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Dec 5

Written by: Larry Huppin, DPM
12/5/2011 3:46 PM

There is a direct relationship between prescribing inversion in your orthotics and the width that you should be prescribing.

Inversion of your orthoses is one of the more common, and effective, modifications that you can make for several of the most common pathologies treated with orthotic devices. Inverting an orthosis offers several advantages in treating the following pathologies.

  • Metatarsalgia: An inverted orthotic has a higher arch. An orthosis with the higher arch is more effective in transferring pressure from the ball of the foot to the medial arch.
  • Hallux Limitus: An inverted orthotic has an arch that is higher near the base of the first ray. This allows plantarflexion of the first ray, which improves available dorsiflexion at the first metatarsophalangeal joint. This is a primary treatment for functional hallux limitus.
  • Plantar Fasciitis: By allowing the first ray to plantarflex the first metatarsal head is moved closer to the calcaneus. This can decrease tension on the plantar fascia.
The downside of prescribing inversion is that the higher arch that results does have more potential to cause the patient arch irritation. You can, however, decrease the potential for arch irritation by prescribing a wider orthosis. Since the use of a wider orthosis spreads reactive force from the orthosis over a larger surface area, there is less potential that the patient will perceive that the arch is excessively high.

Our recommendation is that if you are going to be prescribing more than 2 degrees of inversion, you should prescribe a wide orthosis. In the case of a fairly severe flatfoot, you should also consider the use of a medial flange. A medial flange will spread force over an even larger surface area.

ProLab takes a scientific approach with our orthoses by integrating evidence-based medicine into orthotic therapy. Our team of Medical Consultants regularly evaluates the medical literature pertaining to orthotic therapy and biomechanics. ProLab clients are encouraged to contact a medical consultant whenever they have questions about an orthotic prescription.

For an easy way to stay up-to-date on evidence-based orthotic therapy, subscribe to our free E-Journal. Your will receive a monthly email synopsis of the research that impacts your practice.


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