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

By Cherri Choate, DPM on 6/23/2010
In today's world stories covering pediatric obesity  are read, nearly on a weekly basis, in both national and local media.  In addition to all the long term health issues related to this epidemic, studies are now being published about the impact on the lower extremity.  But now, we have two intervening issues to make our decisions even more difficult:  Childhood Sports and Obesity
By Cherri Choate, DPM on 6/16/2010
Case Information: 
A 48 year old female presents with pain in the ball of her foot and in her 1st MPJ.  She has attempted to change her shoes and primarily only wears athletic shoes now, and they seem to be the only comfortable shoes.  She walks or rides her bike daily, as she does not drive.  She has always been an active walker, but only walks to get from one place to another now, due to the pain.  She states the pain has gotten increasingly worse over the past 8 months.  She has seen another physician, who gave her an injection and a pad for her shoe, neither of which helped relieve her pain.

Physical Exam:  
    MSK- pain on ROM and palpation 1st MPJ with mild pain on palpation of 2nd MPJ plantarly; mild edema dorsal 1st MPJ; no erythema; no pain on 3-5 MPJs;  hallux dorsiflexion NWB limited but arch raises with hallux dorsiflexion WB< ...
By Cherri Choate, DPM on 6/2/2010

     I was recently on a trip and when I returned home, my husband had left out an article for me to read from the Wall Street Journal.  The article title was:  Why the Hightop Has One Foot in the Grave ( see link below).  I am a former hightop wearer so the article was of interest on a number of levels.  In fact, I had some pink Avia hightops that traveled with me for many years.  Ironically, it was not the information on the demise of the high top athletic shoe that caught my attention.  The second half of the article discussed foot injuries and stated that they are the number one injury in the NBA.  The implication from the article was that players are now being fit with orthotics, to try to protect their feet from injury, instead of solely relying on the shoe.  This is certainly another application of the important orthotic research that is being done throughout the world by many s ...

By Cherri Choate, DPM on 5/26/2010
Efforts to standardize issues in research always intrigue me. Since there is such a chasm between a great idea, and a practical and validated process, I always have respect for those who not only propose, but develop their idea into a working measure. Such a measure is the Foot Posture Index 6 (FPI-6). In the early 21st century a group from the Univeristy of Leeds developed this stardardized method to determine foot posture. 

So, why do you, as a practice based physician, need to know about the Foot Posture Index? Well, it really has to do with the value of valid clinical research.  As practitioners we would like studies to be reliable and quantifiable. We would like the methods section of a research paper to be written in common language so that we can compare results and conclusions with ease.  Returning to the original  FPI article, their motivating issue ...
By Cherri Choate, DPM on 5/19/2010

Prolab offers three different types of accommodative orthotics devices.  Al the devices should be fabricated from a semi-weightbearing casts, due to the production process of not adding soft tissue expansion (no fill). All three options have some similarities:  14 mm heel cup, standard width and no cast fill.  The differences are listed below:

   Custom Diabetic- Firm Plastazote shell, diabetic cover to toes
   Custom Insole- Full length medium Plastazote shell, P-cell cover to toes
   EVA Accommodative- 3 mm VF shell, extended EVA arch fill, 3 mm nylene to toes

All three devices are a good option for pathology such as severe Charcot deformity, late stage RA and severe fat pad atro ...
By Cherri Choate, DPM on 5/12/2010

Heel cup irritation with orthotic use is not uncommon.  If this is happening on a regular basis in your practice, then perhaps a few changes in habit will help.  Unlike many other aspects of troubleshooting with orthotics, a narrow heel cup is difficult to adjust in your office.  If you do a large volume of orthotics, you probably have already invested in calipers.  If you are newer in practice, these may seem unnecessary, until you face a series of patients with poor heel cup fit. 

When do you need to provide the lab with heel width measurements?  Can you tell by the patient weight, shoe ...

By Cherri Choate, DPM on 5/5/2010
FAQ Series:  Does Prolab recycle any of their materials?
Since we have entered the 21st century, the importance of being environmentally responsible, is vital for any company.  Prolab has developed a set of programs which are aimed at lowering the environmental impact of the production process:

     1)  Polypropylene shavings are recycled into other types of plastic products.
     2)  Wood shavings and scraps are recycled locally into mulch.
     3)  Prescription forms are printed on recycled paper.
By Cherri Choate, DPM on 4/28/2010

 The lateral (inversion) ankle sprain is the most common sports injury. In fact, the inversion ankle sprain may have actually been the impetus for the development of the "RICE" treatment option. With this being said, once the early phase is over and the patient is "back to normal", treatment often becomes inconsistent and ineffective. What is the most effective means of treating chronic ankle instability due to chronic sprains or poor mechanics?

By Cherri Choate, DPM on 4/21/2010
See full size imageJust like an old pair of shoes, replacing an old pair of orthotics can become a frustrating situation for the physician and the patient.  Many patients have "worn in" their devices to the point of ultimate comfort but limited therapeutic use.  This balance must be recognized and discussed PRIOR to an attempt at making a new pair of devices.  In my experience, usless there are significant symptoms present, it may be more beneficial to create a devices that are as close to p ...
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