Thousands of miles. Three different conferences so far. Hundreds of docs presented to. And the same exact question keeps being asked over and over.
So I thought today I’d address it directly.
Let me be straight upfront. This is not an attack on Foot Levelers. The same key differences I’ll be discussing apply to all traditional orthotics. It’s just that it’s that specific question I’ve been asked repeatedly, at every event I’ve attended. Their level of market penetration over here is truly impressive.
This is not a discussion of better or worse… just different. Two completely different approaches, aiming to achieve different clinical targets.
With that being said, let’s get into it.
Because it is an important question. And it’s answer really defines the entire point of Better Balance Orthotics.
The short answer is:
It’s the PARADIGM.
The long answer is… everything else.
Let’s start with the short answer first.
Every traditional orthotic I’ve ever seen (and I’ve investigated hundreds) is asking the same question-
“How can we stabilise and/or support the foot?”
They are all some version of an arch support.
Better Balance Orthotics begin with a completely different question-
“What input do we need to change to encourage the foot, and consequently the entire body, to function better?”
Better Balance Orthotics are not an arch support. They are a neurological stimulation device that happens to work through the feet.
Why the feet?
Because outside of the cervical spine, they’re one of the most mechanoreceptor-dense areas of the entire body. Changing the input here gives us one of the highest bang-for-our-buck interventions available.
We call it the…
Stimulation vs Support Paradigm.
When you support something, you naturally reduce its function. It doesn’t have to work as hard to achieve its outcome… so it doesn’t.
This is known as a negative feedback loop. An example is when you take exogenous hormones, such as melatonin or oestrogen. The body recognises that levels of that substance are already high in the blood, so it naturally downregulates production.
This is simply an efficient, intelligent response.
A more mechanical example, which I often share with my patients, is the idea of wearing a back brace. I ask them…
“If you had back pain, and I gave you a back brace to wear every day, your back might feel better in the short term… but do you think over time it would get weaker or stronger?”
They always get the right answer. They intuitively understand that the brace is doing the work that ideally their back should be doing for itself.
The same concept applies to any form of arch support, or even a modern shoe. They’re all trying to “do the work for us.”
The consequences of this are significant. The more we rely on external supports, the more reliant we become on that support.
I think that’s one reason why I hear so often when talking to chiropractors: “There’s just always been something that didn’t quite sit right with me about orthotics.”
I believe what they’re trying to articulate is the cognitive dissonance generated by the paradigm mismatch between the idea of external support and the Above Down, Inside Out (ADIO) paradigm that chiropractic is founded upon.
My understanding of the human body is that it is naturally designed to heal, grow and thrive. My job as a chiropractor is to remove interference from the nervous system so it can do exactly that. The idea of external support doesn’t fit neatly into that framework.
In order for the nervous system to function optimally, and therefore express optimal health, it doesn’t need more support from the environment. It needs more information.
In other words, it needs more Stimulation.
That’s exactly what Better Balance Orthotics were designed to provide.
A question I was asked the other day was…
“But what if their arch is collapsed… don’t they need that support?”
This is a fair question, but it fails to take into account the incredible adaptive capacity of the human body and nervous system.
Supporting the arch is fine, and sometimes may even be necessary, but that arch will always continue to require that support.
On the other hand, if we stimulate the muscles, nerves and fascia that comprise the arch, they will begin to adapt, strengthen and become more functional. This is no different to muscles growing in response to weightbearing exercise. If you demand more of the body, it adapts accordingly.
Of course, this doesn’t happen overnight… but with continued stimulation, it does happen.
Just the other day at the event I attended in Green Bay I had a doc telling me that he now has arches in his feet for the first time in his life. I had the same experience. Because I wasn’t expecting it, I wasn’t looking for it, so I couldn’t even say exactly when it happened.
I’ve shared the story before of how Jodie one day noticed that my footprint had changed when we were walking on the beach. I think at that point I had been wearing the orthotics for a few years.
When it comes to postural changes, I expect to see them happen quickly. In my clinic we retake our posture photos 3 months after prescribing the orthotics. Of course, those changes continue and consolidate over time.
When it comes to lasting, long-term structural changes like bunions straightening or arches visibly lifting, I tell my patients to give it 12 months. I actually think it often happens faster, but I think that’s a reasonable expectation to set.
It’s always better to under-promise and over-deliver.
So that’s the short answer (I realise it wasn’t actually that short!)
But with that understanding in place, the long answer becomes quite short.
Here’s the rundown:
Traditional orthotics are relatively rigid. Better Balance orthotics are completely soft and flexible.
Traditional orthotics provide support. Better Balance orthotics provide Stimulation.
Traditional orthotics may not fit in some shoes. Better Balance orthotics fit in virtually any shoe (I’ve even worn them in my snowboarding boots. The only possible exceptions I’ve found may be hockey skates and some soccer cleats.)
Traditional orthotics may or may not be comfortable. Due to their soft, flexible and minimalistic nature, Better Balance orthotics are generally considered very comfortable– in fact after the first week most patients don’t even notice they’re wearing them.
Traditional orthotics are only helping while you are wearing them. Better Balance orthotics function more like a rehab device, so their benefits persist even when you’re not wearing them.
This one deserves a little more explanation… it’s one of the things I genuinely love about our paradigm. When I used to wear (and prescribe) traditional orthotics, I would tell my patients…
“You have to wear these as much as possible, if you’re not wearing them, they’re not helping you.”
This is not true of Better Balance orthotics.
I live in Sydney, Australia. For 6 months of the year, it’s hot. That means I’m wearing thongs (flip flops for my US friends.) Back in the days when I wore traditional orthotics, that meant my lower back hurt for 6 months of the year… my feet were lacking the support they had come to rely on, and my pelvis and spine were suffering as a result.
That doesn’t happen anymore.
These days I wear thongs with impunity… no more back pain (I feel like this is kind of an embarrassing admission for the “foot guy” that I’ve somehow become… but come on- it’s hot!)
Wearing my Better Balance orthotics for the last 10 years has genuinely rehabilitated my feet (and brain.) I have arches now. I can get away with wearing crappy footwear for a good portion of the year and function effectively. I can’t tell you what a blessing this has been.
This leads me to the next point…
Traditional orthotics create temporary support. Better Balance orthotics create lasting correction and long-term structural change.
I realise this is a controversial claim and open to debate- at this point we simply don’t have the published, peer-reviewed evidence to support it. Yet I stand behind it. My clinical experience over the last decade or more completely aligns with it.
The reality is… research is expensive. And we’re small (for now.) We simply don’t have the $ to back this up yet. But I believe that’s coming. Every paradigm shift didn’t make sense… until it did. Watch this space.
One thing I will say is that the published literature increasing supports this position. There are more and more studies validating the mechanisms that I’m describing. We’re building a database of those studies.
Today I presented at the National Nutrition Standard conference in Fort Lauderdale to an audience of DCs, MDs and Functional Medicine Specialists. It was the most highly-referenced, evidence-informed presentation I’ve ever given. And it was well received.
Clinical experience has almost always preceded scientific validation. If you’re reading this, and utilising Better Balance Orthotics with your patients, you’re on the cutting edge. Thank you for taking a chance with us, and being open-minded enough to validate our paradigm with your own experience.
There’s one thing I’m sure of… the scientific validation is coming. There is a rapidly evolving body of peer-reviewed literature on the effects of “somatosensory stimulation foot orthoses.” These are not our orthotics (I’ve looked at them, and I believe ours are lightyears better) but they are genuinely validating our paradigm.
The fact that Nike have released the “Nike Mind” shoes, claimed to enhance recovery through plantar foot stimulation, gives a clue as to where the research is headed. As they say… follow the money.
The revolution is coming. The question is… will you be on the right side of it?
Cheers,
PS. One other question I’ve been asked a bunch of times throughout my trip is… “I’ve been prescribing Foot Levelers for years… how do I introduce this to my patients?”
The key is that the old thing is not wrong, the new thing is just different. My experience has been that patients love the fact you are learning, evolving and bring the latest innovations to their care. I’ve been working on some scripts and systems that allow you to seamlessly transition to bringing this new technology to your patients in a way they completely understand and appreciate. If you’d like me to send it to you, just reply TRANSITION to this email and I’ll send it your way.