The Neurorthotic™ Paradigm

neurorthotic paradigm

What does Neurorthotics mean and why is it important?

Definition

Neurorthotic is simply a combination of the terms neural and orthotic in one word. Orthotic refers to an artificial mechanical support, in our case of the foot. Neural (neurological) in this case emphasises the importance of the neurological aspect in this equation.

Why is this important?

Orthotic aspect

The vast majority of current orthotic supports still predominantly concern themselves with a mechanistic approach to foot support. What I mean by that is that orthotic devices mostly are concerned with correcting foot malfunctions by mechanical means. This is mostly done through a corrective contour of the medial or lateral foot arches and occasionally a rearfoot slant in order to force the foot out of its excessive distortion into a more neutral position. It is then also assumed that this has a flow off effect into general posture and locomotion.

The wast majority of current orthotic supports still predominantly concern themselves with a mechanistic approach to foot support.

Traditionally the footwear industry has further assisted (corrupted?) this process by adding ever-new vertical shock absorption materials to minimise impact stress. All sounds good so far…

However looking at the continuous deterioration of our feet and examining the long-term research of these devices, the results simply don’t appear to stack up.

Neurological aspect

The main point of the current shortcomings is that the role and the behaviour of the nervous system has either not been considered or rather from my experience, not been understood.

Posture and healthy movement depend on excellent kinaesthetic (position/movement) awareness and accurate somatic (body) coordination…these are neurological phenomena not mechanical functions.

Therefore it is imperative that we understand in very simple terms how the nervous system functions, what it likes or dislikes so to speak!

If we only think in mechanistic terms, chances are we will work against our desired outcome, as we are not aligned with our nervous system!! The long-term consequence will be a further deterioration of our feet and all the associated sequelae.

Basically we should know 2 different qualities of the nervous system:

  1. It needs a lot of stimulation or in other words a lot of communication between brain and target organs (feet in our case).
  2. It likes novelty experiences also known as problem solving

1.

In todays urban environment we sadly lack stimulation to our feet due to the predominantly flat hard surfaces and the excessive shoe wear. A built up high contoured orthotic device whilst initially forcing physical alignment, will further add to this foot confinement (see article the silent foot). The understimulation is largely why we are in this mess in the first place!!

2.

The novelty experience is probably even more important and less understood. Simply put, the nervous system likes uncertainty followed by certainty. This is what it gets every step when barefoot on natural surfaces. For instance on grass there is the upper layer softness (uncertainty) followed by the lower layer firmness (certainty). The softness/firmness ratio can vary greatly but interestingly this does not seem to matter much as long as it’s there. It even can be translated to an unknown/known surface angle (as for example on a cobble stone surface: the brain is not quiet sure of the angle (uncertainty) until the weight pushes the foot onto the surface (certainty)).

Posture and healthy movement are neurological phenomena not mechanical functions.

Two further important functions have not been addressed in this article, but I believe are worth mentioning:

  1. Foot conditioning
  2. Shock absorption

Both of these areas will be discussed in further detail in a coming article. Suffice to say though that neither aspect have been properly addressed in the current mechanistic approach, therefore leading to more problems down the track.

New research also has found that (foot) sole friction with the walking surface has a major input on neural organisation.

We also know that fascial tension (e.g. plantar fascia) interphases with the autonomic nervous system (involuntary nervous system). So were does it all finish?

Outcome

We could continue to dissect neurological and physiological research showing the importance and effects of the nervous system on what is happening to our feet in our modern environment.

The point of this article is simply to emphasis that when dealing with footbeds or orthotic supports we cannot simply consider the mechanistic effects, we have to incorporate a neurology understanding!

equilibras™ are not only a fashionable flat-sole footwear but were specifically designed to satisfy not just the orthotic (mechanical) features but also the neurological requirements. Thus it is the world's first flat-sole registered by the TGA as a Class 1 medical device. Therefore we call it a Neurorthotic device.

equilibras™ are not only a fashionable flat-sole footwear but were specifically designed to satisfy not just the orthotic (mechanical) features but also the neurological requirements.