Orthotics Q&A

Guest Clinical Editor: Patrick DeHeer, DPM
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   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... Read More.
Guest Clinical Editor: Cherri Choate, DPM
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   As podiatry continues to emphasize evidenced-based medicine more and more, some of the leaders in biomechanics research share their thoughts on current studies and speculate about how future research with orthoses may eventually alter the way podiatrists practice.    Q: What orthotic-related research projects have your completed or are you currently in the midst... Read More.
Guest Clinical Editor: David Levine, DPM, CPed
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   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... Read More.
Guest Clinical Editor: Edwin Harris, DPM
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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... Read More.
Guest Clinical Editor: Ronald Valmassy, DPM
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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... Read More.
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You may prescribe orthotics for a variety of problems. However, the success or failure of treatment may depend on the type of shoes your patients wear along with the type of modifications which you make to the shoe. With this in mind, our expert panelists address the use of shoe modifications as an adjunct to care. Q: What type of modifications do you use most often and how does this affect... Read More.
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Using rearfoot posts on custom foot orthoses has become a mainstay of orthotic therapy in podiatry. However, it has been shown that measuring neutral position of the subtalar joint via inversion and eversion of the calcaneus is flawed in terms of its reproducibility. Studies concerning whether neutral position of the subtalar joint is a viable method of assessment have questioned the foundation... Read More.
Guest Clinical Editor: Ronald Valmassy, DPM
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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:... Read More.
Clinical Editor: Howard Dananberg, DPM
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You may find that even the best of custom foot orthotics are insufficient to manage a particular patient’s problem. Either too much force is applied to the foot or perhaps the foot orthotic cannot provide the necessary support. In some of these cases, one may consider using an ankle foot orthotic (AFO). In a follow-up to last month’s cover story, a panel of experts address how and when they... Read More.
Guest Clinical Editor: Nicholas Sol, DPM, CPed
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Have you seen your share of patients who have back pain as a result of compensating for gait-related problems? If so, you’re not alone. Some patients may indeed get relief from lower back pain after getting custom orthotics. With this in mind, our expert panelists tackle this important subject. Q: Podiatrists often report that many of their patients experience relief of low back pain after... Read More.
Clinical Editor: Nicholas Sol, DPM, CPed
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When patients have certain occupations, you may have to take a different approach to try to control abnormal forces in the foot. Obviously, performing a biomechanical evaluation is essential as you have to identify individual demands before tackling occupation-specific modifications. With this in mind, our panelists address the more demanding occupations and what considerations come into play... Read More.