Recognizing and addressing the symptoms of functional hallux limitus (FHL) are a basic part of all podiatric practices. Too often these patients live with the pain for many years, because they subconsciously adjust their shoes and habits.
This week, the ProLab E-Journal discusses an article published by Scherer et al in 2006. One of the important aspects of this study was the role of the casting position in the clinical outcomes. During casting, the 1st ray was plantarflexed in order to encourage maximum plantarflexion of the 1st ray during stance and gait. This position, should ultimately lead to maximum dorsiflexion available at the 1st MPJ.
Although it is unknown which of the study variables was most effective (PF position of 1st ray, custom orthotic or 4 mm medial skive), it is importnat to acknowledge that all these variables are worthy of consideration when fabricating orthotics for the patient with functional hallux limitus.
Reminder to all: The success of any orthotic begins with the CAST!