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Author: Larry Huppin, DPM Created: 4/7/2010 12:59 PM
Foot orthoses troubleshooting hints and pearls

By Larry Huppin, DPM on 9/6/2012 8:46 AM
If you ever have a patient who complains that they feel like they are leaning too far forward or feel too much pressure on the ball of the foot when wearing a new pair of foot orthosis, the first thing you should look at is whether or not there might be some excessive heel lift. 

Even in a situation where
By Larry Huppin, DPM on 10/31/2011 10:18 AM
  If you are having shoe fit problems with your orthoses, make sure you are taking the following into account. 
  • Instruct your staff to tell patients to bring 2-3 pairs of shoes to their initial appointment
  • Evaluate the patient’s shoes before prescribing orthoses
  • Which type of shoe does the patient plan on using for their orthotics? The prescription must be different if the orthotics are for a dress shoe vs. an athletic shoe.
By Larry Huppin, DPM on 4/7/2011 6:49 AM
 I have written about this before but it is an important aspect of orthotic therapy, so I wanted to mention it again. I just got off the phone with a ProLab client who called requesting help on writing a prescription for a patient with plantar fasciitis and hallux limitus. We have studies available showing that for both of these pathologies an orthosis that conforms very closely to the arch of the foot is more effective at
  • Decreasing tension on the plantar fascia
  • Decreasing compression in the first metatarsophalangeal joint to help decrease functional hallux limitus symptoms.
To conform close to the arch requires a foot orthosis with a minimum cast fill and also a couple degrees of inversion. You can read more about minimum fill orthotics for plantar fasciitis here and for hallux limitus here.

By Larry Huppin, DPM on 2/11/2011 10:51 PM
A year or two ago I was talking to Kevin Kirby about troubleshooting orthotics and the subject of topcovers came up - proving once again that few people in the world live more glamorous lives than do podiatrists.

We all know how frustrating it can be trying to remove a topcover from an orthosis - specially if it's been glued on for a long time.

Kevin described a simple yet brilliant idea for easily removing topcovers.
By Larry Huppin, DPM on 11/15/2010 2:03 PM
MatrixLast week we discussed carbon fiber AFOs in the treatment of dropfoot. Some studies indicate that in many situations they may be a better choice than traditional plastic AFOs due to the fact that there is evidence that there is greater function of the posterior muscle group with use of the carbon fiber AFOs.

Most carbon fiber AFOs, such as the ProLab Matrix, are prefabricated. This brings up the question of what kind of customization can be done. Below is information on how to customize the matrix AFO.
  • Add a Foot Orthotic: One of the most important advantages of carbon fiber AFOs is the ability to control different planes of motion independently. Much of this abil ...
By Larry Huppin, DPM on 6/10/2010 2:08 PM

Have you ever had a patient complain that their orthoses cause pain under the anterior distal arch or feel they are "too far forward”? More often than not, what the patient is actually experiencing is excessive pressure from the orthoses under the anterior metatarsal shafts. You can quickly and easily troubleshoot this problem by increasing the flex of the orthosis under the distal metatarsal shafts.

By Larry Huppin, DPM on 12/10/2009 1:49 PM
  If your patients are complaining about squeaky orthotics, here are a few solutions. 

The first part of finding a solution to the squeaking is to understand what causes it. Rarely does the orthosis itself squeak, rather it is friction between the orthosis and shoe that causes the noise. This is usually the front edge of the orthosis against the bottom of the shoe or the side of the orthosis against the side of the shoe. Here are our recommendations
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