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Author: Larry Huppin, DPM Created: 8/6/2009 8:04 AM
Discussion of orthotic therapy for specific patients

By Larry Huppin, DPM on 8/24/2009 1:26 PM
A client called today with a question about a patient with OA of the left ankle joint. His biomechanical examination was significant for a 10 degree everted RCSP. Xrays show a valgus angulation of the ankle joint with increased moment through the lateral ankle and decreased moment medially.

Our goal with the orthosis to reduce the RCSP and bring the heel as close as possible to perpendicular in order to equalize force across the ankle joint. Thus, this will be an aggressive orthotic prescription. In fact, I would recommend warning the patient that the orthosis may have to be adjusted if the patient experiences uncomfortable pressure on the foot. The patient would not likely tolerate an orthosis that applied enough force to bring the heel all the way to perpendicular, but our prescription will act to bring it as close as possible to perpendicular.

Here is what we recommended:
By Larry Huppin, DPM on 7/23/2009 1:46 PM
I had a patient present yesterday with complaint of a 10 year history of right-only lateral knee pain when running. Pain would occur on every run after 20 - 30 minutes. He never went more than 30 minutes without pain occurring. Biomechanical exam and knee exam were both normal except for a slightly under-pronated foot (RCSP was slightly inverted) He has had a complete work-up of the knee by an orthopedist and exam was normal.
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