The Kinetic Wedge is a patented and trademarked extension that can be used to plantarflex and evert the first ray in those with a functional hallux limitus, sagittal plane blocks and windlass mechanism dysfunctions. It was designed and developed by Howard Dananberg, DPM. It is licensed for use commercially to custom made orthotic laboratories (eg Langer). It is made of a thicker material under the proximal phalanx and under metatarsal heads 2 to 5.
The Kinetic Wedge from Langer
Brooks running shoes:
In 1987, Brooks incorporated the Kinetic Wedge in their Brooks Nexus running shoe under license from Dananberg. Wolverine World Wide, Inc, a former owner of Brooks Running held the trademark on ‘Kinetic Wedge’ from 1986. They sold Brooks in 1992 and cancelled the trademark in 1994. This version of the Kinetic Wedge consisted of a lower durometer EVA under the first metatarsal head than the surrounding area. It was shaped wider and softer medially to allow the first metatarsal to plantarflex and evert when the peroneus longus muscle is active.
Vasyli+ Dananberg Foot Orthotic:
Howard Dananberg collaborated with Vasyli Medical in 2006 to produce a prefabricated foot orthotic that has design features similar to the Kinetic Wedge principles, the Vasyli+ Dananberg Foot Orthotic.
Patent Application:
A patent was filed for the Kinetic Wedge in 1985 by Howard Dananberg:
A human shoe sole has a foot engaging surface, that area of the sole immediately underlying the first metatarsal head being designed so that the first metatarsal head is free to plantarflex under load thus permitting and encouraging the first metatarsal to plantarflex as weight shifts from the heel to the toe during walking. Link to patent application
Images from the patent:
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Research on the Kinetic Wedge:
| Study: | Findings: | Commentary: |
| Rambarran et al (2003) (conference abstract; unpublished) | In those diagnosed with a functional hallux limitus, in the Kinetic Wedge condition there was reduced pressure under the 1st MTPJ; reduced, but not statistically significant pressures under the hallux; and no change under the 5th MTPJ. | Some of the predicted changes in the plantar pressure pattern that could be expected with a Kinetic Wedge in those with a functional hallux limitus did occur, but others did not. |
| Schembri (2014) (thesis, University of Malta; unpublished) | The range of dorsiflexion was not changed in the shoe conditions with and without the "Kinetic Wedge". The range of motion of the joint was higher in the barefoot condition. | This was an experiment on the 'Vasyli+ Dananberg' prefabricated foot orthotic and not on the Kinetic Wedge product itself. The study assessed the range of motion of the first MTPJ and not the kinetics of the movement to see if motion was 'easier'. |
Alternatives to a Kinetic Wedge:
First ray cut out | Reverse Morton’s extension | Cluffy Wedge | Dancers pad | Forefoot valgus post | Morarty Pad | 2-5 Bar
Howard Dananberg, DPM was a guest on episode 26 of PodChatLive.
External Links:
Kinetic Wedge (Podiatry Arena)
Kinetic wedge function and levels of success (Podiatry Arena)
Kinetic Wedges: Question (Podiatry Arena)
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