Aug
31
Written by:
Larry Huppin, DPM
8/31/2009 2:19 PM
A patient presented to my office today for follow-up on her posterior tibialis tendonitis. On the last visit we had dispensed a pair of ProLab PTTD orthoses to control her extreme pronation. She was doing great. She loves the orthoses and all of her tendon pain has resolved. The only problem is that she has developed some blisters pn the left foot in the area of the talo-naviuclar joint plantarly.
The orthoses appear to fit well and they do not appear to be too narrow (which could lead to blistering as the medial foot can ride over the medial edge of the orthosis.
This is a relatively easy problem to troubleshoot. What we find works well is to simply increase the flex of the orthosis in this area. We do this by grinding the arch thinner (from the plantar aspect of the orthosis) in the area that is blsitering. This reduces the force that the orthosis is applying to the foot in this local area. If you don't have a grinder, read this.
In additon, we have used a new product designed to reduce friction. The Richie Ulcer Guard is a thin teflon-like self adhesive pad that can be applied directly to the orthosis or the orthotic topcover to decrease friction in a local area. I keep a siupply of these pads in our office for just this reason.
The best orthotic practitioners are expert troubleshooters. ProLab clients are welcome to call a medical consultant regarding any orthotic problem. We'll work with you to troubleshoot the issue and help make you the expert.
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