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Dec 8

Written by: Larry Huppin, DPM
12/8/2011 12:56 PM

I had a patient come into our clinic last week who was experiencing plantar fasciitis. Along with that, she has a long history of knee and hip pain. She has had the diagnosis of some mild osteoarthritis affecting the medial knee.

We did discuss the use of custom orthotic devices to treat her problem, but I am always concerned on whether orthoses will be tolerated by those patients with a history of knee, hip, and back pain. Certainly, in many situations, orthotic devices can help these symptoms but they also can make those symptoms worse.

We discussed the options including potential risks and complications and decided that it would be a good idea to try a pair of prefabricated orthosis before proceeding with custom orthotic devices. This would give us a chance to evaluate how her proximal joint pain might be affected by using an orthotic device before investing in custom orthosis.

In fact, she did call me today and let me know that she developed knee pain about five days after starting to wear the prefabricated orthosis. I had her take them out and once she is pain free, we will have her work into them again, but this time using an extremely slow break in. If she still develops proximal pain, then I will modify the prefabs by thinning them to increase the flexibility.

Certainly at this point, it would seem contraindicated to try and proceed with a custom orthotic if she cannot yet tolerate a prefab.

I would recommend that all practitioners of orthotic therapy keep a size run of quality prefabricated orthosis such as the ProLab P3 Functional Prefabs. These are the perfect devices to test the effects of orthotic therapy as they are semirigid, have a rearfoot post, a medial skive inferiorly and a relatively high arch for prefabricated device.

ProLab takes a scientific approach with our orthoses by integrating evidence-based medicine into orthotic therapy. Our team of Medical Consultants regularly evaluates the medical literature pertaining to orthotic therapy and biomechanics. ProLab clients are encouraged to contact a medical consultant whenever they have questions about an orthotic prescription.

For an easy way to stay up-to-date on evidence-based orthotic therapy, subscribe to our free E-Journal. Your will receive a monthly email synopsis of the research that impacts your practice.

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