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Sep 17

Written by: Larry Huppin, DPM
9/17/2012 1:13 PM

I had a patient come in today who is a runner and for whom we had made orthotic devices to treat hallux limitus pain. Overall, she has done very well. This was a very controlling orthotic which conformed close to the arch of the foot. It is the full width of her foot and it was inverted several degrees to allow first ray plantarflexion.

Since she was still having symptoms, I wanted to accentuate the plantarflexion of the first ray. We accomplished this in two ways. The first is that I added a varus wedge to the heel post of the orthosis. This will invert the rearfoot and theoretically could also invert the forefoot. In reality, however, what happens when a varus wedge is added to the heel only is that gravity will bring the front edge of the orthotic down to the ground. This puts a bit of a valgus twist into the orthotic device and lets the first ray plantarflexed. In addition, we added a reverse Morton’s extension. This further accentuates plantarflexion of the first ray.

These are simple modifications that can be done in your office. In-office modifications are much more cost effective and provide your patients with better customer service then sending the device to the lab for simple modifications. We recommended every podiatrist that practices orthotic therapy should be able to do simple modifications like this in their office.

ProLab clients are encouraged to contact one of our medical consultants with any orthotic trouble shooting questions.

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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