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

Larry Huppin DPM
1/8/14 | 4712 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 | 1872 reads | 0 comments
A while back, I wrote a blog on why I rarely recommend first ray cutouts (see ). 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 | 2703 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 | 4080 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.

Addressing Retrocalcaneal Exostosis Pain With Friction Management

Larry Huppin DPM
8/29/13 | 2472 reads | 0 comments
I recently had a patient in my office who had a complaint of posterior heel pain when wearing several different pairs of dress shoes. He had a fairly large retrocalcaneal exostosis on the right calcaneus at the proximal aspect of the posterior calcaneus. There are obviously a number of ways to address the retrocalcaneal exostosis. Our primary goals are to reduce pressure and reduce friction. Reducing pressure in this area is always a little tough without changing shoes. Although you can attempt to stretch shoes in this area, it is usually not particularly effective. Read More.

Is The Orthotic Really Too Hard Or Was It Just The Wrong Prescription?

Larry Huppin DPM
8/2/13 | 2678 reads | 1 comments
A fellow podiatrist called me recently, stating that she wanted to make a soft orthotic for a patient who had a significant pes planus foot type and was suffering from plantar fasciitis. She wanted to make a soft device because she said the patient had “hard orthotics” in the past and did not tolerate them. Read More.

Should You Use A Morton’s Extension For A Forefoot Varus?

Larry Huppin DPM
7/5/13 | 2827 reads | 0 comments
A colleague recently asked me the following question: In patients with a pediatric flatfoot or a young adult with flatfoot deformity with the subtalar joint in neutral upon standing and the first ray doesn't touch the ground, do you add a forefoot extension, first ray cutout or get the forefoot on the ground? Read More.

Another Tip For Eliminating Orthotic-Induced Heel Slippage

Larry Huppin DPM
6/7/13 | 3015 reads | 0 comments
A fairly common complaint that I hear in my office is that of patients saying that their heel is slipping up inside one or more shoes when they wear their orthotic devices. This is usually a very easy problem to address and one that every orthotic practitioner should be aware of. Jenny Sanders, DPM, recently wrote an excellent DPM Blog ( ) on how to use lacing techniques and tongue pads to decrease heel slippage. Read More.

What To Do If The Orthotic Heel Cup Is Too Narrow

Larry Huppin DPM
5/7/13 | 2923 reads | 0 comments
I recently saw a patient who came back in for followup after getting her orthotics. She was comfortable in the orthotics for the most part and they have worked very well in relieving her symptoms. However, there was one area that was bothering her and that was the lateral heel cup on one orthosis. Read More.