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By Dianne Mitchell on 9/27/2012 7:19 AM
Drs Scherer and Huppin both wrote articles in this months Podiatry Management regarding things to think about when prescribing orthotics for diabetics. Check it out!
By Larry Huppin, DPM on 9/26/2012 3:37 PM
  The goal of any orthosis used to treat pediatric flatfoot is to limit excessive force that might lead to pain or deformity. The collapse of the medial longitudinal arch seen in children with pes planus can lead to a number of problems, including:
  • Excessive tension on plantar structures resulting in conditions such as calcaneal apophysitis
  • Excessive compression dorsally, leading to dorsal foot pain in the short term and increased likelihood of midfoot arthritis in the long term.
  • Increased forefoot pressure and associated conditions.
  • Functional hallux limitus leading to increased likelihood of bunion formation or hallux rigidus
In order to limit excessive pronation in the pediatric flatfoot a foot orthosis should incorporate the fo
By Dianne Mitchell on 9/25/2012 7:15 AM
Check out this months Podiatry Management magazine. If you are a skeptic about scanning patients feet for orthotic devices ... well, so was I. Here is what I encountered and learned in the process! Enjoy the article.
By Larry Huppin, DPM on 9/24/2012 1:18 PM
  We have a new webinar available on the website.  This one reviews literature that demonstrates that foot orthoses may be effective in helping to prevent ACL and knee collateral ligatment injuries.   In the webinar we review the literature and make specific orthotic recommendations.   ProLab clients can watch the webinar here.  
By Larry Huppin, DPM on 9/20/2012 11:03 AM
I recevived this question today from a ProLab client regarding orthotic width in running shoes:  

Hi Larry,

I've been finding that some of the orthotics I prescribe for running shoes are coming back too wide for the patients shoes  Do you have any recommendations on how to prevent this problem?  Should I send a tracing of the shoe insole?   

I find a wide width works fine as long as the patient purchases shoes AFTER getting their orthoses.  The problem you are running into is that the shoe is likely too narrow for the patient.  In this case fitting an orthosis is always going to be difficult.  
By Dianne Mitchell on 9/18/2012 2:05 PM
New patients frequently arrive at my office with custom molded prescription foot orthotics complaining that they still have the same pain as before the devices were prescribed! (the orthotics didn't help!)
When I evaluate the devices they tend to be under-corrected.
By Larry Huppin, DPM on 9/17/2012 1:13 PM
I had a patient come in today who is a runner and for whom we had made orthotic devices to treat hallux limitus pain. Overall, she has done very well. This was a very controlling orthotic which conformed close to the arch of the foot. It is the full width of her foot and it was inverted several degrees to allow first ray plantarflexion.

Since she was still having symptoms, I wanted to accentuate the plantarflexion of the first ray. We accomplished this in two ways. 
By Dianne Mitchell on 9/12/2012 8:43 AM
Webinar Thursday 9-13 at 12:30 ... Here is your reminder to sign up!!

Topic: Can Foot Orthotic Therapy Decrease the rate of ACL Injuries?

sign up on the home page!
By Dianne Mitchell on 9/11/2012 8:15 AM
So, what is the best way to accommodate a prominent plantar fascia? If your patient has a prominent fascial band on exam it is important to take note of this structure in order to offload it so your patients doesn't irritate it on the device. Side affects of an irritated fascia include: pain and nodule (fibroma) formation.
By Larry Huppin, DPM on 9/10/2012 8:52 AM
  If you ever have a female patient with a severe pes planus who needs the support of a medial flange but who also wants to wear dress shoes, consider ordering a polypropylene orthosis with a very shallow heel cup and medial flange. It is, in fact, not usually the arch that limits orthotic fit in the shoe but rather heel cup 
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