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

By Dianne Mitchell on 6/14/2012 12:07 PM
Today's webinar was great! It addressed the role of functional foot orthotics for the unstable ankle.The talk ended with viewers learning two orthotic prescriptions for the unstable ankle. One is for the pronated foot type and the other for the cavus foot type.
By Dianne Mitchell on 6/13/2012 9:33 PM
Several great lectures I attended at The Western Podiatry Conference were delivered by Dr. Bouche and Dr. Kirby. They are both lecturing at the Learning in the Vineyards Seminar this October! Don't forget to register! They are great speakers and teachers. You are certain to leave their talks with new pearls to apply right away in the office.
By Dianne Mitchell on 6/11/2012 10:28 PM
If you haven't already done so, sign up for the webinar for this Thursday, June14th. Dr Huppin will be talking about functional foot orthotics and their role for the unstable ankle. These are great and brief discussions which offer great insight and advice for quick clinical application!
By Dianne Mitchell on 6/11/2012 10:06 PM
The second half of day #1 at The Western Podiatry Conference was regarding SPORTS MEDICINE. Dr Bruce Williams, past president of the American Academy of Podiatric Sports Medicine, presented a video gait analysis lecture. He emphasized many great points, but spoke a lot on limb length discrepancies (LLD) and the importance of evaluating patients for them.
By Dianne Mitchell on 6/7/2012 5:03 PM
Dr Paul Scherer closed the Bill Olson Biomechanics Lecture Track this morning discussing the biomechanics of friction of the bottom of the foot. The talk was geared at the diabetic foot, but easily applied to the athletic population, or anyone who experiences callusing, blistering, and ulceration. He asked us to look not only at vertical load pressure, but also shear forces. He presented a material, PTFE, which has a super low coefficient of friction, meaning there is minimal resistance, and likely less chance of callusing, blistering, and therefore, ulcerating.
By Dianne Mitchell on 6/7/2012 4:54 PM
Today is day one of The Western Podiatry Conference in Southern California. The morning started with the Bill Olson Biomechanics Track. Dr. Kevin Kirby started off the track discussing effective foot orthosis treatment of the adult acquired flat foot. His take home point was to ensure there was increased pressure applied medial to the STJ axis in the form of inversion of the orthotic or a medial heel skive, for example, in order to keep the patient from maximally pronating the foot during gait. This can be coupled to a wide orthotic, possibly with a medial flange, a deep heel cup, and minimal arch fill. Also, a rearfoot post can add to the device for completed support of the hindfoot.
By Dianne Mitchell on 6/4/2012 9:51 PM
Some thoughts on LLD's and functional foot orthotics (for LLD's equal to or less than 1/4"). I find that when the orthotic is ordered with the heel lift already attached, it works great if the device is used/worn primarily in an athletic shoe (running/walking shoe). However, that doesn't always seem to be the case in other shoe gear. Patients might complain of the heel popping out of the shoe while attempting to ambulate, so I don't order the device with the heel lift attached. Instead, I make a separate heel lift in the office and start breaking it in right away and then add the orthotic on top of it when they arrive back from the lab. This allows more compliance in wearing the orthotic, or the lift, in isolation in select shoe gear where both do not fit. For LLD's greater than a 1/4" I find a full length outsole lift is better tolerated by patients.
By Dianne Mitchell on 5/24/2012 10:35 AM
For patients experiencing pain during cycling, here are some thoughts to consider:
- are the cycling shoes properly fit to the patient's foot?
- what type of socks does the patient wear (thin cycling socks versus thick padded running socks)?
- where is the pain? Many riders complain of forefoot numbness, specific great toe numbness, inner-metatarsal space neuromas.
By Dianne Mitchell on 5/17/2012 9:43 PM
Modifying diabetic accommodative orthotics is similar to modifying a standard functional foot orthotic. I had a patient in the office earlier this week with 5th metatarsal base pain and irritation on his custom molded accomodative inserts. Interestingly, this is a neuropathic patient, so he was really concerned about the fact that he had pain and what looked like a skin lesion. 
By Dianne Mitchell on 5/15/2012 9:21 PM
When prescribing functional foot orthotics it is important to not only discuss that orthotic devices should be comfortable and address foot mechanics for pain relief, but also explain which shoes the devices fit best in. I frequently see patients who present with orthotics and the complaint that they can't wear them everyday because they don't fit in their shoes.
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