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Jan 19

Written by: Cherri Choate, DPM
1/19/2011

Sweet spots are a commonly ordered modification in orthotic fabrication.  They are often included in prescriptions for pathology such as plantar fibromatosis and posterior tibial tendon dysfunction (adult acquired flatfoot).  The presence of these sweet spots can be the key to the sucess of the orthotic as they often target significant pain complaints from the patient.  Fabricating an orthotic with the "perfect" sweet spot can be a challenge for any lab, but there are a few pointers that should help improve the success of this modfication:

   1)  Be sure to mark the spot on the negative cast
          - Either on outside or inside
          - Also mark the location on the foot diagram on the Rx form
          - Double check the accuracy of the exact foot and location on the Rx form
   2)  Mark the spot larger than the actual lesion
          - As the foot bears weight, the location of the lesion, epecially forefoot lesions, tend to move more distal
   3)  Inform the lab of the desired depth, but be reasonable about your request
          -  The depth of the sweet spot is normally between 3-6 mm
          -  If a sweet spot is ordered too deep, the raised area may be lower than the lowest point of the device, causing a stress area within the plate and possible rocking of the device on that spot
   4)  If two sweet spots are very close in proximity, consider making one larger spot to avoid any edges
   5)  Sweet spots at Prolab are filled with poron
          -  If the padding within the sweet spot is counterproductive, then make a note for the lab to leave out the Poron
   6)  Sweet spot placement demands a vacuum molded device, so the CD option is not available
   7)  If you order a sweet spot, consider not gluing the cover over that area, so you can troubleshoot any problems in your office.

Just a few tips on improving the success of sweet spots in your practice.

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