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Author: Cherri Choate, DPM Created: 6/20/2009
Orthotic therapy blog

By Cherri Choate, DPM on 1/27/2010

About a month ago, I tried on a popular "rocker soled" shoe for the first time.  Although I did not purchase it, I started wondering about our professional approach to shoe trends.  Since most shoes are not a medical product, there is not a mandate for any supporting medical research.  Yet, we include shoes as part of our treatment regimen for patients on a daily basis.  Many trends come and go quickly, but some get a foothold in the market and become permanent options.
To saitisfy my curiousity, I would like to know what your current opinions are regarding the rocker type of shoes that are now on the market?  A few studies have been completed, but I am interested in personal expeiernce.   If you have a moment to write a quick Blog in ...

By Cherri Choate, DPM on 1/20/2010
As our population ages, and remains active, foot health will become more complex.  The term "geriatric" leads one to image an elderly patient who is sitting by the window in their easy chair, but in many cases this image is far from the truth.  Attempts to formulate a "geriatric" orthotic would be challenging due to the variability of this population.  What can be discussed are a few consideration due to the natural process of body aging.  Three common changes with age include poor balance, diminished sensation and decreased fat pad.  Addressing each of these as you consider an orthotic for a patient later in years may include the following considerations:
     1)  Balance-  Decreased ...
By Cherri Choate, DPM on 1/13/2010

Over the holidays, many people spend a great deal of time standing in their kitchens, usually in socks or slippers.  As a result there are a lot of sore feet, ankles, knees, hips and backs following all the festivities.  This is an opportune time to recommend that patients with patholgy need to invest in a shoe/orthotic combination that is dedicated to the indoor areas of their home.  The best received shoe recommendations are those that are easy to slip on and off, so some type of "clog" like shoes or mule would would great.  My personal recommendation is the Merrell Jungle or Encore line, but many other brands, including Keen, have similar types of shoes.  The important qualities for the shoes include a removable insole, deep toe box, th ...
By Cherri Choate, DPM on 1/6/2010

     As we all know, research topics seem to go through phases.  We are currently in a phase that is well overdue:  Pediatric Biomechanics.  At Prolab, we are certainly focusing more energy on effective, evidence based treatment options for pediatric foot pathology. I have mentioned Peditric Flat Foot in a previous blog and I will likely mention it again in the near future.  As research is published we should begin to build a treatment protocol based on medical evidence.  One such article was published in 2001 in N ...

By Cherri Choate, DPM on 12/30/2009
As we look forward toward a new year, most of us are already placing vacation and CME dates on our calendars.  Although we strive to keep you updated on current research regarding Biomechanics of the lower extremities, CME programs can also be very inspiring and enlightening.  The Prolab site has a complete listing of the progrmas where we are participating, but here are a few to consider:
By Cherri Choate, DPM on 12/23/2009
Due to the manufacturing process of the CAD CAM system vs. the vacuum press, only the vacuum pressed devices can be made with a sweet spot.  All the Pathology Specific Orthotics that need a sweet spot, or other type of intrinsic accommodation, will be made by the vacuum formed method.  The other instrinsic accommodations include: medial/lateral flanges, plantar fascia grooves and EVA arch fill.    If you want to include any of these in the orthotic order, the vacuum formed device is your only choice. 

In addition, only Vacuum Formed devices can be heat adjusted.  The most common adjustment include expansion of sweet spot and raising/lowering of arch height.  CD devices can not be heat adjusted, so they are not as flexible when patient fit is an issue.
&l ...
By Cherri Choate, DPM on 12/16/2009
    When do we treat chil ...
By Cherri Choate, DPM on 12/9/2009

With all the functional prefabs out on the market, here is a quick primer on Prolab's choices.  Firstly, all the devices are made of a semi-rigid polypropylene shell with 2 mm medial skive, 14 mm heel cup and 3 degrees valgus correction
Below are the differences:

  • P3 Low-Impact: Full length 1/8" plastazote and 1/6" poron topcover; 4/4 polypropylene RF post
  • P3 Sport:  Full length synthetic suede 
By Cherri Choate, DPM on 12/2/2009
SandFootprints.jpg image by weirdscience_photos
Although the term center of pressure is used widely in research circles, and infrequently in clinical practice, it is an important concept to consider when fabricating orthoses. The center of pressure is a representative map of where the body weight is focused during each step.  If we are attempting to offer control of medial or lateral instability, then we are trying to modify the patient's natural center of pressure.   An article in our eJournal this week (Paton 2006) is about the impact of different types of rearfoot posts on the ce ...
By Cherri Choate, DPM on 11/25/2009
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A publication (Kinoshita 2002) referenced in the Journal Club section of our web site a few weeks ago focused on the effect of foot position in tarsal tunnel syndrome. The researchers  presented a quick easy clinical exam where the foot and ankle were held in a dorsiflexed and everted position for a few minutes. When this test was conducted in patients with diagnosed tarsal tunnel syndrome, 84% had an increase in symptoms. 

So how does this translate to orthot ...
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