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By Cherri Choate, DPM on 6/23/2010
In today's world stories covering pediatric obesity  are read, nearly on a weekly basis, in both national and local media.  In addition to all the long term health issues related to this epidemic, studies are now being published about the impact on the lower extremity.  But now, we have two intervening issues to make our decisions even more difficult:  Childhood Sports and Obesity
By Larry Huppin, DPM on 6/21/2010 12:36 PM
Orthoses for dress shoes can be great. Personally, I prescribe many graphite orthoses with a shallow heel cup, normal width, and vinyl cover to the sulcus for these shoes. This device works wonderfully in many women’s and men’s dress shoes.

I tell every patient, however, that I make NO guarantee that the orthoses will fit in ANY shoe that they currently own. In fact, I tell them that they probably will NOT fit in any of their current shoes but that I will give them a list of fashionable shoes that often work well with orthoses.

Even if you send the shoe to the lab, we can only guarantee you that the orthosis will fit the shoe. We cannot guarantee that the foot will then fit into the shoe with the orthosis. It may make the shoe too tight or the patient’s heel may slip ...
By Cherri Choate, DPM on 6/16/2010
Case Information: 
A 48 year old female presents with pain in the ball of her foot and in her 1st MPJ.  She has attempted to change her shoes and primarily only wears athletic shoes now, and they seem to be the only comfortable shoes.  She walks or rides her bike daily, as she does not drive.  She has always been an active walker, but only walks to get from one place to another now, due to the pain.  She states the pain has gotten increasingly worse over the past 8 months.  She has seen another physician, who gave her an injection and a pad for her shoe, neither of which helped relieve her pain.

Physical Exam:  
    MSK- pain on ROM and palpation 1st MPJ with mild pain on palpation of 2nd MPJ plantarly; mild edema dorsal 1st MPJ; no erythema; no pain on 3-5 MPJs;  hallux dorsiflexion NWB limited but arch raises with hallux dorsiflexion WB< ...
By Larry Huppin, DPM on 6/10/2010 2:08 PM

Have you ever had a patient complain that their orthoses cause pain under the anterior distal arch or feel they are "too far forward”? More often than not, what the patient is actually experiencing is excessive pressure from the orthoses under the anterior metatarsal shafts. You can quickly and easily troubleshoot this problem by increasing the flex of the orthosis under the distal metatarsal shafts.

By Larry Huppin, DPM on 6/3/2010 1:57 PM
Providing Realistic Expectations about Orthotic Therapy

We spend a lot of time educating our patients about the benefits of orthotic therapy. We spend just as much time ensuring that our patients understand the limitations of their new orthoses.

We try to provide our patients with very realistic expectations about some of the limitations of orthotic therapy. By making sure that they understand these limitations before making the decision to proceed with casting for the orthoses, we eliminate most disappointment and misunderstanding. Just a few of the issues we raise with patients are:
  • New shoes will likely be necessary as we cannot guarantee that the orthoses will fit in any shoes they currently own.
  • Women need to choose whether their first pair of orthoses will be used in dress or athletic shoes. They will not work for both
  • Orthoses are not a cure, just a tool to r ...
By Cherri Choate, DPM on 6/2/2010

     I was recently on a trip and when I returned home, my husband had left out an article for me to read from the Wall Street Journal.  The article title was:  Why the Hightop Has One Foot in the Grave ( see link below).  I am a former hightop wearer so the article was of interest on a number of levels.  In fact, I had some pink Avia hightops that traveled with me for many years.  Ironically, it was not the information on the demise of the high top athletic shoe that caught my attention.  The second half of the article discussed foot injuries and stated that they are the number one injury in the NBA.  The implication from the article was that players are now being fit with orthotics, to try to protect their feet from injury, instead of solely relying on the shoe.  This is certainly another application of the important orthotic research that is being done throughout the world by many s ...

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