Orthotics Q&A
Can orthoses have a positive impact for conditions such as Achilles tendinosis, posterior insertional spurs on the calcaneus and plantar fasciitis? Our esteemed panel weighs in with their perspectives.
Q:
Do you think orthotics can be helpful for Achilles tendinosis? If so, can you explain how they help and what you do with your devices to improve outcomes for this condition?
A:
James Clough... Read More.
These expert panelists examine the role of orthoses in the management of common clinical presentations such as bunions, hammertoes and Morton’s neuromas.
Q:
Do you think orthotics can be helpful in the treatment of bunion deformities?
A:
James Clough, DPM, FACFAS, notes most people have some limited motion of the first metatarsophalangeal joint (MPJ), which causes compression of the joint when... Read More.
Our expert panelists discuss the role of orthotics, orthotic modifications and other conservative solutions for pregnant women, female athletes and CEOs in dress shoes.
Q:
What is your treatment protocol for the active pregnant woman with medial calcaneal neuritis and associated plantar fasciitis?
A:
Alona Kashanian, DPM, notes the multifaceted etiology of medial calcaneal neuritis with... Read More.
These experienced panelists discuss the unique challenges of fabricating orthotics and creating modifications for various types of sports, high heels and Morton’s neuroma.
Q:
What are some key orthotic considerations for a sport or sports that you are particularly familiar with in treating athletic patients?
A:
In regard to sports activities, Ronald Valmassy, DPM, finds that the standard three... Read More.
Given the common presentation of limb asymmetry, these panelists describe how leg length discrepancy affects orthotic prescription. They also offer insights on effective orthotic management of patients with heel pain.
Q:
In what percentage of patients do you find differences in lower extremity structure or function, and how does this asymmetry affect your orthotic prescription?
A:
All four... Read More.
Our expert panelists discuss the pre-casting workup for orthotics, the advantages of plaster casting and the importance of checking range of motion. They also offer pointers on what you should look for before sending casts to the lab and troubleshooting when patients say their orthotics are not working correctly.
Q:
What biomechanical assessments optimize a pre-casting workup for functional... Read More.
These expert panelists explore the efficacy of orthoses for hallux limitus, the impact of orthotic devices on the kinetic chain and key considerations with topcovers.
Q:
How do you use orthotics for hallux limitus?
A:
David Levine, DPM, CPed, notes hallux limitus can be a challenging problem to treat conservatively and surgically. He says it is helpful to distribute the pressure more evenly... Read More.
Are orthotics prescribed too much or are they underutilized when it comes to biomechanical issues in the lower extremity? In addition to emphasizing a tailored treatment approach for each patient, these experts also detail their casting methods and the standards they use to choose orthotic fabrication materials.
Q:
Do you think every patient can benefit from orthotics?
A:
None of the panelists... Read More.
In addition to sharing their perspectives on rearfoot posting, these expert panelists discuss their approaches to assessing the effectiveness of their orthotic prescriptions and when it is time to replace orthoses.
Q:
How do you determine the type and amount of rearfoot posting you prescribe?
A:
Russell Volpe, DPM, prefers extrinsic rearfoot posting. He says it provides stability to the device... Read More.
Q:
What is your approach and what has been your success with the conservative management of peroneal spastic flatfoot secondary to tarsal coalition?
A:
Noting that peroneal spastic flatfoot/tarsal coalition can be very difficult to treat with orthoses, Russell Volpe, DPM, may use a peroneal block to break the spasm and then fabricate a neutral cast. After fabricating the orthoses around this... Read More.
Prefabricated orthoses can play a valuable role in the podiatric practice. Accordingly, our expert panelists offer insights on the key characteristics of these devices and how they utilize prefabs in the treatment of patients. The panelists also discuss the use of orthotics to prevent and treat common soccer-related injuries.
Q:
How valuable are prefabricated orthoses in your clinical practice?
A... Read More.
Our expert panelists discuss current approaches to orthotic management of pediatric flatfoot, whether functional orthoses can have an impact for hallux abducto valgus and when to employ orthotic modifications in rigid and semi-rigid devices.
Q:
Given some of the most recent literature concerning pediatric flatfoot, what is your opinion about using prefabricated or custom orthoses for patients... Read More.
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