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Does shoe insole modification prevent stress fractures? A systematic review
Rebecca A Snyder1, Joseph P DeAngelis, Michael C Koester
1Vanderbilt University School of Medicine, Nashville, TN, USA.
Summary
Shoe insoles may help prevent stress fractures, particularly in the femur and tibia, for military personnel. However, evidence for their effectiveness in athletes remains inconclusive, requiring further research.
Area of Science:
- Sports Medicine
- Biomechanics
- Orthopedics
Background:
- Stress fractures pose a significant risk to athletes and military personnel.
- Insoles are hypothesized to reduce stress fracture incidence by enhancing biomechanics, mitigating fatigue, and absorbing impact.
Purpose of the Study:
- To systematically review the highest-quality evidence on the efficacy of insoles for preventing stress fractures in high-risk populations.
Main Methods:
- A systematic review of randomized (Level I) and quasi-randomized (Level II) controlled trials.
- Searched databases: MEDLINE, Cochrane, Current Controlled Trials, UK National Research Register, ScienceDirect, CINAHL, and EMBASE.
- Intervention: insoles; Outcome: stress fracture incidence.
Main Results:
- Five trials were included; pooled analysis indicated a benefit of orthotic use.
- A significant reduction in overall stress fracture incidence was observed in one study using semirigid insoles.
- Stratification revealed reduced incidence of femoral and tibial stress fractures.
Conclusions:
- Shoe insoles may decrease overall femoral and tibial stress fracture incidence during military training.
- The effectiveness of insoles in preventing stress fractures in athletic populations is currently unclear.
- Further research is needed to establish the efficacy of insoles for athletes.