Nowadays, going to the supermarket or an orthopaedic store and buying an insole seems like a piece of cake! But it hasn't always been like this and only recently have we had the convenience and accessibility to be able to pamper our feet in the most appropriate way. Here we will discuss the interesting evolution of a product that is as useful as it is popular: orthopaedic insoles.
Orthopaedic orthoses or insoles are removable or fixed medical devices that are used inside the shoe or in contact with the foot to correct postural problems in the feet and relieve possible pain. It is clear that in prehistoric times, humans essentially walked barefoot and only with the appearance of the shoe did the need to add complementary elements arise.
That is why the history of insoles is intrinsically related to that of shoes. According to the Etymological Dictionary of the Spanish Language, the word shoe would be onomatopoeia of the sound tsap when stepping on the ground, and hence the name shoe. What is certain is that the word is of uncertain origin and others associate it with the Turkish word “zabata”, which was the tanned bovine leather used to make shoes.
Although several texts mention cave paintings as evidence of the use of shoes some 15,000 years ago, these theories are highly debatable since the images are not conclusive and there was not enough knowledge at the time to create them. They would only show the use of handcrafted outer clothing. The only indirect clues are a footprint on soft ground recorded in the Fontanet cave, corresponding to the Upper Paleolithic, which has been interpreted as being generated by a foot covered by a kind of sandal. But this clue remains a mere and simple clue.
The first rudimentary attempts at insoles…
The first documented sandals were discovered in Arnold Cave, Missouri (United States) and were made of thistle plant fiber approximately 7,500 years ago. In contrast, the first possible attempt to create some additional element of protection or comfort such as a rudimentary insole is documented with the famous discovery of Vaytoz Dzor. In 2008, the first shoes made of cowhide were found between Armenia, Turkey and Iraq, dating back 5,500 years. These shoes had plant material inside and it is unknown whether it was an attempt to generate insole-style padding or an attempt to maintain the shape of the shoe. A very similar event occurred with the discovery of the oldest mummy in the world, Otzi, in the Italian Alps, dated 3,500 years ago, found with remains of shoes in conditions similar to those of the Caucasian region.
Later, the material used to pad shoes gradually improved until wool was finally used, as confirmed some 2000 years ago, to relieve foot tension and fatigue.
From the Neolithic period and throughout the Bronze Age, rudimentary padding elements had a pure function of increasing comfort and relieving fatigue. It is always good to remember that man still walked mainly barefoot at that stage and shoes were an accessory limited to the noble and wealthy class. In the region of Egypt, only the Pharaoh and dignitaries were allowed to wear shoes. The sandals used were made of braided straw or sheets of palm leaves and were only used by men and were used ceremonially, either to highlight the figure of the Pharaoh or to celebrate victory over enemies, since the defeated enemies were incorporated into the sandals. It was in Mesopotamian times that the use of sandals became widespread, while in ancient Greece shoes began to be used by priests, warriors and nobles. Slaves could not wear shoes and therefore shoes had a very strong value in differentiating social class.
It was during the Greek and Roman period that people began to become aware of postural problems and the balance of the musculoskeletal system. So much so that we owe the first scientific analysis of walking and the first geometric analysis of muscular actions on bones to Aristotle (384-322 BC), a Greek scientist and philosopher. Later, Galen (129-201 AD), a Roman physician and surgeon, was the first to explain the difference between motor and sensory nerves and agonist and antagonist muscles.
In Rome, footwear was an obvious symbol of social class: consuls could wear white shoes, while senators wore brown shoes and legionaries wore ankle boots. It was during the Middle Ages that the most important change occurred, leading to the subsequent invention of insoles. Shoes began to become widespread, partially abandoning their symbolism of social class and beginning to develop their aesthetic function. Shoes with heels, pointed leggings, high slippers, flats and the most varied models were born.
Aesthetics had become so important that the Catholic Church began to disapprove of the extremes of fashion and on the contrary authorized flats. Their discomfort made walking difficult, thus reducing thoughts of sins such as dancing.
And for this reason and as it is easy to imagine before orthopedic insoles, corrective or orthopedic shoes were born…
Before insoles, the attempt to improve posture was concentrated on shoes which were modified in such a way as to reverse possible pathologies. With this same logic in the mid-1700s Nicholas Andry (1658-1742), French doctor, creator of the word orthopedics, expressed: “If the feet lean too much to one side, you should give the child shoes that are higher on that side which will make him lean to the opposite side.” Following this trend, Petrus Camper (1722-1789), a Dutch physician and pediatrician, published in 1781 the famous book “On the best form of footwear”, a book so popular that it was reprinted in 14 editions, placing special emphasis on placing arch support orthoses on children with flat feet.
Taking a short break from this wonderful history of insoles, I think it is useful to make a brief summary. Since prehistoric times, humans have gone from walking barefoot to creating sandals, trying to make them more comfortable with vegetables or wool, and turning shoes into a fashion phenomenon, causing postural pathologies and trying to correct them with corrective shoes. And now we can finally ask ourselves: when was the first time modern insoles were made? There are disputes about who has the honour of having created or marketed the first insoles. One fact is almost indisputable and certain: the first insoles were made of leather.
In Europe, some attribute the first leather orthosis to 1845 by Lewis Durlacher (1792-1864), a British royal podiatrist appointed by Queen Victoria. This leather orthosis on the feet served to correct plantar pressure injuries and imbalances in the feet. Following the use of leather, these support insoles were popularized by Hugh Owen Thomas (1834-1891), a British orthopedic surgeon who in 1874 suggested that with “a few pennies’ worth of leather” shoes could be raised and wedged to treat foot problems.
In contrast, in the United States, others attribute the first arch support in 1865 to Dr. Everett H. Dunbar, from the city of Bridgewater, in the state of Massachusetts. In a similar way to what doctors did in Europe, this insole relieved arch pain by inserting pieces of leather under the sole of the shoe.
Over time, these insoles were improved and their usefulness expanded. Thus, Newton M. Shaffer (1846-1928), an orthopedist from New York City, designed a high medial arch orthosis with a heel cup that became known as a 'Shaffer Plate'. Royal Whitman (1857-1946) is credited with developing the first modern custom insole in 1905, known as the Whitman insole. It consisted of a plaster molding, taken with the foot in a supine position, with the aim of elevating the medial arch so that the foot would be less pronated.
Current literature partially refutes Whitman's conclusions, but his contribution to the history of orthoses remains undeniable. In contrast, the first generic rigid insole was invented by Percy W. Roberts (1867-1937), an American orthopedic surgeon who developed the metal foot orthosis in 1912. This orthosis had a deep cup in the inverted heel that attempted to tilt the foot into an inverted position. In the following decade of the 1920s, the German podiatrist Otto F. Schuster (1881-1936) emigrated to New York and combined ideas from the Roberts brace with the Whitman brace to create the Roberts-Whitman brace. This device had a wider profile providing better control of pronation and allowed for a more comfortable medial arch.
It is quite clear that insoles as we know them commercially today were born between the end of 1800 and the beginning of 1900. While the first insoles were equally inflexible and ergonomic, the real change in innovation occurred in the 1940s. This is because we had to wait until 1938 when James Franklin Hyde invented silicones. As a result, the company Dow Corning was established in 1943, and later acquired by the competitor DuPont, to benefit from this invention that opened the doors to a large number of resins and elastomers. That is why during the following decade silicone insoles and their multiple accessories such as toe protectors, separators, toe caps, etc. could finally be produced.
Thanks to the invention of polymers and elastomers, the shoes themselves began to benefit and thus the first Adidas were born in Germany, by the hands of the Dassler brothers, and in the United States the competitive Nike, by the hand of Phill Knight… but this deserves another story and another history…
Today the insole market is already widely developed and there are strong and stable competitors such as Dr School, Future, Muller and Profoot in the United States, Pura+ in Latin America, Orliman in Spain, Maseur in Australia or Donguan in China.
Did you like this incredible journey through the history of orthopedic insoles?
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