One of the more common issues that patients might complain of when first wearing a new orthosis is that one or both orthoses may feel like they are “too far forward” in the shoe. The patient may even complain that he or she feels like the orthotic does not match his or her foot well. However, when you compare the orthosis to the foot, you will likely find that, as long as you took a good negative cast, the orthosis matches the foot very well. One of the great benefits of using orthotics from ProLab is that our cast work is extremely accurate compared to that used on most orthoses and so In most cases the orthoses will better match the foot.
The first thing to do is to ensure that the orthosis is really not sitting too far forward in the shoe. The most common reason for this is that the shoe is too narrow for the heel cup, so the orthosis simply does not sit all the way back in the shoe. If the orthosis appears to fit well in the shoe then follow the instructions below.
The most common reason for the patient to feel as if an orthosis is sitting too far forward in their shoe is simply the device applying more force on the anterior aspect of the foot than on the posterior aspect. This can occur for a number of reasons; one being that one foot pronates a bit more than the other thereby increasing force between the foot and orthosis on that side.
Podiatrists can address this issue very easily. Simply grind the bottom aspect of the polypropylene orthosis in the anterior medial arch. This will thin the orthosis distally, making it more flexible and decreasing the force the orthosis is applying to the foot. By decreasing the force applied anteriorly, you will increase relative force being applied more posteriorly. This will usually eliminate the sensation of the orthosis sitting too far forward in the shoe.
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.
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