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Jan 28

Written by: Cherri Choate, DPM
1/28/2011

Are there times when patient's feet just don't tolerate the typical orthotic?  I recently evaluated a friend's feet who has not been able to tolerate even well made devices. My friend has very flat, wide mobile feet.  Over the past few years he has used a variety of over the counter devices, and his only complaint is a continued tendency to sprain his ankle.  Because of the severity of his flat feet, he had functional orthotics made.  The devices were casted in neutral position and the corrections were appropriate for his age and pathology.  He tried to break in the devices over many months, but continued to have pain in his arch and felt overall discomfort when they were in his shoes.  He eventually removed them and started wearing more flexible pre-fabricated devices and he felt much better.

This is not the first time I have had friends, or patients, who have difficulty tolerating functional orthotics that are fabricated correctly.  In this case, as in the others I have encountered, the orthotic addressed the visual foot pathology, but did not focus simply on my friend's complaints.  I still believe that the physician made the correct decisions, but in this case, the patient may have been better served by attempting to address his complaints of ankle sprains by modifying his prefabs.  Due to the significant mobility of his feet, he may need to have a series of orthotics that increase control slowly and to a point that he feels improvement of function, without increased pain.

I'll keep you posted on this patient, as he continues on his orthotic journey. 

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