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Author: Dianne Mitchell Created: 5/16/2011 9:38 AM
Orthotic Therapy Blog

By Dianne Mitchell on 7/2/2011 7:20 AM
I perform quite a few orthotic modifications each day in the office. These are on over-the-counter orthotics, poorly controlling custom devices, and minor adjustments to otherwise good devices. Sometimes the modification will really change how the foot functions on the orthotic. 

Patients often prefer that I don't significantly change their device, so I started using adhesive felt (1/8" and 1/4" thickness) to perform modifications and give patients a taste of what needs to be done. This allows me to modify the orthotic but still give the patient the opportunity to remove it (carefully un-peel it) if they can't tolerate it.
By Dianne Mitchell on 6/15/2011 10:20 PM
A patient with persistent forefoot callusing presented today for debridement.
By Dianne Mitchell on 5/20/2011 6:26 PM

I never thought I would place a full-length valgus wedge on a patient's orthotics.

I see a lot of workers comp cases and presently see a roofer. After about 2-3 hours on the roof he feels pain. In a stance exam of this patient, he is bow legged b/l with pronounced tibial varum and his RCSP is nearly perpendicular to the ground. Initially, he presented with typical plantar fasciitis symptoms and we tried a 0/0 motion rearfoot posted functional foot orthotic, neutral device with no inversion. This seemed to help the arch, but the patient slowly developed peroneal pain. In my initial attempt to relieve this, I added a reverse Morton's extension of cork to the devices that the patient enjoyed; then he increased time on the roof and this was proving to not help. So, I ...

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