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By Cherri Choate, DPM on 4/28/2010

 The lateral (inversion) ankle sprain is the most common sports injury. In fact, the inversion ankle sprain may have actually been the impetus for the development of the "RICE" treatment option. With this being said, once the early phase is over and the patient is "back to normal", treatment often becomes inconsistent and ineffective. What is the most effective means of treating chronic ankle instability due to chronic sprains or poor mechanics?

By Cherri Choate, DPM on 4/21/2010
See full size imageJust like an old pair of shoes, replacing an old pair of orthotics can become a frustrating situation for the physician and the patient.  Many patients have "worn in" their devices to the point of ultimate comfort but limited therapeutic use.  This balance must be recognized and discussed PRIOR to an attempt at making a new pair of devices.  In my experience, usless there are significant symptoms present, it may be more beneficial to create a devices that are as close to p ...
By Cherri Choate, DPM on 4/14/2010

Just yesterday, I was speaking with someone who was having foot pain ...

By Larry Huppin, DPM on 4/12/2010 3:28 PM
Twice in the last week I have had a question about the best orthotics for ballet flats.  These are a currently popular style of womens dress shoe based on ballet shoes.  They are very flexible and have little or no heel height.   They tend to be very shallow.  

The short answer is that it is nearly impossible to fit an orthosis of any kind into a ballet flat and you are setting yourself, and your patient, up for failure if you give them the impression that any orthosis will fit in their ballet flats.  

We can make orthoses to fit many, maybe most, women's dress shoes.   But ballet flats are simply too shallow to accept an orthosis.  ...
By Larry Huppin, DPM on 4/8/2010 8:00 AM
A client emailed some pictures today of a patient who was having heel cup irritation from his orthoses. You can see the pictures below. He wanted to know what we could do to fix the problem.

Unfortunately, there is no way to effectively adjust this orthosis to reduce heel irritation. The device will need to be redone with a more heel expansion on the positive to create a wider heel cup.

This problem occurs because the non-weightbearing cast ...
By Cherri Choate, DPM on 4/7/2010
Since I live in California, I fight the flip flop battle nearly every day of the year.  I discourage the use of flip flops for a variety of reasons, but most importantly because they are unstable and cause numerous foot complaints.  I found some interesting reading on flip flops, inlcuding a letter written in 1967 by a British phsyician regarding some issues with the growing fashion trend of flip flops.   
 The use of flip flops as the sh ...
By Larry Huppin, DPM on 4/1/2010 1:33 PM
We had a patient present earlier this week who had a prominent plantar fascia that was being irritated by her new orthoses. Below is detailed our standard troubleshooting plan for creating a plantar fascial groove in an orthosis that was made without one:
  1. If you have an EVA cover on the orthosis, leave it on. If the cover is anything other than EVA, remove it.
  2. If there is on cover, glue 3mm EVA or Poron to the dorsum of the orthosis
  3. Mark the plantar fascia with lipstick
  4. Line the orthosis up with the foot and press it into the foot in order to transfer the lipstick mark to the orthosis
  5. Use a Ticro Cone to grind a groove into the orthosis
  6. Put a thin cover on top of the device.
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