How To Recreate The Benefits Of Low Dye Strapping With Orthotics

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How To Recreate The Benefits Of Low Dye Strapping With Orthotics
Here one can see the dorsal exostosis formation that is common with medial column jamming.
The gray area shows where the cutout would allow for greater first ray plantarflexion.
By Scott A. Spencer, DPM

Capturing The Benefits Of Low Dye Strapping With Orthotics
How would one recreate the positive results the low Dye strapping provided? Based on our clinical exam, we fabricated a foot orthotic device that incorporated a rearfoot post that corresponded to the patient’s neutral calcaneal stance position.
The forefoot was a different matter. We applied an intrinsic forefoot post for metatarsal heads two through five. There was also a cutout within the shell of the foot orthotic device for the first ray. This allowed for more plantarflexion of the first ray relative to the lesser rays. After a break-in period for the foot orthotic devices, we cleared the patient to run in them. In short, using the orthotics alleviated the patient’s symptoms.

In Conclusion
This patient required something beyond just capturing his first ray plantarflexed in a negative cast. By closely examining this runner’s foot and with the help of the low Dye strapping, we prescribed a foot orthotic device that eliminated the jamming of his medial column by allowing his first ray to plantarflex adequately.
There are other means of further promoting first ray plantarflexion in an orthotic. One may employ a cutout beneath the first ray in a forefoot extension, a kinetic wedge under the first metatarsal head, a reverse Morton’s extension or a cutout in the shell of the orthotic itself.
The important thing is to listen to what an athletic patient says about wearing a low Dye strapping. Couple that with a careful and thorough clinical exam and the odds are good of creating a foot orthotic device that will provide maximum patient benefit by promoting adequate first ray plantarflexion.

Dr. Spencer is an Associate Professor of Orthopedics/Biomechanics at the Ohio College of Podiatric Medicine. He is also a Diplomate of the American Board of Orthopedics and Primary Podiatric Medicine.

Dr. Caselli (shown in the photo) is a staff podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is also an Adjunct Professor at the New York College of Podiatric Medicine and a Fellow of the American College of Sports Medicine.


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