Orthotics Q&A

Clinical Editor: Nicholas Sol, DPM
26,624 reads | 0 comments | 08/03/2003

When treating pediatric soccer players, you may see common conditions such as calcaneal apophysitis and injuries such as lateral ankle sprains. Prescribing orthotics for players also comes with its own set of considerations. Indeed, finding the right orthotic can sometimes be tricky. With that in mind, our expert panelists weigh in on how best to treat this unique group of patients. Q: What are the two or three most common biomechanical complaints you see in your pediatric patients who play soccer? A: All three panelists say Sever’s disease (calcaneal apophysitis) is among the co

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Guest Clinical Editor: Nicholas Sol, DPM, CPed
44,586 reads | 1 comments | 04/03/2003

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 receiving custom orthotics. What is the relationship?

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Clinical Editor: Howard Dananberg, DPM
10,400 reads | 0 comments | 02/03/2003

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 employ these devices in treatment. Q: In what type of situation do you consider using an AFO or similar brace? A: Alan Banks, DPM, uses an AFO in various situations, saying the device can be

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Clinical Editor: Howard Dananberg, DPM
34,276 reads | 0 comments | 12/03/2002

As December arrives, patients who enjoy winter sports begin to think about skiing. Ski boot technology has come a long way in recent years, with many comfort features added to complement the performance the boots are designed to provide. Patients will often ask your opinion as to what they need and how they can enhance their skiing. With this in mind, our expert panelists offer their opinions. Q: What are the most interesting advances now available in ski boots for the upcoming season? A: In the past five years, ski boots have moved in a few directions, according to Ben Wax, CPe

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Clinical Editor: Nicholas Sol, DPM, CPed
12,247 reads | 0 comments | 10/03/2002
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 with orthotic modifications. Q: How and why do you modify your orthotic prescriptions for patients whose jobs require standing in place for prolonged periods? A: Milton J. Stern, DPM, and Ambik | Continue reading

12,880 reads | 0 comments | 08/03/2002
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 patient symptoms? A: Nicholas Sol, DPM, says he most commonly prescribes a double rocker sole. He says most of his colleagues have a supply of these soles in the form of their cast shoes and boo | Continue reading

110,673 reads | 2 comments | 06/03/2002
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 of podiatric biomechanics. Yet in offices around the world, the 4-degree varus rearfoot post seems to be a standard approach. With this in mind, our expert panelists offer their take on this issue. | Continue reading

2,999 reads | 0 comments | 06/03/2002

32,055 reads | 0 comments | 04/03/2002

Muscle strength testing is not always part of a standard podiatric biomechanical evaluation. Unfortunately, muscular weakness can often influence function and, if undetected, can lead to chronic pain in the joints which the weakened muscles support. There are several reasons for muscular weakness, but the most common cause is chronic inhibition signaling from the CNS. Since motor signals to muscles normally cycle between facilitation (excitation) and inhibition, an alteration in this signaling can often cause chronic inhibition and subsequent pain. With this in mind, our expert panelists offe

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9,955 reads | 0 comments | 02/03/2002

When it comes to understanding the effect of functional hallux limitus (Fhl) on foot function, Howard Dananberg, DPM, has published over 30 articles on the subject. “Early on, it was quite challenging to convince other DPMs of the relationship of the metatarsophalangeal joint’s mobility during walking to late midstance pronation,” notes Dr. Dananberg. “Since that time, many have gravitated to the significance Fhl has on the foot and postural alignment.” With this in mind, our expert panelists offer their opinions on the significance of Fhl and how it has impacted their biomechanical

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