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By Larry Huppin, DPM on 6/28/2012 6:53 AM
We are recommending that all ProLab clients read a recent article in Lower Extremity Review: Role of foot orthoses for patellofemoral pain

This article discusses level 1 evidence for the use of foot orthoses in treating PFPS. From the article: 

“Specifically, there were significantly more self-reported improvers at six weeks in a group receiving prefabricated foot orthoses compared to a group receiving a control intervention (flat inserts). The number needed to treat for one additional improver in th
By Larry Huppin, DPM on 6/25/2012 6:00 AM
 ProLab provides webinars on a specific topics in orthotic therapy on the second Thursday of every month at 12:30 PST. These webinars are available to ProLab clients, podiatric students, and podiatric residents. They are focused on Evidence-Based Orthotic Therapy and about 20 minutes in length.

All of the webinars are recorded and available for viewing at anytime, day or night. We currently have the following webinars available and we'll be adding more every month:
  • Evidence-Based Orthotic Therapy For Plantar Fasciitis
  • Evidence-Based Orthotic Therapy For Metatarsalgia
By Larry Huppin, DPM on 6/21/2012 5:54 AM
Prescribing orthoses for patients with plantar fibromas can be challenging. In general, our treatment goal is to reduce tension on the plantar fascia and then reduce pressure on the plantar fibromas. This can lead to a Catch-22 situation; orthoses that conform closely to the arch of the foot can help reduce tension on the plantar fascia, but they may also increase pressure on the fibroma. Luckily, there are some fairly straightforward orthotic modifications that can lead to an excellent clinical outcome for these patients.

To decrease plantar fascial tension, you will want to prescribe the initial orthosis 
By Dianne Mitchell on 6/14/2012 12:07 PM
Today's webinar was great! It addressed the role of functional foot orthotics for the unstable ankle.The talk ended with viewers learning two orthotic prescriptions for the unstable ankle. One is for the pronated foot type and the other for the cavus foot type.
By Dianne Mitchell on 6/13/2012 9:33 PM
Several great lectures I attended at The Western Podiatry Conference were delivered by Dr. Bouche and Dr. Kirby. They are both lecturing at the Learning in the Vineyards Seminar this October! Don't forget to register! They are great speakers and teachers. You are certain to leave their talks with new pearls to apply right away in the office.
By Dianne Mitchell on 6/11/2012 10:28 PM
If you haven't already done so, sign up for the webinar for this Thursday, June14th. Dr Huppin will be talking about functional foot orthotics and their role for the unstable ankle. These are great and brief discussions which offer great insight and advice for quick clinical application!
By Dianne Mitchell on 6/11/2012 10:06 PM
The second half of day #1 at The Western Podiatry Conference was regarding SPORTS MEDICINE. Dr Bruce Williams, past president of the American Academy of Podiatric Sports Medicine, presented a video gait analysis lecture. He emphasized many great points, but spoke a lot on limb length discrepancies (LLD) and the importance of evaluating patients for them.
By Dianne Mitchell on 6/7/2012 5:03 PM
Dr Paul Scherer closed the Bill Olson Biomechanics Lecture Track this morning discussing the biomechanics of friction of the bottom of the foot. The talk was geared at the diabetic foot, but easily applied to the athletic population, or anyone who experiences callusing, blistering, and ulceration. He asked us to look not only at vertical load pressure, but also shear forces. He presented a material, PTFE, which has a super low coefficient of friction, meaning there is minimal resistance, and likely less chance of callusing, blistering, and therefore, ulcerating.
By Dianne Mitchell on 6/7/2012 4:54 PM
Today is day one of The Western Podiatry Conference in Southern California. The morning started with the Bill Olson Biomechanics Track. Dr. Kevin Kirby started off the track discussing effective foot orthosis treatment of the adult acquired flat foot. His take home point was to ensure there was increased pressure applied medial to the STJ axis in the form of inversion of the orthotic or a medial heel skive, for example, in order to keep the patient from maximally pronating the foot during gait. This can be coupled to a wide orthotic, possibly with a medial flange, a deep heel cup, and minimal arch fill. Also, a rearfoot post can add to the device for completed support of the hindfoot.
By Dianne Mitchell on 6/4/2012 9:51 PM
Some thoughts on LLD's and functional foot orthotics (for LLD's equal to or less than 1/4"). I find that when the orthotic is ordered with the heel lift already attached, it works great if the device is used/worn primarily in an athletic shoe (running/walking shoe). However, that doesn't always seem to be the case in other shoe gear. Patients might complain of the heel popping out of the shoe while attempting to ambulate, so I don't order the device with the heel lift attached. Instead, I make a separate heel lift in the office and start breaking it in right away and then add the orthotic on top of it when they arrive back from the lab. This allows more compliance in wearing the orthotic, or the lift, in isolation in select shoe gear where both do not fit. For LLD's greater than a 1/4" I find a full length outsole lift is better tolerated by patients.
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