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Jul 16

Written by: Larry Huppin, DPM
7/16/2009 11:34 AM

The lateral heel skive is a positive cast modification technique that is very similar to the medial heel skive, first described by Kevin Kirby, DPM in 1991. The lateral heel skive, also introduced to the profession by Dr. Kirby, works on the same principle of shifting the force that the heel cup of the orthosis applies to heel of the foot.

While the medial heel skive creates a varus heel wedge in the heel cup, the lateral heel skive creates a valgus wedge. It is created by shaving plaster from the lateral-plantar aspect of the heel of the positive cast. This valgus wedge creates a pronatory moment around the STJ axis and is used to treat symptoms caused by excessive supination. These may include peroneal tendonitis, lateral ankle instability and medial knee osteoarthritis.
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The lateral heel skive is often combined with other anti-supination orthosis modifications such as valgus wedges on the plantar orthosis and/or valgus forefoot extensions.

The lateral heel skive is a valuable orthotic modification. In the coming weeks we will discuss some of the pathologies where you might include it in your orthotic prescriptions.

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