1. Can I wear orthotics with my MBTs?

Answer Orthotics are not necessary with MBT shoes. This is because MBT shoes are an active footwear device, which stimulates the intrinsic musculature of the foot and will, over time, help to re-establish the arches in the feet. MBT footwear also serves as a proprioceptive tool thereby enhancing ankle stabilising musculature. It is however, possible to wear heel raises in MBTs if an individual has a true leg length discrepancy, see question 15 for more information on this condition.

2. How long should I wear my MBTs each day?

Answer MBT usage should initially be between 1 -2 hours per day for the first week. Gradually building up by 30 minutes per week, until the MBT shoe can be comfortably worn for extended periods, by which time muscle activation and proprioceptive feedback are sufficiently attuned to wear the MBT shoes all day, every day.

3. Why do I get burning in my feet after wearing them?

Answer The burning sensation experienced by certain individuals is due to increased blood flow to the intrinsic foot musculature. This should settle after a few weeks. In certain individuals it may persist for longer and can actually be an indication of vascular impairment, possibly due to conditions such as arteriosclerosis or diabetes. If the burning sensation persists the individual is advised to contact their family physician who will be able to organise baseline investigations.

4. Why do my leg muscles ache after wearing my MBT shoes?

Answer The aching sensation experienced by individuals especially in the first few days of wearing MBT shoes is a well recognised phenomenon in any individual undertaking a new exercise programme. It is known as delayed onset muscle soreness and normally settles after the first 5 days of wear.

5. Why do I get backache after wearing MBT shoes?

Answer This is due to the increase activation of the lumbo-sacral musculature and is also in part due to the alteration of trunk angle relative to the pelvis when wearing MBT shoes. An individual walking in MBT shoes automatically attains a more upright posture rather than a forward leaning gait. This is due to the patented negative heel technology.

6. Why have I still got varicose veins when MBT shoes are meant to help varicose veins?

Answer A varicose vein is due to the failure of a valve, which prevents back flow in superficial venous aviculture. MBT usage cannot correct for this mechanical venous malfunction. What MBT shoes do is increase the blood flow in the deep calf veins, thereby minimising superficial venous return.

7. I have diabetes, can I wear MBT shoes?

Answer MBT shoes can be worn by individuals with both insulin dependent and non-insulin dependent Diabetes Mellitus. Wearing MBT shoes stimulates blood flow to all muscle groups in the legs. It is also a potent aid to proprioceptive thereby stimulating the nerve supply to muscles, joints, ligaments and tendons in the lower limbs. This is of benefit and may help individuals who are prone to develop the nero-vascular complications of Diabetes Mellitus.

8. I have had a stroke, can I wear MBT shoes?

Answer The aims of treatment after the acute phase of a stroke are to minimise impairments, disability and secondary complications with minimal adverse effects from treatment. To this end MBT shoes may be beneficial. As previously mentioned, MBTs are a potent activator of vascular flow in the lower limb. When used in conjunction with certain specific exercises such as those in the DST programme muscle activation significantly improves in the gluteals, hamstrings and calf musculature.

MBT footwear also give active proprioceptive feedback with every step taken. It should always be remembered, however, that MBT is fundamentally an unstable footwear devise. Certainly with prolonged, supervised usage they should aid rehabilitation, but initially there may be an increased risk of falls if used in an unsupervised setting by an inexperienced individual.

9. I am due to have knee/hip replacement surgery, can I wear MBT shoes?

Answer Clinical studies at Calgary University and Sheffield Hallam University have demonstrated that MBTs reduce loading through the hip, knee and ankle. This may well reduce the pain in these joints due to osteoarthritis. MBT shoes also activate knee and ankle musculature and stimulate proprioceptive feedback around these joints. All of these factors may be beneficial. They will certainly be of benefit in the pre-operative period.

10. I have had a joint replacement. How soon after surgery can I start wearing MBT shoes?

Answer Provided you are already familiar with MBT shoes they can be a valuable tool in postoperative rehabilitation.It is advisable, however, that they are not worn until 4 - 6 weeks post operatively as the potential risk of a fall in this period would dislodge the artificial joint.

11. I have just had a heart attack, is it OK for me to wear MBT shoes?

Answer Cardiac rehabilitation improves coronary risk factors and reduces the risks of major cardiac events in people after heart attack. MBTs may therefore be used as part of a cardiac rehabilitation programme together with suitable education, medication and lifestyle modification.

12. Do MBTs help people who have multiple sclerosis?

Answer Multiple Sclerosis is a chronic inflammatory disease of the central nervous system. In Europe and North America it is the most common cause of neurological disability in adults aged 20-40 years and occurs in 1 in every 800 people. In 90% of affected individuals the disease process is relapsing and remitting in nature. Randomised clinical trails have demonstrated that outpatient rehabilitation reduced MS symptom frequency and fatigue. Clinical studies have failed to demonstrate the benefits of exercise on disease progression. MBT shoes may therefore be worn by individuals who have MS as part of their normal rehabilitation programme. The MBT will aid proprioception and muscle function.

13. Do MBT shoes help people who have motor neurone disease?

Answer As with multiple sclerosis MBT shoes may be used as part of active rehabilitation programme. The MBT will not alter the natural clinical progress of the disease but may assist maximal motor functioning during the disease process.

14. I have arthritis in the big toe, will MBT shoes help me?

Answer MBT footwear dynamically alters loading through the foot, ensuring that the load is distributed evenly through the foot from the moment of heel strike until the foot leaves the ground at toe off. This mimics walking barefoot. Conventional shoes concentrate on loading through the heel and then through the forefoot thereby accentuating loading through the joint of the big toe. Therefore patients who have arthritis in the big toe should benefit from wearing MBTs.

15. I have a difference in leg length and have to wear a heel raise. Can I put this in the MBT shoes?

Answer Yes. Heel raises for true leg length discrepancy (most commonly caused by congenital abnormality or following a fracture to either the femur or tibia), may be worn with MBT shoes. However if the leg length abnormality is caused by muscle shortening or joint dysfunction due to tendon or ligament dysfunction, the individual should consult a muscular-skeletal specialist as the problem may be amenable to remedial treatment and heel raises may in fact not be required.

16. I have poor blood supply to my legs, will MBT shoes help this?

Answer Depending on the severity of the altered or abnormal vascular supply MBT shoes may be an aid to improving peripheral circulation in the affected limb. It is important to realise, however, that as MBTs may increase muscle activation initially the compromised circulation in the affected limb may actually lead to an increase in pain. This is due to inadequate blood supply.

17. I get anterior knee pain can I wear MBT shoes?

Answer MBT shoes reduce loading through the knee and benefit the muscles acting around the knee. Specifically MBT shoes cause an eccentric stretch of the hamstring muscles and also specifically cause activation of the quadriceps. These features assist the management of anterior knee pain. It is always advisable to contact an MBT Medical specialist (i.e. doctor, physiotherapist or osteopath) for a definitive diagnosis.

18. I have had a DVT can I wear MBT shoes?

Answer MBTs should not be worn in the early stages following diagnosis of a deep vein thrombosis. This is because the increased muscle activation of the calf musculature may lead to the clot becoming dislodged and leading to a potentially fatal pulmonary embolus. Most individuals who have a DVT are given the drug Warfarin. Once stabilised and told by their doctor to resume exercise, MBT shoes may be worn.

19. I have a problem with recurrent ankle ligament sprains, will MBT shoes help with my rehabilitation?

Answer Yes definitely. In the UK alone there are some 6,000 ankle ligament sprains per day .Approximately 30% of these individuals will have symptoms of pain stiffness and recurrent sprains if not managed appropriately. The big benefit of MBT shoes in rehab is the proprioceptive stimulus, which they provide. They are also potent activators of the ankle stabilising musculature. Many individuals who have ligament injuries are given wobble boards' to assist rehab. These are used for 20-45 minutes per day. In effect the MBT acts like a permanent wobble board due to its inherent instability and can comfortably be worn every day, thereby eventually strengthening the ankle.

20. Will the MBT shoes cure my sciatica?

Answer Over 70% of people in developed countries will experience low back pain at sometime in their lives. It is most common between the ages of 35-55 years.

Pain is non-specific in 85% of people. Only 1-3% of individuals with low back pain actually have a prolapsed inter vertebral disc. Symptoms, pathology and radiological appearances are poorly correlated. Acute low back pain is usually self-limiting and the majority of people will have recovered within 6 week. Activity speeds symptomatic recovery, reduces chronic disability and leads to less time off work than bed rest or usual care. MBTs also affect the angle of the trunk relative to the pelvis; this causes the lower back to load optimally through the pelvis and hips, rather than the forward lean individuals have with conventional footwear. MBTs also cause some activation of the limbo-sacral musculature, which also helps to strengthen the lower back and aid recovery.

In summary MBT shoes will not cure sciatica, there is no known cure. MBTs should however, be seen as a tool which may help to resolve the pain associated with the condition. Obviously if back pain persists then an individual should see their doctor to rule out more serious conditions such as infection, tumor, fracture, inflammation, osteoporosis or rheumatoid arthritis.