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Jan 13

Written by: Larry Huppin, DPM
1/13/2013 9:18 AM

 In November, I gave a webinar on using orthotic devices to treat plantar fasciitis. ProLab clients can watch that webinar here. After the webinar there were a number of questions. One of those was from a podiatrist who stated that he prescribed prefabricated orthotics for feedback on whether orthotic therapy was likely to function for a particular patient. He wants to know how long a period of time that I would let my patients use prefabs to find out if custom devices will likely work.

With any orthotic therapy, whether prefabricated or custom, our treatment goal is to reduce stress on tissue that has been overstressed. For example, if it is plantar fasciitis, our goal is to reduce tension on the plantar fascia. If we are treating metatarsalgia, our goal is to reduce pressure on the metatarsal heads. In most cases, it does not take very long to see if there will be improvement when using an orthotic device. This does not mean the patient will have 100% improvement, but if an orthotic device is going to reduce stress on tissue, in most cases the patient will start to see pain relief fairly quickly.

I ask my patients to wear the orthosis with a stable shoe at all times for two to three weeks. I emphasize the importance of wearing them all the time by telling them that the only time that they should bear weight without shoes is that they get up in the middle of the night to go to the bathroom. Otherwise, they should be wearing the shoes and the orthotics. If an orthotic device is going to provide any relief, it is likely we are going to see within two or three weeks of that protocol that the pain will decrease. If there is no decrease in pain whatsoever, I think you have to question your diagnosis and whether orthotics are likely to be effective.

The ProLab P3 prefabricated orthosis is the perfect device to help determine whether a custom device is likely to be effective because it is the only orthosis that incorporates many features that are usually only found in custom orthotics. This includes valgus forefoot correction, medial heel skive, and a semirigid polypropylene shell. In my office, I keep both posted and un-posted devices and also covered P3 posted orthosis so that I can fit them in most any shoe that the patients might be wearing. You can learn more of about P3 prefabricated orthosis here.

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