US20140053430A1 - Orthotic insole - Google Patents

Abstract

The present disclosure provides an orthotic insole1 comprising a cupped heel plate2 with an extension portion3 extending forward of the heel plate2 and terminating in the region of the talonavicular junction on the plantar aspect of the foot, the extension portion is cut away at both a lateral portion4 and medial portion5 so that the extension portion forms a central band. The insole supports and facilitates motion and alignment of the arches of the foot by the application of a dorsiflexory force, a force applied in an upward direction, to a defined central area whilst facilitating medial and lateral movement of the foot by only primarily supporting the central portion of the calcaneum (heel bone) and plantar aponeurosis (plantar fascia) from its origin at the calcaneum tuberosity.

Description

PRIORITY APPLICATIONS
• This application is a National Phase Application of and claims priority to PCT/EP2012/058620 filed May 10, 2012, which claims priority to Great Britain Patent Application No. 1108203.9, filed May 17, 2011, the disclosures of which are incorporated herein by reference in their entireties.
FIELD OF THE DISCLOSURE
• The present disclosure relates to an orthotic insole and in particular to an orthotic insole that can be inserted into an existing shoe. However, an orthotic insole in accordance with the present disclosure may also be used as an integral part of the construction of a shoe.
BACKGROUND
• Available designs of insoles, orthotics and arch supports work on the premise that the instep, medical longitudinal arch, or natural arch of the foot requires support and this is achieved by physically filling the natural arch of the foot. The instep is therefore fully supported by one or more of a variety of materials, which control and support the foot function by infill of the arches. These devices are tolerated, but may take time to adjust to the foot. Also due to the necessity of width and length they are sometimes difficult to accommodate into footwear.
SUMMARY
• It is an object of the present disclosure to provide an alternative form of orthotic insole.
• It is a further object of the disclosure to provide an insole which facilitates and improves effective foot motion
• It is a further object of the disclosure to provide an insole which facilitates improved weight bearing of the foot instep.
• It is a further object of the disclosure to provide an insole which facilitates optimal (and normal) functioning of the plantar fascia (plantar aponeurosis) tendon including the “windlass mechanism”, a podiatric term to denote the “winding up” of the deep flexor tendon as the first metatarso phalangeal joint—big toe—bends into a 90° position for propulsion and “toe off” stage in gait. The disclosure seeks to aid this propulsive movement by enabling and not obstructing the medial longitudinal arch component.
• Still another object of the disclosure is to provide an insole which can more easily fit into footwear and improve shoe wearer comfort.
• According to the present disclosure there is provided an orthotic insole comprising a cupped heel plate and an extension portion extending forward of the heel plate and terminating in the region of the talonavicular junction on the plantar aspect of the foot, the extension portion being cut away in both a lateral portion and a medial portion, so that the extension portion forms a central spur.
• The term “cut away” is used to describe the shape of the insole and does not relate to the method of forming the “cut away” portions.
• The insole will preferably be designed for either the right or left foot, wherein the medial portion is more extensively cut away than the lateral portion.
• The present disclosure provides an insole which may be inserted into a shoe or which alternatively may be integral with the structure of the shoe. Where the insole is to be inserted in a shoe the heel plate is generally configured in the shape of a cupped heel base to the calcaneum area, so that the centrally placed extension of the insole extends to the soft tissue junction of the talar navicular joint and is retained in place below the talar navicular joint by the shape of the heel portion being retained in place by the shoe and the wearer heel. An insole in accordance with the present disclosure supports and facilitates motion and alignment of the arches of the foot by the application of a dorsiflexory force, a force applied in an upward direction, to a defined central area whilst facilitating medial and lateral movement of the foot by only primarily supporting the central portion of the calcaneum (heel bone) and plantar aponeurosis (plantar fascia) from its origin at the calcaneum tuberosity.
• The plantar fascia tendon has three distinct segments; medial, central and lateral. For normal gait patterns the requirement is for the foot to pass through the fulcrum of force and momentum in a centrally, symmetrically manner for the most appropriate mechanics, because normal foot motion requires a balance between pronation and supination throughout the gait or walking cycle, where any deviance to the lateral is referred to as supination and any deviance to the medial is referred to as pronation.
• In anatomical skeletal terms the central ligament of the plantar fascia has its origin from the calcaneus (heel bone) and the three segments to the plantar fascia run under the transverse arch consisting of cuboid, navicular and cuneiforms. The plantar fascia then inserts into the distal phalanges of the toes as tendon slips.
• Other muscles involved in the functioning of the foot are Quadratus Plantae, flexor hallucis longus, the peroneal tendons and abducto hallucis longus and tibialis posterior.
• When a human biped is walking or running the foot arches supported by the tendon and ligament complex normally facilitate the central support and fulcrum for forward propulsion. Along with ankle movement (plantarflexion and dorsiflexion) sub talar joint motion (tri-planar and then onto mid-tarsal joint movement culminating in the propulsive toe-off phase). A complex tri-planar movement.
• By wearing shoes with varying heel heights the normal foot function can be impaired. The lesser metatarsal arch has to load for longer time sections as the shoe front loads the foot mechanics. By taking into account the requirement for dorsiflexory force in this defined area, the plantar fascia and central soft tissue anatomical positions can be enhanced.
• Impaired biomechanical foot function, not related to pathological excess pronation (hyperpronation) or supination leads to excess forces loading prematurely on to the lesser metatarsals heads and increases tendencies for the formation of callosities on the plantar aspect of the ball of the foot, buckling or hammering of lesser toes as the plantar fascia insertions are involved prematurely and excessively in the gait cycle.
• By employing the present disclosure, the central portion of soft tissues and skeletal structures is supported facilitating improved effective foot motion and improved weight bearing of the foot instep whilst permitting normal functioning of the plantar fascia tendon including the “windlass mechanism”. Also by placing a supportive uplift to the central portion of the soft tissue, the skeletal structures terminating at the talonavicular joint, an insole in accordance with the present disclosure results in the ease of pressure on the distal aspects of the weight bearing aspects of the metatarsals.
• The cut away portions of the insole, preferably with more insole material on the medial side being absent than on the lateral side, facilitates the normal motion of the central ligaments and the transverse keystone arch of the foot.
• The insole may be formed from a polypropylene material and advantageously comprises a single homogenous structure. The composition of the insole may comprise copper, known to have healing properties. The material of the insole is preferably a semi-rigid material.
• It is advantageous if the distal end of the extension portion of the insole curves downwards, such that the extension portion forms an arch with a void below the arch, thereby permitting the extension portion to flex when inserted into a shoe and weight is applied to the upper surface of the insole, permitting a more constant force to be applied by the extension portion to the foot than would be the case if there was not a void below the extension portion.
• Preferably, the insole is dimensioned such that 80% of the area of the insole has a thickness of between 3 and 5 mm, enabling it to be accommodated in a shoe and to provide the required rigidity. Advantageously, a central portion in the length direction of the extension portion, is between 40% and 60% of the maximum width of the insole. Also it is preferable that the medial portion is cut away by more than 25%, but less than 40% of the maximum width of the insole and/or that the lateral portion is cut away by more 15% but less than 30% of the maximum width of the insole.
• The insole preferably has a total length of between 100 and 150 mm, such that it terminates in the region of the talonavicular junction of the foot of a wearer.
BRIEF DESCRIPTION OF FIGURES
• The present disclosure will now be described, by way of example only, with reference to the accompanying drawings, of which:
• FIG. 1A is a plan view of an insole in accordance with the present disclosure;
• FIG. 1B is a side elevation of the insole of Figure la;
• FIG. 2 illustrates the positioning of the insole relative to the plantar surface of a right foot;
• FIG. 3 shows the positioning of the insert relative to the plantar ligaments of a right foot; and
• FIG. 4 illustrates the positioning of the insole relative to the plantar fascia of a left foot.
DETAILED DESCRIPTION
• Referring toFIG. 1A, an insole, indicated generally as1, in accordance with the present disclosure is preferably constructed as a homogenous semi-flexible to rigid plastic polymer, for example polypropylene, to which copper may be added for its known medical properties. The insole comprises aheel plate2, preferably in the shape of a heel cup base to the calcaneum area, with a central extension portion extending forward of theheel plate2, thecentral portion3, being cut away at alateral portion4 andmedial portion5 so that theextension portion3 is in the form of a central band.
• Thedistal end6 of the extension portion curves downwards in theregion6 so that its lower surface forms an arch in theregion7 which arch can be compressed when weight is applied to the upper surface of theinsole1.
• Theinsole1 has a length A preferably between 100 and 150 mm. Theinsole1 has a maximum width B in the heel plate region of between 50 to 70 mm, with the insole having a thickness of preferably between 3 and 5 mm over at least 80% of its area.
• Theextension portion3 at a point midway between the widest point of the insole and the distal end of the extension portion has a width C of between 40% and 60% of a maximum width B of the insole. At this point, the medial portion is preferably cut away by an amount D greater than 25%, but less than 40% of the maximum width B of the insole. The lateral portion is preferably cut away at this point by a width E of more than 15%, but less than 30% of the maximum width B of the insole.
• Referring toFIG. 2, there is illustrated a plantar view of the bones of the foot comprising thephalanges8,sesamoids9,metatarsals10, themedial cuneiform11, theintermediate cuneiform12, thelateral cuneiform13, cuboid14,navicular15,talus16 andcalcaneum17. Theinsole1 is shown superimposed on the plantar supporting thecalcaneum17 and extending to the region of the talus navicular joint18.
• FIG. 3 illustrates the plantar ligaments of the foot comprising the longplantar ligament19, the plantar calcaneonavicular ligament (the spring ligament)20 and the shortplantar ligament21. Theinsole1 is shown superimposed over the plantar ligaments and is seen to extend to the region of thetalar navicular junction18 in the region below the long plantar and short plantar ligaments.
• Referring toFIG. 4, there is illustrated the position of theinsole1 relative to the plantar fascia, indicated generally as22 and comprising acentral portion23, alateral portion24 and amedial portion25. Thelateral portion23 is inserted into the digital slips in theregion26.
• From the figures, the insole can be seen to support the central portion of the plantar fascia distal to its insertion to the calcaneum, terminating at the talar navicular joint just proximal to the ascending transverse arch.
• Support the central portion of the plantar aspect of the foot distal to the calcaneum as the arch commences, causes the underlying bone structure to be supported at the moment it is in a plantarflexory motion hence enabling optimal foot function.
• Supporting the ligaments as illustrated causes the ligaments to be supported at the biomechanical moment of transfer of weight from heel strike to midfoot loading.
• Supporting the plantar fascia in the region of the central band of the plantar fascia cause the medial and lateral bands of the plantar fascia to work without impingement from orthotic material and facilitate first and fifth ray functionality.
• The absence of theextension portion3 in the lateral and medial portions permits the first ray (first metatarsal and cuneiform section) and the lateral ray (5^thand 4^thmetatarsal complexes) to move without impingement from orthotic material.
• The absence of the medial and lateral portions of the insole permits the deep ligaments to the first ray (first metatarsal and cuneiform section) and the lateral ray (5^thand 4^thmetatarsal complexes) to move without impingement from orthotic material.
• This arrangement is advantageous because it permits normal plantarflexion and dorsiflexion movement of the first ray mechanics (first metatarsal and cuneiform section) and the lateral ray (5^thand 4^thmetatarsal complexes) without impingement from orthotic material (in individual optimal mode). It also permits active engagement of the lesser metatarsals and the first ray on the pivot point to be centrally supported by the insole.
• The insole has been illustrated in the previous drawings by way of example as a separate insole to be inserted into a shoe. However, a shoe may comprise such an insert within the construction of the shoe.

Claims (14)

1. An orthotic insole comprising a cupped heel plate with an extension portion extending forward of the heel plate and terminating in a region of a talonavicular junction on a plantar aspect of a foot, the extension portion being cut away in both a lateral portion and a medial portion so that the extension portion forms a central spur.

2. The insole as claimed inclaim 1, wherein the medial portion is more extensively cut away than the lateral portion.

3. The insole as claimed inclaim 1, formed from polypropylene.

4. The insole as claimed inclaim 1, comprising a single homogenous structure.

5. The insole as claimed inclaim 1, comprising copper in the composition of the insole.

6. The insole as claimed inclaim 1, comprising a semi-rigid material.

7. The insole as claimed inclaim 1, wherein the distal end of the extension portion curves downwards such that the extension portion forms an arch with a void below the arch, to permit the extension portion to flex when inserted in a shoe and weight is applied to its upper surface.

8. The insole as claimed inclaim 1, wherein 80% of the area of the insole has a thickness of between 3 mm and 5 mm.

9. The insole as claimed inclaim 1, wherein a central portion in the length direction of the extension portion is between 40% and 60% of the maximum width of the insole.

10. The insole as claimed inclaim 1, wherein the medial portion is cut away by more than 25% but less than 40% of a maximum width of the insole.

11. The insole as claimed inclaim 1, wherein the lateral portion is cut away by more than 15% but less than 30% of a maximum width of the insole.

12. The insole as claimed inclaim 1, having a length of between 100 mm and 150 mm.

13. The insole as claimed inclaim 1, arranged to be inserted into a shoe and retained in place by an external shape of a heel portion of the insole engaging with sides of the shoe in the region of the heel of the shoe.

14. A shoe with the orthotic insole as claimed inclaim 12, fabricated as an integral part of the construction of the shoe.

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