Orthotics Q&A

Guest Clinical Editor: Nicholas Sol, DPM, CPed
11,089 reads | 0 comments | 08/03/2005

   Evaluating biomechanics in static stance poses unique challenges because of the differences between static stance and dynamic gait. In addition, one must take the occupation of patients into account when modifying orthotics for patients who spend a significant amount of weightbearing time in static stance. That said, let us take a closer look at what these expert panelists have to say on the subject.    Q: What are the key differences between approaching the biomechanics of static stance and dynamic gait?    A: Podiatry schools and

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Guest Clinical Editor: Bruce Williams, DPM
40,049 reads | 1 comments | 06/03/2005

   Metatarsalgia is one of the more commonly seen complaints in any podiatry practice. Common treatments for the disorder include ice, removable metatarsal pads, antiinflammatories, injected steroids and physical therapy. While such treatments often completely resolve an acute bout of metatarsalgia, they often do nothing to remedy the true underlying biomechanical causes of the problem.    To correct the faulty foot biomechanics, DPMs rely on custom foot orthotics. Unfortunately, the devices are often no different than what one prescribes for any other foot di

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Guest Clinical Editor: Eric Feit, DPM
28,875 reads | 0 comments | 04/03/2005

   While one must take special considerations into account while prescribing orthotics for children, different pediatric conditions also warrant special care. Following up on the previous discussion of pediatric orthotics (see “Expert Insights On Prescribing Pediatric Orthotics,” page 24, February issue), our expert panelists discuss key orthotic pearls in treating metatarsus adductus, abnormal femoral torsion and flatfoot in the pediatric population.    Q: Are orthotics helpful for a rigid metatarsus adductus foot type?    A: Rich

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Guest Clinical Editor: Eric Feit, DPM
50,601 reads | 0 comments | 02/03/2005

   There is an array of special considerations one must take into account when prescribing pediatric orthotics. In addition, it is important to work with both children and their parents to encourage compliance so the child does not develop problems later in life. With this in mind, our expert panelists share their experience on prescribing pediatric orthotics.    Q: When prescribing an orthotic for a child, how do you explain to the parents that the child may need to wear these devices for many years or the rest of his or her life?    A:</

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Clinical Editor: Timothy Dutra, DPM
21,420 reads | 0 comments | 10/03/2004

When prescribing orthotics for athletes in widely varying types of sports, one must take into consideration both the needs of the athletes and the advantages and disadvantages different types of shoes may offer. With that said, these panelists offer their expertise on orthotic modifications they use to keep their patients on the athletic field. Q: What influence does athletic shoegear have on sport specific orthotics and orthotic modifications? A: For Stephen M. Pribut, DPM, the patient’s specific shoe category and sport have a “major impact” on the orthotics he prescribes. H

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Guest Clinical Editor: Lawrence Huppin, DPM
16,717 reads | 0 comments | 08/03/2004

With summer in full swing, more and more patients are moving from the rigidity of dress shoes into the comfort of sandals. Fitting orthotics into both types of footwear has its own unique challenges as the sizes of each vary and the amount of control is also different between shoe types. With this in mind, our expert panelists offer pearls on how they alter orthotic prescriptions for dress shoes or sandals. Q: What are important concepts to keep in mind when prescribing orthoses for women’s dress shoes? A: Lawrence Huppin, DPM, says patient education is of paramount importance

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Guest Clinical Editor: Nicholas Romansky, DPM
19,502 reads | 0 comments | 06/03/2004

There is no shortage of issues to consider when you are prescribing custom orthotics for different types of patients, whether it’s knowing what to look for during the biomechanical exam or understanding the keys to proper casting. With these things in mind, our expert panelists explore various issues from prescribing orthotics for athletes to altering orthotics in case of improper fit. Q: What keys do you look for in your biomechanical exam? A: Patrick Nunan, DPM, starts his biomechanical exam by having the patient sit on an exam table while he evaluates the joints’ range of mot

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Guest Clinical Editor: Nicholas Sol, DPM, CPed
14,874 reads | 0 comments | 04/03/2004

Patients who tackle the slopes have specific requirements for orthotics. In addition to reviewing the pedal mechanics and biomechanics of skiing, our expert panelists take a closer look at the design of ski boots and what impact the skier’s skill level will have on prescribing an appropriate orthotic. Without further delay, here is what they had to say. Q: What pedal mechanics are unique to skiing? A: During alpine skiing, the patient’s lower extremities never go through a complete gait cycle, notes Nicholas Sol, DPM, CPed. He says skiers should ideally have knee flexion during

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Clinical Editor: Nicholas Sol, DPM, CPed
80,608 reads | 0 comments | 12/03/2003

At this time of year, many people begin to run on treadmills after receiving them as holiday presents and some seek to lose weight during the winter months. However, treadmill use increases the amount of repetition, possibly leading to biomechanical injury and potentially complicating common conditions like plantar fasciitis. With that in mind, our expert panelists take a look at the finer points of diagnosing and treating injuries sustained by patients while using treadmills. Q: What are the most important biomechanical considerations? A: Exercising on treadmills exacerbates the i

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Clinical Editor: Nicholas Sol, DPM
42,328 reads | 1 comments | 10/03/2003

When weighing the options for ankle foot orthoses (AFOs), you must consider many different factors in order to find the most appropriate device for the patient. Both hinged and non-hinged AFOs work well for patients with certain conditions but not so well for others. In addition, shoe modifications may be necessary in order to help ensure the success of the AFO. With these issues in mind, our expert panelists take a look at the ins and outs of prescribing hinged and non-hinged AFOs. Q: What are the three or four most frequent diagnoses for which you prescribe a non-hinged AFO? A: N

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