CA1264939A - Variably adjustable shoe insert - Google Patents

Abstract

ABSTRACT OF THE DISCLOSURE
Disclosed herein is an insert or a shoe, boot, or the like which is capable of plural adjustments so as to adapt the insert to the unique physical conformation of the wearer's foot, to hold the foot in a neutral axis position substantially at all times, to return a foot into the neutral axis mode automatically, and to provide a wide range of support, resiliency, and angulation based on the needs of the user. The device as set forth lends itself to modification for various sports where lateral motion is of primary importance, shock absorption and longitudinal extension of the foot is of paramount importance, or for geriatric patients whereby a single insert and the modifying devices associated therewith address the vast spectrum of orthotic needs.

Description

- 1269~939 ~. VARIABLY ADJUSTABLE SHOE INSERT

03 This invention relates generally to orthotic 04 appliances.
05 Fairly recently, greater attempts have been made to 06 provide footwear which i8 anatomically correct so as to not only 07 increase the comfort of the wearer, but also to minimize fatigue 08 and injuries. This requires an analysis of the typical human 09 gait. When one is moving substantially in a single linear direction, the gait consists of three distinct phases. First, the 11 heel strike phase occurs during which the foot is essentially a 12 "mobile adapter" ready to conform to the topographical contours 13 encountered. Second, the transistion or mid-gait phase transforms 14 the mobile adapter into a "rigid lever" where the mid-tarsal joint becomes locked preparing the foot for translation of the 16 accumulated forces in a stable manner throughout the foot during 17 the remainder of said cycle and the impact forces are dissipated 18 through the ankle and leg bones to the upper torso. Third, the 19 "toe roll" phase finishes the gait cycle and the next step is begun. The critical phase is the mid-gait or transition phase 21 where the foot is transformed from a "mobile adapter" to a "rigid 22 lever". The optimum configuration for the ankle at this point is 23 to have the sub-taler joint in a neutral position as the mid-tarsal 24 joint becomes locked and the foot becomes a "rigid lever". This allows the impact load to be properly dissipated. While 26 podiatrists have long been aware of the need to maintain the foot's 27 proper orientation relative to the leg to provide a "rigid lever"
28 and accordingly have prescribed orthoses for that purpose, the 29 general populous rarely avails themselves of these services until after a certain amount of discomfort and/or damage has been done.
31 The following citations relfect the state of the art 12fi4~39 ., 01 of which applicant is aware in so far as these patents apear to be 02 germane to the patent process:
03 2,669,814 Ritchey 1,240,066 French-Strasbach 04 2,680,919 Riggs 465,940 British-King 05 3,922,801 Zente 06 Of these, the patent to ~itchey appears to be of 07 great interest since he teaches the use of an orthopedic device 08 suitably positioned within a shoe or the like, in which the upper 09 surface thereof has a complex contour addressed to the peculiarities of a given foot. The instant invention can be 11 contrasted over this prior art by noting the contrasting ease with 12 which the apparatus according to the instant application can be 13 initially fitted to a person, or successively fitted as a function 14 of time, while providing immediate relief.
Similarly, the patent to Riggs teaches the use of an 16 insole type appliance having a compound contour like the 17 Ritchey invention configured in such a manner as to provide foot 18 relief based on Rigg' 8 perception of a universal foot disorder.
19 Similarly, the Zente patent teaches the use of a liquid filled orthopedic apparatus comprised of a plurality of 21 discrete internal liquid filled ampules which are strategically 22 placed between upper and lower laminae and sealed in place to 23 provide separate support for various parts of the foot.
24 The remaining references show the state of the art further, the British patent teaching the use of an insert having a 26 compound contour based on the inventor's attempts at defining a 27 single insert for addressing a wide spectrum of problems.

Jl SUMMARY AND OBJECTS OF THE INVENTION
02 By way of contrast, the instant application is 03 directed to and specifies an orthotic appliance adapted to be 04 placed as an insert within a shoe, boot, or the like formed 05 initially as a blank having an upper surface that generally 06 follows the contour of the plantar surface of a foot.
07 Thereafter, on a bottom portion of the appliance, means 08 defining recesses having various dimensions are provided, all 09 of which are adapted to have inserted therewithin plugs, finger like members, or absorptive pads capable of different ll degrees of resilience so that such an insert can be modified 12 to "fine tune" the insert to accommodate the wearer.
13 Specifically, resilient fingers disposed within certain areas, 14 and certain plugs are adapted to beneficially distort the upper surface contour of the insert so as to provide an 16 identical correspondence with the plantar surface of a foot, 17 and in addition to provide beneficial angulation of the foot 18 as may be desired, and in addition to encourage the foot to l9 remain and return to a neutral position in which the proper alignment is provided between the leg and the foot so as to 21 encourage a uniform force distribution and 1issipation 22 throughout the bone structure of the foot and of the leg, 23 thereby minimizing unwanted torsion etc., a frequent cause of 24 discomfort or injury. Additionally, the contour of the insert can be modified to accommodate and support any patient but 26 especially the geriatric patients so that by specially 27 modifying the cuboid and shaft on the lateral metatarsal areas 28 of the foot or anywhere else along the lateral aspect of the 29 foot to provide relief of pressures. Similarly the contour along the medial arch area or along the medial aspect of the 31 foot may be accommodated and supported. Such accommodation 32 and support along the medial and lateral segments of the foot 33 are frequently necessary in all age groups but especialLy with 34 the geriatrics. Moreover, the device according to the present inventisn is provided with a recessed area on the bottom 'l~fi4~39 face thereof so that force applied by the foot into the insert 02 encourges greater support of the foot, and the natural elongation 03 of the foot during a walking or running mode can be beneficially 04 accommodated by the dynamic characteristics of the insert in which 05 longitudinal elongation of the foot during its flexure is taken 06 into account by the insert geometry.
07 According to a further embodiment of the invention, 08 there is provided an orthotic appliance having a forward to rear 09 lengthwise axis and adapted to be placed as an insert within a boot, shoe or the like, comprising an upper substantially 11 continuous surface portion adapted to engage a lower surface of a 12 foot, and a lower relatively resilient main body portion which 13 extends beneath the foot. The main body portion has at a rear 14 part thereof upstanding edge portions to engage lower rear side portions of the foot. The rear part of the main body portion has 16 at a lower surface thereof a lengthwise extending recessed area 17 with side strips positioned on opposite sides of the recessed area 18 and protruding downwardly from the recessed area. Furthermore, 19 the appliance is characterized in that when a downward force is applied by a heel portion of the foot downwardly on a rear upper 21 middle surface area of the appliance, the recessed area deflects 22 downwardly in a manner that the upstanding portions grip the lower 23 rear side portions of the foot, whereby when weight is transferred 24 initially to the heel portion of the foot and then toward a middle portion of the foot during a gait cycle of the foot, proper 26 lateral support of the foot is provided by the upstanding edge 27 portions.
28 An additional preferred form of the invention 29 provides an orthotic insert formed from two pieces, one piece running substantially the length of the foot, similar to a first 31 embodiment, and a second piece serving as a cap which underlies 32 and is removably affixed to the first piece not only for ease of 33 manufacture, but also for an additional degree of freedom. In 34 this embodiment, some of the plug members may be formed and ` 121~,4939 01 carried along the initial blank, and score lines are provided for 02 separation from the blank so as to reduce manufacturing costs.
03 Thus, it is a primary object of this invention to 04 provide an orthotic insert that is to be disposed within a shoe, 05 boot or the like whose contour and angulation can be modified 06 initially and incrementally thereafter in an iterative process so 07 as to support the foot properly and encourage correct relative 08 bone orientation.
09 It is yet a further object of this invention to provide a device of the character described above which is 11 relatively inexpensive to manufacture, extremely durable in 12 construction, safe to use, and lends itself to mass production 13 ~echniques.
14 It is yet a further object of this invention to provide a device of the character described above which is 16 relatively inexpensive to manufacture, extremely durable in 17 construction, safe to use, and lends itself to mass production 18 techniques.
19 It is yet a further object of this invention to provide a device of the character described above in which plural 21 adjustments can be effected in order to address a wide spectrum of 22 oxthopedic problems.
23 It is still a further object of this invention to 24 provide a device of the character described above which is so configured as to lend itself by adaptation to a plurality of 4a 01 specific needs (walking, running, basketball, tennis, 02 etc.) specifically by the plural alterations 03 available.
04 It is still a further object of this 05 invention to provide a device of the character 06 described above which encourages a proper orientation 07 of the foot, its associated bones, relative to the leg 08 in such a manner that the weight distribution is 09 substantially uniform along the longitudinal axis of the foot based upon the individual foot components' 11 weight bearing capabilities.
12 It is an object of the invention to 13 provide a device which assists in orienting the 14 sub-talar joint so as to be more aligned towards the neutral position, the mid tarsal joint also in its 16 more functional position, that is locked.
17 These and other objects will become 18 manifest when considering the following detailed 19 specification when taken in conjunction with the appended drawing figures.

01 According to the present invention, there 02 is provided an orthotic device for controlling the 03 re].ationship betwcen the sub-talor and mid-tarsal 0~ joints of a person' 5 foot during a gait cycle OS comprising in combination, apparatus for absorbing the 06 impact caused by the foot at heel strike in a 07 controlled manner when the foot is a mobil adapter, 08 deforming apparatus adjacent the absorbing apparatus 09 for supporting the heel area of the foot just after heel strike in a controlled manner when the foot is 11 still a mobil adapter, and transition apparatus 12 proximate the deforming apparatus and forward of the 13 absorbing apparatus for delivering the foot from a 14 mobil adapter to a rigid lever, whereby the sub-talor joint is in a neutral position when the mid-tarsal 16 joint becomes locked thereby the gait cycle is 17 completed with the foot locked in a neutral position.

19 - 5a -lZ~i4939 - ,. BRIEF DESCRIPTION OF THE DRAWING FIGURES

03 Figure 1 is a top plan view of the apparatus 04 according to the present invention, 05 Figure 2 is a sectional view taken along lines 2-2 06 of Fig. l;
07 Figure 3 is a sectional view taken along lines 3-3 08 of Fig. 1 showing the application of the orthotic in a shoe as an 09 example; and Figure 4 is a bottom plan view of the forward 11 portion shown in Fig. l;
12 - Figure 5 is a bottom plan view of a top portion of 13 a second form of the invention;
14 Figure 6 is a top plan view of that which is shown in Fig. 5;
16 Figure 7 is a partial sectional view taken along 17 lines 7-7 of Fig. 5;
18 Figure 8 is a top plan view of the cap portion of 19 the insert according to the second preferred embodiment adapted to engage the bottom surface of that which is shown in Fig. 5; and 21 Figure 9 is a bottom plan view of the cap of Fig.
22 8.

1%64939 01 DESCRIPTION OF THE PREFER~ED EMBODIMENT
02 Referring to the drawings now wherein like 03 reference numerals refer to like parts throughout the 04 various drawing figures, reference numeral 10 is directed 05 to the orthotic insert according to the present invention.
06 The insert 10 is formed initially as a blank o7 having a top surface 1 formed from an abrasion resistant 08 padded material such as a synthetic fabric, nylon, dacron, 09 felt, cloth and a resilient underlying pad 21 of rubber or the like which is affixed to a lower portion 2 by means of 11 adhesion or fusion. The lower portion 2 is preferably 12 formed from a foamed material such as Freelen~, 13 Plastizote~, or any open or closed cell foams characterized 14 in being relatively resilient, having 5ufficient memory to return to its original state when unstressed, and capable 16 of moderate shock absorption properties.
17 Specifically, the top surface 1 reflects the 18 contour of a top surface of the lower portion 2 and 19 includes an arch support area 3 of raised dimension, a depressed heel cup area 7, and a heel supporting rim or lip 21 4 which surrounds the heel in a manner to be defined 22 shortly.
23 The bottom surface 2 of the insert is provided 24 with an elongate rectangular recess 5 extending substantially from the calcaneal area 7 of the foot up to 26 the cuboid and lateral metatarsal areas 8, the transition 27 of the recess along the longitudinal axis having a 28 substantially beveled edge 6 so that a smooth transition 29 between the normal undersold 2 and the recess 5 along the longitudinal axis is provide~. The lateral edges 24 of the 31 recess are provided with an abrupt drop-off so that when 32 the foot applies force onto the insert, the distortion of 33 the insert that takes place occurs along a central 34 longitudinal axis whereby the foot at that area translates vertically downwardly to a greater extent than along the 36 edges of the heel due to recess 5, and a minor distortion 37 of the insert occurs so that the peripheral 12~939 01 heel support area 4 turns in slightly and grasps the heel of 02 the person somewhat more greatly, this heel cupping effect is 03 enhanced by foot elongation which occurs during the heel strike 04 phase of the gait cycle when the foot elongates and becomes 05 somewhat more narrow allowing emphasis of the deformation of 06 the lip 4.
07 The insert is provided with a medial edge 14, a 08 lateral edge 13 so as to provide two strips: a medial strip 11 09 and a lateral strip 12 about the recess 5 and between edges 24, 13 and 14. These strips 11, 12 underlie upper zones 22 and 23 11 and are provided with a plurality of holes so that plugs may be 12 frictionally disposed therein. These plugs 15 define inserts 13 for controlling height, will increase or decrease the long or 14 medial arch, and can adjust calcaneal inclination. The lateral strip 12 as shown includes the ability to protect the subluxed 16 cuboid by its proximate position thereto, thus during the 17 transitional or mid-gate phase of the gait cycle these strips 18 11, 12 and their associated plugs 15 ensure the proper 19 alignment of the sub-talor joint in a neutral position as the mid-tarsal joint becomes locked and the "mobil adapter" becomes 21 a "rigid lever". Furthermore, these plugs can be deployed and 22 adjusted to tune the insert for certain types of activities 23 involving extensive lateral movement such as racquetball or 24 tennis where the impact loads are often placed on the areas of the foot overlying these strips 11, 12. Accordingly, by 26 selecting plugs of appropriate resiliency and geometrical 27 configuration based on specific needs, the device enables one 28 to cradle, cushion, and continuously realign the foot on the 29 long axis thereof. Note the depiction in Figure 3 in which the insert is aligned to the shoe's longitudinal axis for example, 31 which provides one application assuring proper alignment for 32 greater responsiveness. As shown, th~ strips 11 and 12 have a 33 somewhat curved contour to assist in the beneficial deformation 34 about the recess 5, thereby "rolling" the lip 4 up about the foot.
36 Additionally however, the righthand portion (Fig. 1) ~264939 01 of the insert which is indicative oE the back 20 of the heel is 02 provided with a plurality of similar recesses and associated 03 plugs 19 therefore which are advantageously deployed at this 04 area and disposed to serve as shock absorber inserts. These o5 can be coded with different durometeric values to aid function 06 in gait and jogging, basketball, and in any sport. In fact, 07 the choice of materials for this area lends itself to improve 08 results when running or walking in this manner.
09 Reference numeral 9 is directed to the general region where the cuboid and metatarsal bases meet and a minor 11 ridge 9 is provided on the bottom surface 2 o~ the sole along 12 this area to correspond to the general anatomy of most people 13 regarding flex. However, among geriatric patients this area is 14 frequently susceptible to pressures along the lateral segment of the foot as well as the metatarsal heads and by the 16 apparatus according to the instant application the pressures 17 can be relieved by selectively building up areas adjacent the 18 pressures sensitive heads so as to relieve the pressure.
19 Specifically, a plurality of apertures 16 are disposed on the bottom face of the insert and adapted to be frictionally forced 21 therewithin a plurality of fingers 17, the fingers preferably 22 being slightly oversized relative to the holes to assure their 23 exact placement. As with the plugs, these fingers 17 can be 24 replaceable with varying degrees of density so as to customize the shock absorption as required.
26 Similarly, a plurality of holes 18 are provided 27 forward of the metatarsal area, preferably in the area between 28 the ball of the foot and the toes, these apertures 18 suitably 29 dimensioned to receive by frictional fit similar fingers 17, the disposition of which therewithin will cause a raised area 31 on the top surface of the insert so as to provide a purchase 32 area for the toes, commonly known as toe cresting so as to have 33 the top surface of the insert follow as closely as possible the 34 contour of the foot. Furthermore, these fingers 17, help maintain the neutral position of the sub-talar joint during the 12~49~9 01 final or "toe rolling" phase of the gait cycle.
02 As pointed out hereinbefore, the plugs and fingers 03 can be made of varying degrees of density to lend themselves to 04 adaptation in many environments, and it is believed that a plug 05 or finger made from Sorbathane~ lends itself quite well to one 06 specific application of these plugs and fingers.
07 Typically, a person desiring to improve the load 08 distribution, support, and orientation of his feet will take 09 the insert as described hereinbefore and adjust the calcaneal inclination at area 7 anywhere from zero to 22 degrees through 11 plugs 19 as would be determined by known techniques.
12 Thereafter, a plurality of different plugs 19 would be 13 available so that after initialization of the insert as by 14 exercising, running, walking, etc, various iterative modifications in the toe cresting or other areas can be 16 effected by the individual himself to take into account 17 whatever type of endeavor is to be undertaken. For example, if 18 one should desire to engage in running of one form or other, 19 the plugs 19 may be replaced with ones having greater resilience, and conversely if one were to engage in a sport 21 entailing lateral shock loads as in tennis or racquetball, the 22 plugs 15 on the strips 11, 12 on either side of the recess 5 23 can be altered to accentuate the recess 5. Additionally, it 24 should be appreciated that a pad or an appropriately dimensioned larger "plug" can be placed within the recessed 26 area 5 to alter the amount of deformation the shoe undergoes 27 should it be desirable. In this regard, the lower portion 2 at 28 the recess area 5 can be so formed as to create a "zone of 29 lesser resilience". In such an event, the recess can be dimensioned smaller or non-existant in which case the gradation 31 in the lower portion's resilience at area 5 provides the 32 deformation. Additionally, it should be observed from the 33 foregoing that the plugs while generally described and shown as 34 being in cylindrical configuration can in fact have any lZ69L939 ~, 0_ type of contour and is therefore not seen to be a limitation. The 02 plugs may have angulated top faces, proximate to the top surface 1 03 for further contouring. For example, the heel plugs 19 can be 04 dimensioned for heel posting and lifting.
05 A second preferred form of the invention, shown in 06 Figs. 5 through 9 detail lends itself especially well to mass 07 production techniques with a minimal amount of complex die 08 tooling, and will now be described solely by the differences 09 between the instant emodiment and that which was previously discussed.
11 As shown in Figs. 5 and 6, the blank 40 forms a top 12 piece having generally the same attributes as the previously 13 discussed embodiment, that is a recess 5 having a feathered 14 leading and trailing edge, etc. The bottom face (Fig. 5) discloses a plurality of holes 31 disposed about the recess, the 16 recess 5 having thickened areas 35 extending into the recessed 17 area so that the medial and lateral strips 11 and 12 have 18 additional surface area to respond beneficially to the plugs that 19 are to be disposed therein which will now be explained. The forward portion of the first piece 40 includes a score line 34 21 allowing a marginal web portion 33 to be separable therefrom as by 22 bending and thereafter fracturing, and it is within the web 23 portion that the plugs 15 can be disposed and therefore provided 24 all in one manufacturing process.
As shown in Figs. 8 and 9, a plurality of upwrdly 26 extending interlocXing lugs 32 are provided on a top face of the 27 second piece 50, and locking lugs adapted to be received within 28 the holes 31 of Fig. 5. Thus, as shown in Fig. 7, the appliance 29 30 according to the second form of the invention is defined by a cap forming a second piece 50, a first piece 40 which engages the 31 plantar portion of a person's foot, each first and second pieces 32 are relatively separable and joinable by the friction fit of the 33 locking lugs 32 into their respective holes 31. In this manner, ~L2649;~9 01 the recess 5 can contain therein a shock absorbing material of 02 different resilience, or no absorber at all as is required, and 03 the top face of the cap 50 could similarly have an indentation 04 to accentuate the recess 5 and its characteristics.
05 Fig. 9 shows the ability to dispose the plugs 15 06 and 19 within the associated holes provided on the bottom face 07 of the cap 50 as set forth earlier embodiment.
08 Moreover, it should be appreciated that numerous 09 structural modifications are contemplated as being a part of this invention as set forth hereinabove and as defined 11 hereinbelow by the claims.

Claims (10)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN
EXCLUSIVE PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED
AS FOLLOWS:

1. An orthotic appliance having a forward to rear lengthwise axis and adapted to be placed as an insert within a boot, shoe or the like, said appliance comprising:
a) An upper substantially continuous surface portion adapted to engage a lower surface of a foot, b) a lower relatively resilient main body portion which extends beneath the foot, c) said main body portion having at a rear part thereof upstanding edge portions to engage lower rear side portions of the foot, d) the rear part of the main body portion having at a lower surface thereof a lengthwise extending recessed area with side strips positioned on opposite sides of said recessed area and protruding downwardly from said recessed area, e) said appliance being characterized in that when a downward force is applied by a heel portion of the foot downwardly on a rear upper middle surface area of the appliance, the recessed area deflects downwardly in a manner that the upstanding edge portions grip the lower rear side portions of the foot, whereby when weight is transferred initially to the heel portion of the foot and then toward a middle portion of the foot during a gait cycle, proper lateral support of the foot is provided by the upstanding edge portions.

2. The appliance as recited in Claim 1, wherein said recessed area extends substantially from a calcaneal area of the foot up to a cuboid and lateral metatarsal area.

3. The appliance as recited in Claim 2, wherein said appliance is provided with opening means at a selected location in which is positioned plug means having a hardness greater than that of the main body portion of the appliance, whereby increased support is provided at said selected location.

4. The appliance as recited in Claim 3, wherein said opening means and said plug means is located at at least one of said side strips, whereby an angular position of the foot can be more closely controlled.

5. The appliance as recited in Claim 3, wherein said opening means and said plug means are located in the body portion of the appliance so as to be adjacent a metatarsal area of the foot.

6. The appliance as recited in Claim 3, wherein said appliance is provided with a marginal web portion which is removable from said appliance, with said marginal web portion containing said plug means which can then be inserted in the opening means.

7. The appliance as recited in Claim 1, wherein said appliance is provided with opening means at a selected location in which is positioned plug means having a hardness greater than that of the main body portion of the appliance, whereby increased support is provided at said selected location.

8. The appliance as recited in Claim 7, wherein said opening means and said plug means is located at at least one of said side strips, whereby an angular position of the foot can be more closely controlled.

9. The appliance as recited in Claim 7, wherein said opening means and said plug means are located in the body portion of the appliance so as to be adjacent a metatarsal area of the foot.

10. The appliance as recited in Claim 7, wherein said appliance is provided with a marginal web portion which is removable from said appliance, with said marginal web portion containing said plug means which can then be inserted in the opening means.