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By Dianne Mitchell on 5/23/2013 7:22 AM
A patient came in today with 5th toe pain. This is a patient who has functional hallux limitus with transfer metatarsalgia and associated pains. She presented with a pair of great custom molded functional foot orthotics, with a shell that supported and corrected her foot appropriately. A minor modification to the soft materials could make this orthotic more effective. I added a top cover and a 3mm cork reverse Morton's extension. While this fit fine in the athletic shoes she had in the office, she headed out for a hike the following weekend in different footwear and reported back to the office the following week with new symptom of 5th toe pain.

Clearly the top cover with the added cork extension was too thick. A simple, quick fix for this is to leave the accommodation in place and simply mark the location of the 5th toe in weight bearing on the device. Next, thin the portion of cork below the marking with the grinding wheel. The patient loved it!

Before removi ...
By Dianne Mitchell on 5/20/2013 7:06 AM
I see a bunch of kids in the office for orthotics and many of them see me frequently for new top covers. The most frequent reason, is: the orthotics got wet and the cover either came off or smells or looks poor. I was also getting similar complaints with the rearfoot post becoming saturated. Typically this involves a puddle at recess that got played in and the shoes are soaking along with the socks and the orthotic device. As everything dried out that evening, parent and child observed damage.
By Dianne Mitchell on 5/16/2013 7:54 AM
A woman came into the office today for custom orthotics and wants them to fit in as many shoes as possible. She understands the types of flats she should be in and really didn't want to have to buy a bunch more shoes to accommodate the orthotic.
Some thoughts ...
By Dianne Mitchell on 5/13/2013 9:44 AM
A patient presented to the office today with a severely planus foot and associated arch pain/strain, posterior tibial tendon dysfunction, sinus tarsi and calcaneofibular impingement. He was miserable and was seeing me for custom orthotics in hopes of the pain being reduced. In stance there was a large degree of bow-legged deformity also in addition to the feet being completely flat to the floor. What to do ...
By Dianne Mitchell on 5/9/2013 7:34 AM
We all see patients in the office who have sustained an inversion ankle sprain. We also see patients who continue to sprain their ankle multiple times later. What can we do to an orthotic prescription to decrease the inversion forces?? How do you create a pronatory torque?
By Dianne Mitchell on 5/6/2013 7:19 AM
We frequently see painful inner-metatarsal space neuromas in the office. Once you confirmed this is indeed a neuroma and not metatarsalgia, capsulitis, stress fracture, etc ...
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