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By Leslie Levy

Reprinted from Focus Magazine

Stomping out Athletes' Excuses

If it’s good enough for Chris Evert, Robert Parish, and Joe Montana, it may be good enough for you. They are just some of the many athletes who will not play without wearing custom molded orthoses (CMO) in their athletic shoes developed by Pro Support Systems. Worn regularly, the custom molded orthoses add balance, support, and control to the foot and decrease the potential for sports-related injuries.

Pro Support Systems is the joint effort of Bala Cynwyd podiatrist Simon Small—a fellow of the American Academy of Podiatric Sports Medicine and associate of the American College of Foot Surgeons—and Kendrick Whitney a member of the faculty of the Pennsylvania College of Podiatric Medicine (PCPM).

It was actually Whitney’s father, Alan, also a podiatrist and professor at PCPM, who developed the first custom orthosis for Kevin McHale of the Boston Celtics of the National Basketball Association.

It was 1987 and the Celtics were on the way to the NBA playoffs. Due to a stress fracture, it was doubtful whether McHale would play. The Celtics’ podiatrist Richard W. Cullen remembered that his professor, Alan Whitney, had developed an orthosis specifically for athletes because those that were commercially available did not address severe foot deformities. Whitney’s CMO was designed to absorb the shock of McHale jumping while providing stability and balance to the foot.

SHOCK ABSORBER: "Most professional basketball players have high arched, rigid feet that do not absorb shock well," said Cullen, "At 6 feet, 10-inches, coming down from a rebound has the impact of five to eight times one’s body weight. On a foot that doesn’t absorb shock well this is a major problem."

McHale found such relief from the CMO that he wore them through the playoffs and into the championships. Now, most of the Celtics wear the CMOs.

Small read about the orthoses in a podiatric publication ad ordered a pair for one of his patients. After talking to Whitney the two realized the CMO could benefit many amateur and professional athletes. The idea for Pro Support Systems took hold.

"The goal of Pro Support Systems is to enhance and strengthen the amateur and professional athlete’s performance and to treat many of their sports-related injuries," stated Whitney. "Athletes are prone to problems caused by overused and the CMO relieves stress to the foot caused by excessive weight bearing."

In addition to helping prevent injuries and being a conservative alternative to surgery, the CMO aids in the recovery of problems stemming from prior injuries and enables players to resume participation faster. For example, Ronnie Lott of the San Francisco 49ers of the National Football League had Achilles Tendonitis. Within two weeks of wearing the CMO the tendonitis has calmed down, according to team podiatrist Andrew Carver.

GROWING LEGIONS: Now Lott teammates Roger Craig, Charley Hale, and Joe Montana wear CMOs, and three to five players are being cast weekly. "The CMO stops the foot from pronating (rolling) and allows it to push off the ground with a much quicker lever-arm force. By taking away pronation we can improve the athlete’s speed on the field," said Carver.

The CMO is made from a plaster of Paris cast of the person’s foot, which gives the most accurate impression. Modified for each individual, it is constructed according to the personal weight and level of activity. "If one arch of the foot is more depressed the other supportive materials are placed in that particular area," explained Small.

What makes the CMO unique is its three layers. A cushion-like top layer dynamically molds to the foot and picks up its contours and irregularities. The layer enables the wearer to adjust quickly to the insert whereas other conventional orthoses take longer to break in. The middle layer has a firm, plastic liner, which facilitates an even distribution of forces across the sole and foot. A firm, resilient bottom layer ensures optimal balance, minimizing injuries associated with malalignment stresses and poor shock absorption.

The CMO restores and adds balance, support, and control to the foot, enabling it to make optimal use of its normal range of motion. The CMO raises the surface area of the foot so that it does not have to travel so far to reach the floor.

CURBS STRESS: "The CMO curbs excessive range-of-foot motions and prevents the development of progressive deformities," Small said. "Individuals with structural abnormalities of the foot or those who have a muscular imbalance can benefit from the orthoses. A person with a forefoot imbalance develops an area of hardened tissue caused by stress to that area. The CMO would relieve that stress."

How do you know if you are a candidate for orthoses? If you tend to frequently sprain your ankle or if you suffer from the recurring heel, arch, or calf pain, schedule an appointment with your podiatrist. A comprehensive podiatric evaluation would show the strengths and weaknesses of the muscles in your feet and whether you would need orthoses.

Traveling to major sporting events around the country, Small has met with athletes, coaches, and trainers. His personalized approach has made a significant difference to Robert Russo, tennis trainer for the United States Davis Cup Team and Men’s Professional Tour. "Dr. Small works closely with our tennis players, giving the exam and overseeing the construction of the CMO," said Russo, who along with his children wears the CMOs. "The continuity of care resulting from working with Pro Support Systems has added to the players’ confidence."

After Small takes the castings he sends them to Whitney at the Pro Support Systems Laboratory in Cherry Hill. Pro Support Systems has made CMOs for Martina Navratilova, Mats Wilander, Stefan Edberg, and Dan Goldie; Thomas Hears’ golfer Janet Robbins, race walker MaryAnne Torzellas, members of the Boston Bruins and Celtics, the Israeli Maccabiah Team; the Intercollegiate Tennis Coaches Association and the Bahamian Sports Medicine Center. Locally, the Philadelphia Wings, Ben Coleman of the 76ers, and numerous Villanova University athletes are wearing CMOs.

SPREADING WORD: Because of their expertise working with athletes, Small and Whitney lectured to the referees at the US Open Tennis Championships on "The Prevention and Treatment of Lower Extremity Injuries." Small also served as a consultant to the trainer for the Association of Tennis Professionals at the Volvo Tennis Hall of Fame Championships held in Newport RI. There he was interviewed live remotely for the Pat Croce Sports Medicine show. And discussed the "Treatment of Foot Injuries in Professional Athletes."

Making excuses that your feet hurt will not help you play the game, much less win it. Whitney and Small are pleased that they are reducing the number of those excuses. The two podiatrists agree that "It is exciting to watch a variety of athletes and know that our CMOs are contributing to their comfort and success."

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