Orthotics Q&A


10,794 reads | 0 comments | 07/28/2009
   In addition to discussing the most common problems they see with orthosis irritation and how they remedy these issues, the expert panelists weigh in on two recent studies and their potential impact.    Q: What is the most common orthosis irritation problem that you see in your practice and how do you solve it? | Continue reading
Guest Clinical Editor: Patrick DeHeer, DPM
15,715 reads | 0 comments | 06/01/2009
   Orthotic modifications can play a valuable role in the treatment of various lower extremity ailments. Accordingly, these expert panelists offer their insights on the use of orthoses and key modifications within the treatment plan for turf toe injuries, posterior tibial tendon dysfunction (PTTD) and lesser metatarsal stress fractures.    Q: What is the preferred treatment for turf toe injuries in terms of orthotic modifications? | Continue reading
Guest Clinical Editor: Cherri Choate, DPM
12,439 reads | 0 comments | 03/27/2009
Guest Clinical Editor: David Levine, DPM, CPed
7,842 reads | 0 comments | 01/30/2009
   While more research continues to emerge on biomechanics, some physicians feel it is not emphasized enough in podiatry and that other specialists may be gaining more of a foothold in prescribing orthotic devices. Accordingly, expert panelists discuss these controversial issues and examine the potential impact for the profession.    Q: With much emphasis in our podiatry journals on surgery, where and how do you see biomechanics in our profession evolving?    A: As David Levine, DPM, CPed, notes, orthotic devices came of age in the 1970s in th | Continue reading
Guest Clinical Editor: Ronald Valmassy, DPM
24,614 reads | 0 comments | 09/30/2008
Given the variety of conditions one sees in practice and ­­the challenge of ensuring optimal results with orthoses, expert panelists offer their take on utilizing orthotic modifications for different case presentations. Q: What modifications would you make for a patient who has flexible forefoot valgus, excessive midstance and propulsive phase pronation? A: As Richard Blake, DPM, notes, a flexible forefoot valgus pronates late in the gait cycle because it initially supinates in contact phase. He emphasizes that control of this foot primarily depends on four factors. The first factor is | Continue reading
(Photo courtesy of Ronald Valmassy, DPM)
Mary Keen, MD, emphasizes the importance of gait training with a pediatric physical therapist.
Guest Clinical Editor: Edwin Harris, DPM
11,018 reads | 0 comments | 09/03/2008
Given that toe walking and other gait disturbances are common among children, these expert panelists take a closer look at these conditions, offer keys to the diagnostic assessment and share their insights on appropriate treatment modalities and physical therapy regimens.

Q: What is your treatment plan for children with diplegia and hemiplegia?
A: Mary Keen, MD, says most children with diplegia and hemiplegia walk so she strives to facilitate independent ambulation. In order to achieve safe, efficient ambulation, Dr. Keen says children need ad | Continue reading

Guest Clinical Editor: Ronald Valmassy, DPM
14,844 reads | 0 comments | 06/03/2008


Choosing the most effective type of orthotic device for a given condition can be tricky as one must consider factors that include materials, potential modifications and cost.
Accordingly, the panelists discuss possible indications for OTC orthoses, conditions that are particularly challenging to treat with orthotics and the role of functional foot orthoses in managing bunion deformities.

Q: Are all prefabricated, over-the-counter (OTC) foot support systems essentially the same? Are there unique characteristics of any of the devices which makes them better s

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Guest Clinical Editor: Douglas Richie Jr., DPM
21,813 reads | 0 comments | 04/03/2008


Injuries to the second metatarsophalangeal joint (MPJ) can be challenging to treat. Our expert panelists discuss predisposing factors to injury and review pertinent biomechanical considerations. They also discuss conservative treatment options, including variations of orthotic therapy and modifications that they have employed in clinical practice.

Q: What are the predisposing factors (gender, foot type, activity, etc.) that are associated with injuries to the second MPJ?
A: Second MPJ injuries may have a variety of etiological causes, accordi

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Scott Spencer, DPM, does not believe that he must focus on one specific area to create a foot orthotic that will properly serve the patient. He stresses the importance of getting a clear idea of what all the areas of the foot are doing during function, an
Guest Clinical Editor: Scott Spencer, DPM
8,655 reads | 0 comments | 12/03/2007

Q: How do you evaluate a patient for foot orthotic devices?
A: All three panelists will perform a gait analysis. Russell Volpe, DPM, begins by assessing what he wants the orthosis to accomplish once he decides a CFO is indicated. If control of motion is needed, he will tailor material selection and many of the plaster modifications and prescription items to help accomplish that goal. If Dr. Volpe’s desired goal is accommodation, soft-tissue supplementation or assistance with motion, he will gear material selection and prescription features toward those goals. He also c

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Guest Clinical Editor: Edwin Harris, DPM
15,623 reads | 0 comments | 10/27/2007

Given that toe walking and other gait disturbances are common among children, these expert panelists take a closer look at these conditions, offer keys to the diagnostic assessment and share their insights on appropriate treatment modalities and physical therapy regimens. Q: What is your treatment plan for children with diplegia and hemiplegia?

| Continue reading