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Sep 18

Written by: Dianne Mitchell
9/18/2012 2:05 PM

New patients frequently arrive at my office with custom molded prescription foot orthotics complaining that they still have the same pain as before the devices were prescribed! (the orthotics didn't help!)
When I evaluate the devices they tend to be under-corrected. A great way to evaluate orthotics to note whether or not they have proper correction is to have your patient stand on the devices and attempt to engage the Windlass mechanism. Try dorsiflexing the hallux through the 1st metatarsal phalangeal joint and supinating the hindfoot.
A under-corrected device will continue to let the foot pronate and make the Windlass mechanism very difficult to engage.

Causes of under-correction may be your prescription or possibly a poor mold and/or using a lab that overfills the arch to ensure comfort (unfortunately eliminating effectiveness).

Orthotics work well if:
1) you cast well
2) you understand the pathology you are looking at and how to prescribe the correct orthotic
3) you use a quality lab that does accurate corrections (ie, minimal arch fill, if you order it!)

It’s well worth taking the time to figure out the source(s) of the problem. This makes for happy patients with no pain!

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