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By Larry Huppin, DPM on 2/24/2014 2:07 PM
  I do a lot of orthotic adjustments in my practice...or I should say that my staff do a lot of adjustments.   Between us, we have some 40 years of orthotic adjustment experience.  Plus, when I'm not in the office, I spend the day talking to ProLab clients about how to adjust orthotics.   

Anyway, I'm fairly proficient in adjusting orthoses and was recently asked by Podiatry Today to write an article on the subject.   

Here is their intro to the article:

Troubleshooting orthoses is a vital skill when a patient returns with a complaint about the prescribed device. This author presents a guide to remediating common problems, including addressing arch irritation, how to add valgus extensions and keys to adjusting orthoses for shoe fit.
By Larry Huppin, DPM on 2/17/2014 2:52 PM
 A ProLab client last week sent in a pair of orthotics for adjustment and included his chart note, which read as:

This 55-year-old female returned several months after being fitted for prescription orthotics. She recently began to wear the orthotics reversed in her sneakers (the left device in the right shoe and vice versa) and peroneal tendonitis quickly resolved. She feels as though the current orthotics when worn in the proper shoe allow her foot to shift laterally. She would like to begin running again and is wondering what her options are. Can the orthotics be adjusted to increase the medial shift or decrease the lateral tilt?
By Dianne Mitchell on 2/14/2014 9:34 AM
Happy Valentine's Day from Prolab Orthotics!
By Dianne Mitchell on 2/12/2014 9:29 AM
What can you do to your orthotic rx to help decrease pain to this area!!
By Larry Huppin, DPM on 2/10/2014 2:36 PM
 A ProLab client called me today with a question regarding a patient who is feeling that his orthoses are very comfortable when he is walking on them but they are feeling hard when he stands in one place on the orthotic devices.

This is an issue I run into a lot. I practice in Seattle and treat a lot of Boeing employees who stand on concrete all day. I have found those people that are standing in one place on hard surfaces do not usually tolerate quite as much arch height as those that spend most of their day walking or sitting.

There are some easy ways to avoid this situation and to correct for it when it does occur. 
By Dianne Mitchell on 2/5/2014 9:24 AM
Diabetic with a new pair (about 1-2 months old) of accommodative orthotics. He came in with a large sub 1st met head and hallux base callus wanting options. No accommodations are on the devices, these are simple inserts. On exam this is a neuropathic diabetic, h/o ulcers to the feet, presently intact skin and a noted hallux rigidus. The patient is worried about re-ulcerating.
By Larry Huppin, DPM on 2/3/2014 3:28 PM
  A fairly common complication for patients with cavus foot type who begin wearing orthosis is to develop pain on the dorsum of the foot secondary to shoe pressure.

Without orthotic devices, the foot is allowed to collapse somewhat which will decrease pressure on the dorsum of the foot. This collapse does, of course, often lead to the symptoms that brought the patient into your practice in the first place. These symptoms are, of course, often treated with foot orthoses. But by placing an orthosis under the arch of the foot, particularly one that conforms well to the arch, it can have the effect of increasing pressure on the dorsum of the foot.

There are several options to address this issue.
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