Heel Rocker
HeathyStep’s thermoplastic polyurethane (TPU) heel rocker additions are not just ‘another’ heel lift for the attempting to balance leg length discrepancy!
They are engineered to be so much more.
These additions are specifically constructed to facilitate the anterior progression of body weight over and in front of the rearfoot during gait. Their use will reduce ankle stresses at loading response, midstance, and during heel lift. Being made of TPU, they can also assist as rearfoot shock absorbers.
These are the perfect addition for any osseous, arthritic, or soft tissue restrictions in ankle motion.
£3.54
Product Description
How to fit to
Suitable for all HealthyStep’s total surface-contact orthoses.
X-Line
Condition Specific
Alleviate
Arch Angel Fallen Arch, Active and Hiking Insole
Heel rockers can be applied under our total-surface contact devices (flat-based) orthoses such as the X-Line and Alleviate Evolve ranges, and Arch Angel Fallen Arch, Active, and Hike insoles. They are also suitable for fitting with adhesive, under the rearfoot seat under the heel cup of the shells of Vectorthotic and Alleviate Select span devices.
Fitting the heel raise is simple. Just peel off the backing and apply as indicated below.
They can be fitted to Vectorthotic and Alleviate Selects as indicated below.
HealthyStep’s heel rockers are 6-7mm thick (depending on size) in the middle but angled in the sagittal plane at 12º and distally at 10º to help reduce ankle stresses during gait.
The unique proximal angulation chosen is designed to delay the rate of the plantarflexion moment applied after initial contact and reduce the total range of ankle motion necessary to complete forefoot loading.
The central raised plateau is there to reduce the amount of ankle dorsiflexion required during late midstance to move body weight forward over the midfoot.
The distal inferior angulation is designed to accelerate weight transfer to the forefoot at the heel lift boundary, making it easier to lift the heel and accelerate from the forefoot.
These heel rockers have a selected hardness that provides some shock-absorbing properties. This shore was chosen because the loss of ankle motion decreases the rearfoot’s ability to act as a shock attenuator during gait. Also, patients with ankle osteoarthritis are likely to require these heel rockers, and they have lost their natural ankle shock-absorbing properties.
During heel contact, the posterior heel strikes the ground first. Because this initial ground impact is behind the ankle (more so with longer strides), ground reaction forces (GRF) cause the ankle to rotate into plantarflexion. This motion brings the forefoot to the ground.
In those patients who have lost their full range of ankle plantarflexion motion, this is a considerable issue that can only be solved by dramatically reducing their stride length. Effectively, they end up having to try to walk with a total plantar heel or even whole foot initial contact. This adjustment to gait requires changes in all other lower limb joint angles and body posture which reduces locomotion energetics, tiring the patient. However, not making these changes can cause further ankle joint damage.
By having a skived posterior aspect on a heel lift, stride length can be maintained to a greater extent, while the plantarflexion toque and motion are lowered. This reduces how much the ankle must move into plantarflex and still achieve a more efficient and stable ankle joint and body posture. Added to this, the TPU material of the central heel rocker platform can act as an assistor to shock attenuation during rearfoot loading and early midstance.
The central platform of the addition is 6-7mm thick. A raise of this height decreases how much ankle dorsiflexion is required before body weight has sufficiently moved forward over the foot to initiate a safe heel lift. The concurrent benefit of doing this is that the midfoot dorsiflexion stresses can be reduced. This is because when ankle motion is restricted and body weight cannot move forward easily, increased dorsiflexion forces are directed into the foot’s vault (arch) profile to cause excessive lowering and higher plantar soft tissue stresses.
Thus, a heel lift lowers stresses applied across the midfoot arising when limited ankle dorsiflexion blocks anterior body weight motion. A heel lift by reducing midfoot pronation, also encourages higher metatarsal declination angles, making digital extension easier at the start of acceleration.
The heel rocker’s distal-angled skive allows a forward-rolling action from the rearfoot without requiring greater ankle dorsiflexion before heel lift. Working with the heel lift height the addition can aid in creating an effective acceleration moment without necessitating higher ranges of ankle plantarflexion after heel lift.
Degenerate articular changes dramatically alter ankle joint stresses. In those with severely restricted ankle motions due to extensive ankle degeneration or after ankle fusion, using an X-Line DJD in a rocker-soled shoe and adding the heel rocker plus a DJD enhanced forefoot rocker or met bar rocker additions, can prove most effective for improving gait energetics. This is an ideal combination used by leading experts in ankle degeneration caused by haemophilia.
For diabetics who suffer loss of ankle motion, the heel rocker effect can be very important to reduce the destructive forces that can create a Charcot foot in those with peripheral neuropathy and limited ankle motion. The insole chosen to be used with the heel rockernshould reflect the other issues and the foot morphology of the diabetic patient.
The heel rocker can help in many situations to improve symptoms before rehabilitation and manual therapy start.A heel rocker added to an X-Line AT for symptomatic Achilles tendinopathy, can be highly beneficial, including for insertional cases. If there is an improvement in any underlying ankle restrictions or triceps surae-Achilles complex issues with therapy, the rocker can be removed later.