Final Major Project - Extensor
Extensor are shoes designed for athletes that have suffered from or are currently experiencing an ankle injury.
The aim of the shoes are to not only prevent ankle injuries, but to improve the user's confidence, allowing the athlete to train without fearing for their ankle's health.
Behind The Project
On the 9th September 2017, I checked myself into hospital for ankle reconstruction surgery. Luckily apart from being able to walk again, it also gave me an idea for my final major project.
The problem: The ankle joint
Why the ankle?
It is one of the most injured joints in the body
Trying to tackle such a large issue meant I had to ensure I took a holistic approach to solving the issue. Breaking down the issue, I found that there were 3 stages to an ankle injury that I would need to research into; Pre-injury (1st Stage), the process of injuring the ankle (2nd Stage) and rehabilitation of the ankle (3rd Stage).
Focus Group
Before starting the research phase, it was crucial to set up a focus group, which acted as a ‘control’ or second point of call for the project. The focus group has a deeper understanding of the ankle joint, as well as extensive knowledge pertaining rehabilitation. This allowed me to get further insights into the professional practice of how ankles are treated. The focus group consisted of 2 Physiotherapists, 2 Sports therapists and 2 Sport scientists.
Understanding the anatomy and function of the ankle joint was the key aspect of my research; once I understood the joint, I could subsequently explore the different methods in which it could be protected.
(Click images below to enlarge)
Summary:
•The ankle socket is made up of four bones- The Tibia, Fibula, Talus and Calcaneus
•There are five main ligaments in the ankle- Posterior tibiofibular ligament, Posterior Talofibular ligament (PTFL), Anterior Talofibular ligament (ATFL), Calcaneofibular ligament (CFL), Deltoid Ligament
•The ankle has four planes of movement which are Plantarflexion, Dorsiflexion, Inversion (Supination), Eversion (Pronation)
•The most common ankle problem is Chronic Ankle Instability
•The ligaments in the ankle are damaged when excessively stretched in one of the planes of movement
After gaining a deeper understanding of the joint, I was prepared to start analysing the three stages to an ankle injury.
The next stage of my research was to investigate the current methods used to prevent ankle injuries and the methods used post injury. Story-boarding the event of an ankle injury helped me to delve deeper in to the process; through story-boarding I was able to identify the parts of the ankle most at risk during a sprain. In order to prevent ankle sprains, I first had to gain a better understanding of the motion that takes place. This was an obstacle in my research, as I could not test people rolling their ankles. In order to overcome this, I set up a controlled and safe experiment, where I recorded myself simulating an ankle roll. Using a slow-motion camera meant that I could observe the progression of the rolling motion in great detail.
(Click images below to enlarge)
Summary:
•There are 4 main methods of prevention/support, Pre-rehabilitation, Tape (Zinc oxide, EAB, Kinesiology), Orthosis, Supportive shoes
•Each method aims to provide support according to the specific ankle injury
•Across all methods, the higher the support level, the more Range of Movement is restricted
•Methods of tackling the issue before the injury can not guarantee the safety of the ankle
•Storyboard- The process from injury to recovery
Research: Survey
Creating a survey and analysing the results obtained provided me with multiple and varied insights into the world of ankle injuries, as no two injuries are the same. This information fed the design process, as I had a wider overview of ankle injuries and was able to recognise key focus points that the design must have. Throughout the survey, I discovered that the main problem with ongoing injuries was not the injury itself, but the rehabilitation that took place afterwards. This consequently led to the design process beginning with ways of rehabilitation, whether through a service or product.
Although I provided examples for each question asked in the survey, some participants did not answer the questions correctly. This was a slight hindrance to my research, but was quickly solved by contacting the participants to gain the correct information. In the survey, participants were asked to provide contact details in the case of further questioning; the option to opt out was also presented (GDPR Compliant).
Key findings of ankle injury survey:
•Most people injured their ankle through sports
•The lateral side of the ankle is the most injured
•R.I.C.E technique is used the most after ankle injury
•Orthotic was the most used method of ankle support post-injury
•Average spent on method of support £50
•Doctor was most used first point of call after injury has occurred. Advice given was rest along with R.I.C.E technique
•54.2% of people started ankle rehab but failed to complete
•Majority of people felt they haven’t actually fully recovered
When sending out my survey, I initially reached out to family, friends and colleagues, and had asked them to also share my survey. I was not getting the response I was expecting, so to counter this problem I put an incentive in place to get a larger response with my survey. I found a discount code for Dominos Pizza online, which was presented on the final page once the survey was completed.
Initial design response
After gaining the insight of rehabilitation being a key problem, I conducted interviews with ankle patients to further explore this is issue. I found that many patients found problems with physiotherapists; they were unable to see a physiotherapist, they would be put on a lengthy waiting list, it was expensive, they simply did not enjoy visiting and did not continue their rehabilitation program. Patients were much happier purchasing an orthotic, to help recover slowly over time.
It was clear that Physiotherapy services were difficult to get a hold of, and costly. A solution I proposed was physiotherapy videos that could be given to the patients, allowing them to complete their rehab program at home.
Using the focus group, we created a collection of videos combining a variety of simple ankle rehab exercises. I presented these videos to patients who would then trial them and report back. The focus group and I also observed a patient following the exercise videos to see how they performed. The focus group identified a key problem which was that even with detailed explanations in the video, the patient still performed some exercises wrong. Having a professional at hand would have corrected the mistakes the patient didn’t realise they were making. Performing the exercises incorrectly, would cause further injury.
After the insights gained throughout this section of the research, I decided to experiment with the idea of an orthotic that could be used to support the ankle and aid rehab. The idea of an orthotic was widely explored through sketching. Consulting the focus group after each design stage was a vital step in my approach, as they could establish what would work effectively in an orthotic and what wouldn’t. Prototyping was difficult throughout this stage, as I could not create model orthoses that would be durable enough to withstand testing. Using physio-tape allowed me to safely conduct tests that simulated the technologies explored through sketching. I ensured the focus group was present during all testing to safeguard the process and confirm that taping methods were applied correctly.
Lab testing
Taking advantage of the facilities the university provides allowed me to gain access to the sports laboratories, where I began conducting tests in favour of preventing ankle injuries. In the short amount of time provided, I set up my experiment along with the help and supervision of my focus group. As time was limited, all tests were carried out as quickly as possible. Having more time to conduct the tests would have allowed me to thoroughly test my designs, as well as test the ankle in different scenarios.
Test:
An electronic insole was used to measure foot pressure.
Participants walked 5 steps with the electronic insole, followed by completing an agility test before re-testing their 5 steps.
Participants then returned the next day to complete the same exercises but with tape.
After an ankle injury the foot’s arch is more likely to collapse as the joint’s alignment is thrown off.
With a collapsed arch (flat foot), unnecessary pressure is put on the foot which can further damage the foot and ankle.
After experimenting with taping techniques, a technique was found that can support the arch, hold the ankle in the correct position and eliminate excess pressure.
The tape also aided the participants athletic performance (agility) as they set faster times on the agility course.
Insole showing excessive foot pressure (red)
Insole showing decreased foot pressure (blue)
Design exploration
After exploring different orthotic possibilities, I began widening my design response to ensure I was researching all of the available options of ankle care. Investigating all of the possible design responses challenged me as a designer and I was able to utilise the knowledge I have gained throughout university. Through exploration I came across the idea of a shoe that could target ankle injuries before they happen as well as protect current injured ankles. Having stuck to the idea of an orthotic was holding the project back. Stepping out of my comfort zone by exploring all options helped with my creative response and allowed me to grow as a designer.
Below shows the top three viable ideas:
- The first being an adjustable orthotic that would allow you to adjust the level of protection needed, ultimately eliminating the need for several orthotics for different levels of support.
- The second idea, was a small device which allowed people to complete basic physiotherapy exercises whilst at work. I decided not to progress with this idea, as this idea requires the ankle to be injured, and the main goal was to prevent injuries in the first place.
- The final idea was a smart shoe, that protected the ankle before the injury occurred, but could also support injured ankles, and support rehabilitation.
Throughout the development stage of the project, ideas were widely explored through sketching and prototyping. Ideas were first sketched out, before validating the idea and progressing onto prototyping. Prototypes were validated through several tests
Below are some examples of sketches and prototypes created through the development phase.
(Click images to enlarge)
Technology investigation
The technology required to overcome ankle sprains was the most difficult component of the project. This was because the technologies required were either underdeveloped or would just not work effectively. This was a major design challenge as researching and testing technologies took time to develop, which left me with less time once I found the technology would not work. The only solution was to continue with the trial and error phase along with further research until a suitable technology was found. In addition to the further research conducted, I contacted material specialists in the engineering department at the university. This helped greatly, as I was introduced to a wide spectrum of technologies that could be applied to the project, which left me with more time to continue the prototyping and testing stages. Reaching out and gaining information from other disciplines helped me as a designer; I could rapidly obtain information and put the data into practice. I was able to fill any gaps in my knowledge by speaking to other professionals
Abandoned technology
Throughout the design and testing stage, there were concepts I had explored but had to abandon as it was over-complicating the design as well as time being limited. The technologies could not be completely developed in the timeframe, which left them in an over-complicated state. A compromise was made to develop the main technologies further, rather than having a series of technologies that worked together to make the injury preventing shoe. This meant I could focus on the need of the users rather than an added luxury. Keeping the user in mind throughout the design process and understanding the intentional use of the product meant I could focus on answering the need of the user more effectively.
Extensor was designed to not only prevent ankle injuries, but to improve the user’s confidence, allowing athletes to train without fearing for their ankle’s health.
