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By Cherri Choate, DPM on 2/24/2010


con-sult-ant ((kən sult′'nt):  
one who is called on for professional or technical advice or opinions

Responsibilities of the Prolab Consultants:
1)  Discuss a challenge case
2)  Give a non-judgmental opinion on a biomechanical scenario
3)  Keep abreast of current trends, technologies and ideas in ...

By Larry Huppin, DPM on 2/22/2010 11:02 AM
 


Sometimes it's important to go back to the basics.  The quality of the negative cast is critical to ensure optimum clinical outcomes from functional foot orthoses.  

For best outcomes, the cast must be taken with
  • The subtalar joint in neutra ...
By Larry Huppin, DPM on 2/18/2010 5:13 PM
I consulted with a client today who had a patient with peroneus brevis enthesiopathy.

The goal with orthotic therapy in these cases is to increase the force that the orthotic is exerting on the foot lateral to the subtalar joint axis. Since the peroneus brevis is acting to evert the foot, our orthoses should assist this action in order to reduce the need to fire this muscle. Not suprisingly, it is often patients who are laterally unstable who experience this problem.

CASTING:
Remove soft tissue varus (supinatus) when taking the negative cast. This is imperative as it results in greater forefoot valgus in the negative cast and ultimately in the orthosis. This results in an orthosis that will better support the lateral forefoot and thus reduce the need for the PB to fire. Watch our casting video

PRESCRIPTION:
  • Material: A semi-rigid polypropylene. Either direct-milled or vacuum formed.& ...
By Cherri Choate, DPM on 2/17/2010
 
As we start the 21st Century, life expectancy is continuing to increase.  Infact, here are a few statistics provided by efmoody.com:
              "The number of people 60 or older will grow to nearly 2 billion in 2050, for the first time in rec ...
By Larry Huppin, DPM on 2/11/2010 7:43 AM
A recent paper by Margaret Evans, PhD has been discussed here on this site several times and we summarized it in one of our eJouranl Club Newsletters.  The paper reviews the best studies currently available on treatment of pediatric flatfoot and lays out a clinical pathway with recommendations on treatment. The most controversial portion of her recommendations had to do with those children with asymptomatic flexible flatfoot. Her paper recommended a “monitor” approach to these children. But some practitioners are concerned that these underlying structural abnormalities, ...
By Cherri Choate, DPM on 2/10/2010

We often receive requests for "flexible"  or "soft" functional orthoses.  For shell material choices we can use either plastazote or polypropylene.  In most cases I prefer the use of polypropylene.   When I hear "flexible" I think of less control, so there are a number of ways to create a more flexible orthotic.
  1)  Choose the most flexible shell
           The most flexible polypropylene we use at ProLab is the 1/8" VF device (black or natural)
  2)  LImit the control of the device
      & ...

By Larry Huppin, DPM on 2/8/2010 4:22 PM
Dr. Choate asked in a recent blog what other practitioners thought about some of the rocker shoes, such as MBT and Sketcher Shape-ups, which are currently available in many shoe stores.

In general I don't recommend these shoes very often. I have a problem with much of their adverting and feel that they make false claims about fitness benefits of their shoes. In addition, they’re ugly.

Given that, however, there are some patients that do relatively well with these shoes.

The first thing to keep in mind is that these are simply shoes with a midfoot rocker sole. For decades, midfoot rocker soles have been effective treatments at reducing motion through the midfoot and reducing ground reactive forces on the heel. < ...
By Cherri Choate, DPM on 2/3/2010

Among the many questions surrounding the pediatric flat foot, is the possible whole body affects of the pathology.  The discussion regarding when and if to treat will become more clear as we have more evidence to help formulate an answer.  An article by Lin from the Journal of Pediatric Orthopedics in 2001, evaluated children with flat feet to determine if their activity levels were different than children wtihout flat feet.  The designation of "flat foot" was based on longitudinal arch height.  Interestingly, they found that the younger children tended to have a higher propensity for flat feet.  In addition they found that the presence of flat feet correlated with lower performance of certain ...

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