The supination wedge is an orthopedic structural element used in footwear and orthotics that rotates the foot outward around its longitudinal axis. The wedge thus weakens pronation positions of the foot and induces supination. The component is used primarily in cases of hyperpronation of the foot and resulting functional restrictions during rolling.
What is a supination wedge?
The supination wedge is an orthopedic construction element used in shoe and insole technology. Deformities of the feet are a common clinical picture. In addition to congenital deformities, there are acquired foot deformities, which are often associated with previous trauma to the bones of the foot. Many of the malpositions result in functional disturbances of the foot, for example in rolling. Various non-invasive methods are available for the treatment of foot malpositions. Posture correction by medical insoles is one of them. In addition to insoles, the supination wedge is used to rotate the foot outward along its longitudinal axis and thus facilitate rolling. The wedge is attached to the medical insole and raises the inner edge of the foot while the outer edge is lowered. The supination wedge must be distinguished from the pronation wedge, which is also used for foot malpositions. Orthopedic shoemakers usually provide both types of wedges as add-ons to various types of orthotics. Supination wedges not only help prevent pain and rolling errors. To a certain extent, they also prevent secondary diseases that could develop from the foot malposition, such as osteoarthritis. The wedge is also called a medial subtalar pad or medial heel wedge.
Shapes, types and styles
Supination wedges usually need to be ground in accurately. The goal is to create a wedge that is ideally suited to the concerns of the individual wearing the insole. The height, length and proportions of the wedge thus differ from patient to patient. In addition, the aids of the wedge differ with the type of insole to which it is attached. Not every type of medical insole is offered with a supination wedge. Widely used are insoles for athletes, because especially in sports proper rolling is required. In most cases, the supination wedge is made of cork, but materials such as felt are also possible. Cork consists of air-filled dead cells. Breathing is possible through these cork pores. The material is a rather gentle corrective material, as it has elastic properties in addition to a support function and can thus adapt to the foot. Compared to this, plastic is much harder and more resistant. The elasticity and adaptability to the foot would therefore not be sufficiently given with supination wedges made of plastic. Cork-leather insoles are therefore called “bedding insoles” for good reason. Plastic material does not so much bedding as it does resistant correction.
Structure and mode of operation
Supination wedges, as the name implies, wear a wedge shape. The exact shape depends on the patient’s foot and the amount of correction to be achieved. The supination wedge is fixed to the corrective insole by the orthopedic shoe technician in such a way that the foot is rotated outward around its own longitudinal axis by the wedge. In this way, the supination wedge lowers the outer edge of the foot and simultaneously raises the inner edge of the foot. The orthopedic-technical component is thus used in the manufacture of insoles to prevent or attenuate the pronation movement. Supination in the foot is supported or rather created by the wedge. The position thus created reduces the load on the medial edge of the foot and also reduces load intensities on the first ray. In return, the loads in the area of the lateral edge of the foot increase. Supination wedges correct malpositions of the foot axis due to their design and thus reduce dysfunctions during the rolling motion.
Medical and health benefits
One of the most common indications for the use of a supination wedge is hyperpronation. This is an exaggerated pronation position of the foot, also known as a bent foot. The joint surfaces of a bent foot are at an unnatural angle to each other and the joints become loose and unstable as a result. The bent foot is usually caused by lack of movement, which leads to a regression of the natural foot muscles.Often, incorrect footwear also contributes its part to the pathogenesis of a bent foot. The supination wedge is often used not only to correct a bent foot, but also in cases of overloading of the tibialis posterior tendon. The tibialis posterior muscle is a muscle of the lower leg musculature and has a stabilizing effect on the arch of the foot. Misalignments can overload the tendon of the muscle, so that secondary diseases are imminent. To prevent such secondary diseases, the supination wedge can be used, as it attenuates the pronation movement of the foot and the associated stress on the muscle. In certain cases, the supination wedge is also used for complaints of the deltoid ligament. This anatomical structure is a strong triangular-shaped ligament that lies on the inside of the ankle joint and runs from the medial malleolus to the tarsal bones. If unnatural lengthening of the ligament occurs, the supination wedge can counteract the progression of this phenomenon. In addition, discomfort at the medial edge of the foot is an indication for the supination wedge. This area of the foot can be relieved by the supination element. Under certain circumstances, pronation malpositions of the foot also irritate the sesamoid bones in the foot area, which can be relieved accordingly with the supination wedge. In addition, the construction element is used for insoles for hallux valgus. This is understood by medicine as a malposition of the big toe, which is laterally angled in the base joint and points with the tip towards the middle of the foot.
