Rocker Technology Beneficial for Pedorthic Patients

With the abundance of rocker bottom shoes on the market, determining which ones are the best for treating your patients can be difficult. John Greco, PE, CPed, Alan Johnson and Vern Walther, CPed explained how to identify good rocker soles and discussed their benefits.

“Rocker shoes are an integral part of therapy and the most prescribed external modification,” Johnson said. “They provide benefits in function, mobility and pain management.”

Know your shoes

The first thing to consider when working with rocker bottom soles is the type of shoe. There are a variety of styles and brands on the market, but the ability to identify a good rocker bottom shoe is crucial for attaining successful outcomes.

“What you need to know is the apex location of the rocker. A lot of shoes that claim to be rocker bottom shoes have the apex too far forward or the rear apex might be too far back,” Greco said. “Know where the apex location is in the shoes you are selecting so you know that you are getting a true rocker function.”


John Greco


The presentation specifically focused on negative heel rockers and the variety of over-the-counter brands that are available.

“The negative heel rocker is the most misunderstood and most copied,” Greco said. “The biggest failure I have seen in over-the-counter rocker bottom shoes is the failure to control motion in the frontal plane.”

This is especially important when the wearer is also using orthoses, because a poor shoe design can negate their effects.

“You don’t want to take [an orthosis] and put it in a shoe that is going to rock side to side and undermine what the orthosis is doing,” Greco said. “You want to complement the orthosis, and you want control in the frontal plane.”

Pedorthists also need to perform an individual assessment for each patient to prescribe the correct shoe and make further modifications if necessary.

“Over-the-counter rocker soles can replace modifications you are doing in-house right now,” Greco said. “But you can’t generalize about rocker soles. You have to do an individual assessment and figure out what that patient can or cannot do.”

Greco encouraged all pedorthists to fit their patients with rocker bottom shoes, and said 90% of his patients use them.

“You’d be surprised what rocker bottom shoes can do for people,” Greco said. “But you have to learn to get people moving in the shoe. It’s a shoe made for motion.”

Useful but unattractive

The benefits of utilizing a rocker bottom shoe include improved circulation, improved balance, increased muscle activation to combat shin splits and assist with durability training and leg strengthening, improved recovery time, core strengthening, arch activation and internal rotation support for the knee. But despite the benefits of rocker shoes, their cosmetic appearance deters patients from wearing them.

“People don’t want to buy bulky-looking shoes,” Greco said. “The styles are getting better, but as the styles change, the performance of the shoe changes. So you want to focus on shoes that stay strict to the pedorthic rockers.

“Rockers are a component of multimodal therapies for compliance within the muscular skeletal system, and they do belong in your practice,” Greco

Disclosure: Greco is the owner of Glen Allen Foot Solutions. Walther is the owner of the Southeast Wisconsin/Milwaukee Area Mobile Unit Foot Solutions. Greco, Walther and Johnson are all sales representatives for Chung Shi North America.

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