Prescribing Orthotics For Pediatric Soccer Players

Start Page: 70
Clinical Editor: Nicholas Sol, DPM

Q: What recommendations do you make regarding soccer shoes?
Since it can be a challenge to fit soccer shoes, Dr. Schwartz notes he works with the athletes’ parents on proper shoe fit and the proper technique for ball striking. He tells patients to look for the same qualities as they would in any performance shoe. The heel counter should not be too loose or flimsy. Dr. Schwartz says he’ll check the torsional stablility of the shoe to control excessive frontal plane motion and makes sure the shoe flexes at the first MPJ to allow for sagittal plane motion.
Dr. Schwartz cautions parents that although shoes with extra heel cleats allow for greater traction, they can cause increased Achilles pressure and lead to a calcaneal apophysitis.
The more stable shoes are a better fit for sports activities, according to Dr. Huppin. He notes that “hard ground” shoes with multiple smaller cleats generally tend to be more stable than “soft ground” shoes with fewer, larger cleats. As far as soft ground shoes go, those with bladed cleats tend to be more stable than those with traditional cleats.
Drs. Huppin and Schwartz agree that fitting soccer orthoses remains a challenge for numerous reasons.
“The shoe should fit tight for the ‘feel’ of the ball but that same tightness can lead to problems like ingrown toenails,” points out Dr. Schwartz.
As Dr. Huppin notes, soccer shoes traditionally have less volume than other athletic shoes so a removable sock liner is helpful in fitting orthoses. He also recommends patients purchase shoes after they receive their orthoses so they can try on both together.
Be ready to adjust the orthoses for size if necessary, Dr. Huppin cautions. If your patient already has shoes, he advises you to send them and the negative casts to your orthotic lab so the orthoses can be fitted directly into the shoe.
Dr. Sol believes soccer shoes have yet to incorporate many of the features necessary to address soccer’s complex biomechanics. “I think that many important changes will be made to soccer shoes in the near future,” he notes.

Dr. Sol (shown at the right) founded the Walking Clinic, PC and practices in Colorado Springs, Colo. He is a consultant to Tekscan.
Dr. Huppin is the Director of Education for ProLab Orthotics/USA and is an Adjunct Associate Professor in the Department of Applied Biomechanics at the California College of Podiatric Medicine.
Dr. Schwartz practices at St. Paul’s Hospital in Dallas, Texas.

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