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By Larry Huppin, DPM on 8/29/2011 7:41 AM
  I had a consult call this morning from a client whose patient was complaining that his heel was slipping out of his shoe when he wore his orthotics. This was a polypropylene orthosis with an EVA rearfoot post.

This is one of my favorite problems both in the office and when I am consulting with clients because it is such a simple fix. All that needs to be done is
By Larry Huppin, DPM on 8/25/2011 1:04 PM
A recent article in Lower Extremity Review reviewed an abstract presented at the International Society of Biomechanics meeting which took place last month in Brussels. Researchers used a new method to measure dynamic plantar pressure distribution. Results showed that custom orthoses can improve distribution of peak pressure during dynamic foot loading in patients with the painful cavus foot.
By Dianne Mitchell on 8/23/2011 10:01 PM
I am a paddler, and last Tuesday I was demoing a racing kayak and promptly flipped it upside down. When I reached the shore, I twisted my foot on a rock I didn’t see. This mishap lead to the following discussion of what attributes a canoe shoe and orthotic should have.
By Larry Huppin, DPM on 8/22/2011 1:06 PM
You can help ensure that your patients are comfortable in their AFOs, both the Stabilizer AFO and the Functional AFO, by providing education as to the type of socks that they should use with their AFO. Features to look for on the sock to work well with an AFO include:
By Dianne Mitchell on 8/20/2011 8:31 PM
While I have only been in practice since 2008, patients are already returning for replacement devices. Most of these patients are children and some are adults.

When I dispense orthotics to patients I review things to look, or feel, for as the device ages such as: return of symptoms, callusing, pain, or a cracked device.
By Larry Huppin, DPM on 8/15/2011 1:58 PM
  I had an interesting consult call this morning. A client from the Midwest called in and said that she had a 14-year-old patient who suffered a metatarsal stress fracture while running in minimalist shoes. She convinced him and his mother to go back to a standard Brooks running shoe after the stress fracture occurred and he did fine for about six months. He then decided to try minimalist shoes again, and once again developed the stress fracture. Both the patient and his mother are insistent that he will continue using minimalist shoes. They think this is the best way for him to be a successful collegiate athletic.
By Larry Huppin, DPM on 8/11/2011 9:48 AM
As part of my job with ProLab, I spend a lot of time calling ProLab clients regarding consults for their patients. This means that I spend a lot of time on-hold with podiatrist’s offices around the United States. In the last half-hour I have had three very different on-hold experiences.  Although this blog has more to do with practice management than orthotic therapy, I think it is important to mention.
By Dianne Mitchell on 8/10/2011 4:17 PM
A patient presented with lateral column pain and the initial evaluation was a cavus foot with rearfoot varus. After utilizing the Coleman Block Test, it revealed that the hindfoot reduced nicely bilaterally to (and slightly beyond) perpendicular. Looking at the forefoot, the 1st metatarsal was rigidly plantarflexed below the transverse plane where the lesser met heads all rested.

The goal in selecting the orthotic prescription was to hold the foot neutral, and then bring the ground up to the lesser met heads. I used a poly shell with an EVA rearfoot post for shock absorption. To accommodate the plantarflexed 1st metatarsal, I added a Korex reverse Morton's extension and a topcover to finish up. Sometimes I back fill the region below the 1st met head with poron for additional padding.
By Larry Huppin, DPM on 8/8/2011 1:47 PM
I spoke with a ProLab client today regarding a patient who is having trouble with her new Cobra orthotics. They had been made to treat pain associated with Morton’s neuroma. Whenever she wore it in her shoe, she felt like her foot was slipping out. When she tried it with a larger shoe, she felt like her foot was slipping excessively in the shoe.

The doctor had sent the shoe to the lab when he had the orthosis made, so the orthosis did fit the shoe very well. The only problem occurred when she put her foot into the shoe.
By Larry Huppin, DPM on 8/4/2011 9:21 AM
There has been an interesting thread lately on Podiatry Arena regarding Carbon Fiber (Graphite) as a material for manufacturing custom foot orthoses.

Personally, I am not a big fan of graphite orthoses, although I use it occasionally for women’s dress flats. Compared to polypropylene, carbon fiber is more prone to fracture and much more difficult to adjust. The material is thinner than poly of the same rigidity, but not all that much thinner.
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