Adjusting Orthoses: Simple Solutions To Common Complaints

Start Page: 64
Larry Huppin, DPM

   Lowering the heel cup. Since a heel cup gets wider as it gets higher, the heel cup width is often the limiting factor in allowing an orthosis to fit into the most posterior portion of the shoe. Be aware that after you lower the heel cup, you must often make the posterior wall of the heel cup thinner.

   Thinning the heel contact. If a patient feels that the heel is pistoning out of the shoe, thinning the heel contact point of the orthosis allows the orthosis to sit lower in the shoe and in many shoes will eliminate the pistoning.

In Conclusion

To provide patients with the best orthotic therapy and optimum outcomes, podiatrists must be skilled at adjusting and troubleshooting foot orthoses.

   It is beyond the scope of this article to provide instruction on performing the majority of orthotic adjustments and modifications that podiatrists might perform regularly in a podiatric clinic. What I hope is that the article will demonstrate the importance of orthotic adjustment skills in providing patients with optimum clinical outcomes and inspire students, residents and practitioners to learn the skills necessary to provide the best possible orthotic therapy for their patients.

   Dr. Huppin is the Medical Director of ProLab Orthotics. He is in private practice in Seattle.

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