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Aug 29

Written by: Larry Huppin, DPM
8/29/2011 7:41 AM

 I had a consult call this morning from a client whose patient was complaining that his heel was slipping out of his shoe when he wore his orthotics. This was a polypropylene orthosis with an EVA rearfoot post.

This is one of my favorite problems both in the office, and when I am consulting with clients because it is such a simple fix. Simply grind the orthosis thinner directly under the heel. If the orthosis has an EVA post, the post cap can be removed. To remove it, I usually pry it off with a skiving knife, then peel it off with a pair of pliers, and then take the orthosis up to a grinder and grind the heel very thin. In fact, polypropylene can be made almost paper thin without any risk of fracture. I know that I have ground enough when the bottom of the orthosis, directly under the heel, is just slightly moveable when I press it with my thumb.

Any polypropylene orthosis can be ground thin like this. Do not, however, try to grind the graphite or carbon fiber orthotics. These will fracture if you grind them in this area.

If you are ordering a new pair of orthoses and you want to ensure that they sit extremely low in the heel just write in the special instruction box on the prescription form “grind orthosis thin at heel contact.” You will receive an orthosis back that is only about 1 mm thick at the heel contact point.

For more orthotic troubleshooting join us at The Science of the Foot Seminar in Napa on October 28 - 30, 2011.

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