A single rocker sole shoe modification (Illustration A) is intended to increase propulsion at toe-off, decrease pressure on heel strike, and reduce the need for ankle motion. It is indicated for use in patients with severe tibiotalar or subtalar arthritis, or those status-post fusion of these joints.
Janisse et al review shoe modifications and foot orthoses as they relate to the nonsurgical management of foot and ankle pathology. With regards to rocker soles, they describe the six-types and how each is specifically used for an individual patient's foot problem. In general, the biomechanical effects of the rocker soles are restoring lost motion in the foot and ankle and off-loading plantar pressure on some part of the foot. Use of a rocker sole can result in overall improvement in gait.
1-Midfoot prominences are best relieved with double rocker soles (Illustration B), which offload this region of the foot with weight bearing.
2-Although all rocker sole shoes relieve forefoot pressure to some degree, severe toe-tip ulcerations in particular achieve the greatest relief with the use of a severe angle rocker sole (Illustration C).
4-Fixed ankle dorsiflexion deformities are best accomodated with a negative heel rocker sole (Illustration D).
5-Rocker sole shoe modifications are not typically used in the treatment of fixed planovalgus deformities.
Janisse DJ, Janisse E. Shoe modification and the use of orthoses in the treatment of foot and ankle pathology. J Am Acad Orthop Surg. 2008 Mar;16(3):152-8.
PMID:18316713 (Link to Abstract)
Jeng CL, Logue J. Shoes and orthotics. In: Pinzur MS, ed. Orthopaedic Knowledge Update: Foot and Ankle 4. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2008:15-24.