Orthotics Q&A

Guest Clinical Editor: Douglas Richie Jr., DPM
14,896 reads | 0 comments | 02/03/2006

   Over the last decade, there have been a variety of changes and trends that have shaped the evolution of orthotic therapy. Accordingly, our expert panelists discuss pertinent orthotic prescription trends. They also examine the importance of having a strong background in biomechanics and whether the podiatric profession is “giving away” its biomechanics expertise to non-podiatric physicians.    Q: What specific changes have you observed in the overall utilization of functional foot orthoses in the typical podiatric practice in the past 10 years? Are or

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19,078 reads | 0 comments | 12/03/2005

   Given the nuances of making adjustments to orthotic prescriptions, our expert panelists discuss their approaches in using adjustments such as first ray cutouts and metatarsal pads, and the tools necessary for making modifications. They also discuss which adjustments they will make themselves and which ones they will send out to an orthotics lab. Without further delay, here is what they had to say.    Q: How do you incorporate footwear when determining appropriate orthotic prescriptions?    A: Ideally, Howard Horowitz, DPM, says one s

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Guest Clinical Editor: Lawrence Huppin, DPM
12,696 reads | 0 comments | 10/03/2005

   The development of new materials and technologies has had an impact on orthotics and biomechanics. These expert panelists discuss the technologies they have found helpful. In particular, they assess the impact of pressure analysis and how it can influence the writing of effective orthotic prescriptions. They also discuss common orthotic modifications and which orthotic materials they use in their practices.    Q: How have new materials and technology changed the state of podiatric biomechanics and orthotic therapy?    A: Russell Vol

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Guest Clinical Editor: Nicholas Sol, DPM, CPed
11,504 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
41,171 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
30,085 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
53,845 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
21,947 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
17,225 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
20,296 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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