Foot Orthotics For Cowboy Boots

Larry Huppin DPM
4/3/14 | 652 reads | 0 comments
It is always a challenge to fit orthotic devices in cowboy boots. First of all, let me say that since I practice in Seattle, I am not the most experienced practitioner in fitting orthoses into cowboy boots. I am sure my colleagues in Phoenix, Austin, and other parts of the Southwest have much, much more experience using these types of devices. Given that, I have had several patients for whom I have made orthotics for cowboy boots. While I have ended up frustrated several times, I seem to have found a formula that works well. Read More.

Facilitating Support And Comfort In Orthoses For Obese Patients

Larry Huppin DPM
3/25/14 | 1098 reads | 0 comments
A colleague recently called about a patient who felt his orthotic device was too hard. He wanted to know if he could possibly make a softer orthotic for this patient, who weighs 310 pounds. Or course, obese patients put significant pressure onto their feet. When they wear an orthosis, there is significant force between the orthosis and the foot, much more so than what would occur with a patient of average weight. This means that these patients have more potential to feel the arch of the orthosis as too high or too hard. Read More.

Do Your Patients Have Orthotic Arch Irritation When Standing For Long Periods?

Larry Huppin DPM
2/27/14 | 3316 reads | 1 comments
A colleague called me recently with a question regarding a patient who feels that his orthoses are very comfortable when he is walking on them but they are feeling hard when he stands in one place on the orthotic devices. This is an issue I run into a lot. I practice in Seattle and treat a lot of Boeing employees who stand on concrete all day. I have found those people who are standing in one place on hard surfaces do not usually tolerate quite as much arch height as those that spend most of their day walking or sitting. Read More.

When A High Arched Patient Has Dorsal Foot Pain With Orthoses

Larry Huppin DPM
2/7/14 | 2078 reads | 0 comments
A fairly common complication for patients with cavus foot type who begin wearing orthosis is to develop pain on the dorsum of the foot secondary to shoe pressure. Read More.

Making An Orthotic Accommodation For Plantar Bone Callus

Larry Huppin DPM
1/30/14 | 1429 reads | 0 comments
A colleague recently asked for my opinion on a patient who suffered a midfoot fracture at the base of the fourth and fifth metatarsal shafts. The patient had no treatment at the time of the injury and healed with a large bone callus on the plantar surface of the metatarsals. These bone calluses create a large prominence on the plantar foot. This area is taking excessive pressure, leading to pain, keratoma formation and occasional skin breakdown. My colleague was looking for suggestions on an orthotic prescription for the patient’s foot. Read More.

Should Prefabricated Orthoses For Plantar Fasciitis Have A Plantar Fascia Groove?

Larry Huppin DPM
1/8/14 | 4355 reads | 1 comments
A colleague recently asked whether prefabricated orthoses for plantar fasciitis require a plantar fascia groove. A plantar fascia groove is used to decrease pressure on a very prominent plantar fascia. I find this accommodation is rarely needed, even when making a custom orthosis. In fact, there are some inherent problems with using a plantar fascia groove because it can cause the orthosis to gap excessively from the arch of the foot. My preference is that if a plantar fascia groove is necessary, the clinician should add it after the patient receives the orthosis. Read More.

Should You Use First Ray Cutouts For Pes Cavus Feet?

Larry Huppin DPM
12/10/13 | 1616 reads | 0 comments
A while back, I wrote a blog on why I rarely recommend first ray cutouts (see http://prolaborthotics.com/Blog/tabid/90/EntryID/113/Default.aspx ). More recently, a colleague asked if I would recommend a first ray cutout for a pes cavus foot with plantarflexion of the first ray. Read More.

When A Runner/Cyclist Presents With Second Metatarsal Pain

Larry Huppin DPM
11/7/13 | 2089 reads | 0 comments
A colleague recently asked me which orthotic type would be best for a runner/cyclist who has chronic sub-2nd MPJ capsulitis, which he felt was due to a relatively short first ray. The goal with any capsulitis is to reduce weightbearing on the painful metatarsal head so one should look at the orthotic prescription rather than a specific type of orthotic. Read More.

When An Orthosis Causes A Patient To Feel Laterally Unstable

Larry Huppin DPM
10/8/13 | 3840 reads | 0 comments
A colleague had a patient who presented with plantar fasciitis symptoms and he made her a pair of posted orthoses with a minimum cast fill. The devices worked extremely well at relieving her symptoms. The only problem is now she is feeling like she is somewhat laterally unstable on the left side only. She told the podiatrist she “wishes she had something to push her inward a little bit.” Read More.