Ad description
A voice-over in a TV ad for Scholl Orthaheel shoe inserts, seen on 11 May 2011, stated "Pain in the lower back, heel or knee? It can be caused by your feet rolling over inwards when you walk. Scholl Orthaheel orthotic inserts are designed by podiatrists to naturally reposition the foot so you could walk away from pain. Walk straight, feel great with Scholl Orthaheel orthotic inserts."
Issue
A viewer challenged whether the claim that the product would reposition the foot and alleviate pain was misleading and could be substantiated, because he believed inserts alone could not rectify the problem of feet rolling inwards.
Response
Reckitt Benckiser said a scientific dossier of evidence was submitted when the ad was originally approved for transmission in 2009 in which an orthopaedic specialist said that the claims made for the product – that the shoe inserts had a proven ability to reposition the foot which in turn alleviated pain caused by poor stature – were appropriate and in line with established podiatric practice. They supplied additional statements from the same specialist in 2010 and 2011 on the use of orthoses, and details of other studies that had become available since the original dossier. The specialist said it was widely recognised that the clinical evidence base for many areas of physical therapy was poor, but that that lack of evidence did not prevent a professional evaluating whether a product was suited to the needs of a specific patient and implementing the Orthaheel in cases of heel, knee or back pain. Reckitt Benckiser said the ad made cautiously worded claims that pain "can be caused" by the feet rolling over and that the product was designed by podiatrists. They did not believe the ad made an absolute claim that the Orthaheel was helpful in every pain situation. They said they offered a full refund to customers who were not satisfied.
Clearcast said they had also obtained a medical opinion which testified to the efficacy of the inserts and which said the claims were accurate in that the inserts could help relieve pain. They supplied a copy of the medical opinion. Clearcast said they had taken care to ensure the wording of the claim was cautious, i.e. that the wearer "could" walk away from pain, which they believed reflected that the product would not work for everyone in all situations. They said the ad had aired since 2009 and this was the only complaint of which they were aware. They believed the BCAP Code allowed for obvious exaggerations that the average consumer who saw the ad was unlikely to take literally. They did not believe average consumers would take the claim "Walk straight, feel great" literally.
Assessment
Upheld
The ASA noted that some of the language used in the ad was conditional ("Pain ... It can be caused by your feet rolling inwards ..." and "... so you could walk away from pain"). We also noted, however, that the visuals in the ad showed leg positioning being corrected by the product with the wearer walking more comfortably as a result and that the ad ended with the phrase "Walk straight, feel great with Scholl Orthaheel orthotic inserts" which we considered suggested that the product was very likely to relieve pain that resulted from feet rolling inwards. We noted that Reckitt Benckiser and Clearcast had between them supplied a considerable amount of scientific evidence and medical opinion which they believed testified to the function and efficacy of the product. We noted, however, that only two were randomised, controlled trials. Those trials had assessed either heel or knee pain only and did not refer to the problem being caused by feet rolling over. Neither had considered whether pain in the lower back could be helped by using inserts. We noted that the trial which had assessed heel pain reported evidence of benefit from a product similar in design and materials to Orthaheel after three months’ use but did not report evidence of benefit after 12 months. We noted that the trial that had assessed knee pain had included participants who were aged 40 years and under only and had reported improvement by those in the control group (who had used flat insoles) as well as by those who had used orthoses. Other trials cited by Reckitt Benckiser and Clearcast raised issues such as having used no control group; having used inserts that were different in design from Orthaheel; or which had used inserts in conjunction with exercise or medication; or which had not been published.
We noted that one of the reviews in the scientific dossier reported that the quality of clinical trials was low and stated there was limited evidence on which to base clinical practice. We noted that the orthopaedic specialist Reckitt Benckiser had consulted had commented on the view that the quality of clinical evidence for many areas of physical therapy was poor but that he believed there was wide endorsement of the use of inserts by medical professionals and that the claims made for the product were appropriate. However, we did not consider that that in itself was sufficient to justify claims that the product was very likely to relieve pain that resulted from feet rolling inwards, which is what we considered the ad suggested. We noted that the BCAP Code required broadcasters to hold documentary evidence to prove claims that were likely to be regarded as capable of objective substantiation. Because we considered the ad suggested that the product was very likely to relieve pain that resulted from feet rolling inwards, but that the evidence was not conclusive on that being the case, we concluded that the claim that the inserts would relieve pain that resulted from feet rolling inwards was not substantiated and that the ad was misleading.
The ad breached BCAP Code rules 3.1 3.1 Advertisements must not materially mislead or be likely to do so. (Misleading advertising) and 3.9 3.9 Broadcasters must hold documentary evidence to prove claims that the audience is likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation).
Action
The ad must not be broadcast again in its current form.
