By Cherri Choate, DPM on
3/10/2010
 While I am sitting here at the lab looking out the window, I am finally greeted with sunshine! This is the first completely sunny day in months and it immediately makes me think of sandal orthotics. As everyone knows, this is a challenging issue for many patients during the summer. Many labs, including Prolab, have Sandal orthotics, and they certainly help fill this part of this void. They are made for specific sandals that have footbeds that are completely removable. Many patients needs have been satisfied with these devices.
BUT, there ...
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By Larry Huppin, DPM on
3/4/2010 9:37 AM
 A question came up on PM News the other day regarding the availability of prefabricated gait plates for in-toeing. As far as we know there are none on the market. There is simply not enough call for these devices to make producing a prefabricated gait plate financially viable.
It is quite simple, however, to make your own gait plate by modifying a ProLab Kiddythotic. Here is how I create a gait plate to reduce in-toeing in my office:
- Choose a ProLab Kiddythotic two sizes too large for the patient – so that the anterior edge extends just distal to the MPJs.
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By Cherri Choate, DPM on
3/3/2010
Childhood obesity is receiving attention from all corners of the globe. In 2002 a European Task Force on Obesity called it a "pan-European epidemic." As always it is important to look beyond the present moment, in order to see the possible long term effects of this signiciant problem. Two groups, (Morrison 2007 and Mauch 2008) published studies regarding foot morphology of normal, overweight and ...
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By Larry Huppin, DPM on
3/1/2010 3:07 PM
 I had three new patients today who presented with relatively new foot orthoses received elsewhere. All were continuing to have pain and had questions on whether the orthoses were appropriate for their feet. Two of the patients had plantar fasciitis and the other metatarsalgia.
Each of the three orthoses were gapping significantly from the arch of the feet and one was flexible enough that it collapsed entirely with finger pressure.
Significant literature supports the use of “total contact orthoses” that conform closely to the arch of the foot to both reduce tension on the plantar fasica and to transfer pressure off of the forefoot. None of these orthoses were conforming to the arch of their respective feet.
This is sometimes a difficult situation. The patient has already paid a lot of money for custom orthoses and no ...
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By Cherri Choate, DPM on
2/24/2010
con-sult-ant ((kən sult′'nt): one who is called on for professional or technical advice or opinions
Responsibilities of the Prolab Consultants:
1) Discuss a challenge case
2) Give a non-judgmental opinion on a biomechanical scenario
3) Keep abreast of current trends, technologies and ideas in ...
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By Larry Huppin, DPM on
2/22/2010 11:02 AM
Sometimes it's important to go back to the basics. The quality of the negative cast is critical to ensure optimum clinical outcomes from functional foot orthoses.
For best outcomes, the cast must be taken with
- The subtalar joint in neutra ...
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By Larry Huppin, DPM on
2/18/2010 5:13 PM
I consulted with a client today who had a patient with peroneus brevis enthesiopathy.
The goal with orthotic therapy in these cases is to increase the force that the orthotic is exerting on the foot lateral to the subtalar joint axis. Since the peroneus brevis is acting to evert the foot, our orthoses should assist this action in order to reduce the need to fire this muscle. Not suprisingly, it is often patients who are laterally unstable who experience this problem.
CASTING:
Remove soft tissue varus (supinatus) when taking the negative cast. This is imperative as it results in greater forefoot valgus in the negative cast and ultimately in the orthosis. This results in an orthosis that will better support the lateral forefoot and thus reduce the need for the PB to fire. Watch our casting video
PRESCRIPTION:
- Material: A semi-rigid polypropylene. Either direct-milled or vacuum formed.& ...
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By Cherri Choate, DPM on
2/17/2010
 As we start the 21st Century, life expectancy is continuing to increase. Infact, here are a few statistics provided by efmoody.com:
"The number of people 60 or older will grow to nearly 2 billion in 2050, for the first time in rec ...
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By Larry Huppin, DPM on
2/11/2010 7:43 AM
 A recent paper by Margaret Evans, PhD has been discussed here on this site several times and we summarized it in one of our eJouranl Club Newsletters. The paper reviews the best studies currently available on treatment of pediatric flatfoot and lays out a clinical pathway with recommendations on treatment. The most controversial portion of her recommendations had to do with those children with asymptomatic flexible flatfoot. Her paper recommended a “monitor” approach to these children. But some practitioners are concerned that these underlying structural abnormalities, ...
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By Cherri Choate, DPM on
2/10/2010
 We often receive requests for "flexible" or "soft" functional orthoses. For shell material choices we can use either plastazote or polypropylene. In most cases I prefer the use of polypropylene. When I hear "flexible" I think of less control, so there are a number of ways to create a more flexible orthotic.
1) Choose the most flexible shell
The most flexible polypropylene we use at ProLab is the 1/8" VF device (black or natural)
2) LImit the control of the device
& ...
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