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By Dianne Mitchell on 7/16/2013 9:12 AM
Patient presented for second opinion of her 1st MTPJ pain. This is an athlete with functional foot orthotics. The main question of the patient was whether or not she was "due for a new pair" ... as the pain in the big toe wasn't going away despite efforts to "pad" the pain area.

On evaluation of the patient: minimal hindfoot pronation with a functional hallux limitus and associated medial hallux and 1st MTPJ callusing.

Prior to pulling the orthotic devices out of the shoe, what do we expect to see on the orthotic? This could be a simple orthotic shell with great hindfoot control and a simple top cover and could potentially include a reverse morton extension, as this modification allows plantarflexion of the 1st metatarsal and therefore increased ROM thru the 1st MTPJ during the gait cycle.

Periodically I see addition of padding beneath the 1st MTPJ in an effort to literally pad the painful region. In this particular in ...
By Dianne Mitchell on 7/11/2013 9:22 AM
Patient presented today with complaint of callusing on her orthotics.
By Larry Huppin, DPM on 7/8/2013 8:40 AM
  A ProLab patient called me today stating that she had a patient who is getting blisters when wearing her new orthotics. She stated that she had sent the orthotics back to be lowered once but that they were still causing blisters.

I asked what kind of orthotics they were and it turns out they were a graphite orthosis with a standard width, a standard heel cup, and no rearfoot post. The patient wanted to get one pair of orthotics that would work in both her dress shoes and her athletic shoes.

It turned out that the blistering occurred only when she was running and using the orthotics.

I explained to our client that the problem was
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