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

By Dianne Mitchell on 3/25/2013 6:43 AM
Saw a child in the office today who simply doesn't want to play sports because of foot pain. He pointed to the arch/heel/and posterior tibial tendon distribution as pain locations despite a history of custom molded orthotic intervention. On exam, there is really only tenderness on palpation at the navicular tuberosity. All other pain spots happen with activity. This is a flexible flat foot on exam with equinus.
The currrent orthotics are
By Dianne Mitchell on 3/20/2013 6:29 AM
A cyclist came to the office today for orthotic molding. He has been in orthotics in the past in running shoes and felt like he would benefit from the additional support in the cycling shoes. This is a flat footed patient with h/o plantar fasciitis and is a distance cyclist, spending many hours on the bike. He reported arch pains at 50+ miles.
By Dianne Mitchell on 3/18/2013 6:15 AM
Saw a patient today for orthotic molding with a painful Morton Neuroma. She had quite a bit more pathology though ... pronated flat feet with everted calcaneus, hallux valgus with bunions, and equinus deformity! Some thoughts for orthotic modifications for a neuroma ... assuming the hindfoot is well controlled with a great orthotic mold and rx for the lab ...
By Dianne Mitchell on 3/17/2013 6:56 AM
Just a note to wish you all a Happy St Patrick's Day! Don't forget to wear green!
From Prolab Orthotics
By Dianne Mitchell on 3/13/2013 6:05 AM
I had a patient in the office today, referred over with custom molded orthotics that she doesn't like, seeing me for an orthotic evaluation and fabrication of new devices ... she didn't seem too happy about this. The devices are quite old and she never really wore them much because she could not seem to get used to them. She reports the big toe hurts and pointed to the 1st MTPJ. On exam this is a functional hallux limitus and in stance she is pronated with an everted calcaneus. When standing on the orthotics, she continued to pronate right over the medial edge of them.

What to do ...
By Dianne Mitchell on 3/11/2013 5:57 AM
Some thoughts for making a laterally unstable hindfoot more stable on a functional foot orthotic. I see quite a few patients with recent ankle sprains who complain of feeling like they are going to re-sprain their ankle. I always make sure strengthening and proprioception-type exercises are being completed at home or with guided physical therapy. However, orthotics can help increase stability by creating a pronatory torque on the hindfoot.
By Dianne Mitchell on 2/27/2013 5:27 AM
A cavus foot patient came into the office today for orthotics to be made. Her only complaint is "ball of foot pain." This is diffuse pain all the way across the ball of the foot - no one spot is more painful than another. She has no other foot /ankle problems and denies any knee/hip/back pain. What can you do to make this patient more comfortable?
By Dianne Mitchell on 2/25/2013 5:14 AM
A patient presented today with an ankle sprain. He also wears custom molded functional foot orthotics, however he states he doesn't always wear them, though they are comfortable. In evaluating the orthotics, I note that they contour well to the arch, are a good width for his foot, and are otherwise acceptable.
By Dianne Mitchell on 2/20/2013 5:08 AM
I was recently asked how do I decide to invert an orthotic versus medially skive a device.
By Dianne Mitchell on 2/18/2013 4:52 AM
Every once in awhile patients present to the office with what they are calling plantar fasciitis and tell me about the months of pain they have had and bring in several pairs of orthotics asking me what to do. My first thought is to make sure they actually have plantar fasciitis! What else can cause heel pain??
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