Larry Huppin, DPM

Why Does a 10-Degree Inverted Orthotic have a Lower Arch than a 9-Degree Inverted Orthotic? The Blake Inverted Paradox

lhuppin@gmail.com — Thu, 02 Feb 2012 15:00:00 GMT

I want to talk today about the "Blake inverted Paradox". Blake inversion refers to balancing the positive cast more than 10 degrees inverted. Additional modifications are performed to make the arch height tolerable. This technique is available only in plaster. The paradox is the fact that a 9 degree inverted orthotic has a higher arch than a 10 degree inverted orthotic.

I consulted with a ProLab client yesterday who wanted to order an orthosis with an arch that would conform extremely close to the arch of the foot. He ordered a standard cast fill, but then inverted the device 10 degrees.

He was surprised when he received the orthotic back and found that it did not conform particularly well to the arch of the

Foot Orthoses and Landing Mechanics in Jumping Sports

lhuppin@gmail.com — Mon, 16 Jan 2012 17:44:00 GMT

Research suggests foot orthoses can affect frontal and transverse plane motion in proximal joints during landing from a jump. This could help decrease the risk of anterior cruciate ligament injury, especially in female athletes.

A recent article in Lower Extremity Review looked at this subject in detail. We are recommending this article to all ProLab clients.

Some of the article highlights include:
In the May issue of the Journal of Applied Biomechanics (JAB), researchers from East Carolina University (ECU) in Greenville, SC, reported that gender and foot orthoses affect frontal plane hip motion during landing from a vertical jump.

“Foot orthotic devices are able to change hip motion in the frontal

Orthosis for Calcaneal-Cuboid Pain

Thu, 12 Jan 2012 17:29:00 GMT

I consulted with a ProLab client today regarding a patient with pain at the calcaneal cuboid joint. He apparently has a fairly stable foot with mild eversion of the heel in stance. Pain is achy with activity and there is a little pain to palpation dorsolaterally. Radiographs were negative.

He does not have an exact diagnosis, but if nothing else, he is certainly having some calcaneal cuboid arthralgia. In a way, it doesn’t really matter what the exact diagnosis is. For patients with chronic pain in the area of the calcaneal cuboid joint we have a fairly straightforward goal of treatment, regardless of the underlying etiology. Our goal is to minimize motion of the calcaneal cuboid joint and to transfer pressure from the lateral column to the medial column.

The following is the prescription that we recommended for this patient:

Short First Metatarsal Post Surgery - Orthotic Considerations

Thu, 01 Dec 2011 16:02:00 GMT

I saw a patient this morning who presented with significant pain affecting the right foot, particularly in the area of the first metatarsophalangeal joint. Fourteen months ago, she had surgery to correct a bunion. It appears that she likely had a head procedure. She developed a nonunion, and then six months ago had a second procedure; a plate was added. She was nonweightbearing for a number of weeks and used a bone stimulator. The nonunion seems to have healed, but she is still having significant pain. She has been using Rocker soled shoes and she did receive a pair of orthotic devices.

She has continued to have significant pain affecting the right foot particularly in the area in the first MPJ and along the first metatarsal shaft.