24 Basketball and Volleyball 280
Custom Foot Orthoses 282
Sport-Specific Pathology 283
Lateral Ankle Sprain 283
Plantar Fasciitis 283
Other Injuries 284
Jones Fracture 284
Summary 284
References 285
25 Aerobic Dance and Cheerleading 287
Aerobic Dance 287
Urban Rebounding 290
Kickboxing 291
Cheerleading 291
References 294
26 Dance 295
Lower Extremity Biomechanics and Considerations in the Evaluation of the Dancer 295
The Foot 296
The Functional Examination 297
The Knee 298
The Hip 298
General Flexibility and Strength 299
What to Look for at the Foot and Ankle 299
The Ankle Joint 301
The Midtarsal Joint 301
Footwear Recommendations and Modifications 302
Foot Hygiene 303
References 304
27 Baseball and Softball 306
Lower Extremity Biomechanics and Considerations of Baseball and Softball 306
General Footwear Recommendations 307
Footwear Modifications 307
Pathology Specific (Acute and Chronic) 307
References 309
28 Special Olympics 310
References 321
Part III Coding and Billing 322
29 Durable Medical Equipment and Coding in Sports Medicine 323
Definition 323
Durability 324
Medical Equipment 324
Medically Necessary 324
Not Medically Necessary 325
Licensure 325
Assignment 326
Participating Supplier 326
Non-participating Supplier 326
FEE Schedule 327
Communication 328
Office Forms/Policies 328
Billing Protocols 328
NPI Number 329
Place of Service 329
Obtaining a Denial 329
Incorrect or Overpayment 330
Modifiers 330
Deductibles and Deposits 331
Sales Tax 331
Dispensing Requirements 331
Patient Education 332
Replacement Interval 332
Inability to Deliver DME 332
Specific Items 333
Orthoses 333
Custom Foot Orthoses 333
Biomechanical Examination 334
Gait Analysis 334
Orthoses HCPCS Codes 334
Orthosis Modifications 335
E/M Services with Regard to Orthosis Management 335
Postoperative/Wooden Shoes/Cast Shoes 336
Covered Items 336
Non-covered Items 336
Strapping 337
Casts 337
Billing Scenario 337
Visit 1 337
Sample Billing 338
Visit 2 338
Sample Billing 338
Visit 3 339
Sample Billing 339
Visit 4 339
Sample Billing 339
Visit 5 339
Sample Billing 340
Further Follow-Up 340
Visit 6 340
Sample Billing 340
Visit 7 340
Sample Billing 340
Visit 8 341
Sample Billing 341
Visit 9 341
Sample Billing 341
Visit 10 341
Sample Billing 342
Visit 11 342
Sample Billing 342
Conclusion 342
Index 343

Chapter 1 Evolution of Athletic Footwear (p. 4-5)

Steven I. Subotnick, Christy King, Mher Vartivarian, and Chatra Klaisri
History of the Running Shoe

Shoes are vital to man’s sole. It is no secret that feet manage the challenges of daily life with the help of shoes. Shoes can stabilize, allow for flexibility or rigidity, cushion, and, in some cases, even injure feet. With the evolution of fast-paced lifestyles, shoes have been scientifically engineered to provide the most comfort and to perform at the highest level for the individual who wears them, but shoes have not always been as systematically constructed.

The earliest footwear ever recorded was discovered by Luther Cressman inside Fort Rock Cave in Oregon and dated to the end of the last ice age, making it almost 10,000 years old [1]. The simple construction incorporated sagebrush bark knotted together, creating an outsole with ridges for traction, a covering for the forefoot, and straps to go around the heel. Although people did not devote much attention to detail when making shoes in the past, even early human beings realized that a basic piece of material covering their feet could afford them the opportunity to explore a larger part of their world.

Ancient History

As the Olympics gained much success in a remarkable empire, the society began to devote more attention to shoes. Most ancient Greek athletes barely wore any clothes let alone running shoes, but these dedicated competitors began to observe that champions from colder climates wore race sandals [2]. Thus, the Greeks gave up the initial notion that their rivals were cheating and realized that this type of foot covering actually increased traction. As the popularity of competitive events in ancient civilizations grew so did the advancement of running sandals.

a type of antelope or gazelle. In the 1980s Reebok explored the market of women’s shoes by designing a flimsy but eye-catching shoe, and the aerobic era added to Reebok’s faithful following [2]. The Reebok Freestyle was developed to be worn in or out of the gym. Later in the decade, Reebok created the Pump, consisting of an air bladder in the tongue of the shoe, to hold the ankle in a more fixed position.

The Amazing Dassler Brothers

In Germany Adolf Dassler began making shoes in 1920 and was later joined by his brother, Rudolph. Their popular shoe was worn by successful German athletes and even donned by Jesse Owens in at least one of his races at the 1936 Munich Olympics [1]. Despite their success, a bitter family feud in 1948 divided the brothers, their small community in West Germany, and the thriving shoe company. Adolf Dassler created Adidas while Rudolph formed Puma, and the two companies have been competing in the runner’s world ever since. Adidas assumed the trefoil sign that represented Adolf’s three sons [1]. He used arch support lacing which is an early form of speed lacing and the classic, three stripes to help support the foot in his shoes [1]. On the other side of town, Puma chose the leaping puma as its logo to convey speed and power.

Tiger Shoes and ASICS Join the Chase

Onitsuka Co. Ltd. started constructing shoes in 1949. At the 1951 Boston Marathon a young, Japanese runner by the name of Shigeki Tanaka won the coveted race and displayed the Tiger shoes as he crossed the finish line. This shoe was designed with the traditional, Japanese shoe, the Geta, in mind and had a separate compartment for the big toe. The shoe with the divided toe box could only be worn by Japanese athletes with a large space between the first and second digits [1]. Eventually, the shoe company known as Tiger became ASICS, which is a Latin acronym for “healthy mind in a healthy body.”

New Balance and Intelligent Design

William J. Riley founded the Riley Company, the predecessor to New Balance, and began crafting shoes in the New England area in 1906. In 1961 the new owner of New Balance, Paul Kidd, took the experience he had gleaned from making orthopedic shoes, poured his knowledge into a running shoe, tested it scientifically, and invented the first modern running shoe, the New Balance Trackster [1]. Due to interest by runners, New Balance modified its Trackster by increasing the heel height, adding a continuous outsole, and placing a wedge of rubber under the back part of the heel.