A ProLab patient called me stating that she had a patient who is getting blisters when wearing her new orthotics. She stated that she had sent the orthotics back to be lowered once but that they were still causing blisters.

I asked what kind of orthotics they were and it turns out they were a graphite orthosis with a standard width, a standard heel cup, and no rearfoot post. The patient wanted to get one pair of orthotics that would work in both her dress shoes and her athletic shoes.

It turned out that the blistering occurred only when she was running and using the orthotics.

I explained to our client that the problem was not the height of the arch of the orthotic but that this orthotic is not meant to be used in a running shoe. The patient wished to have an orthosis that work in both dress shoes and running shoes, but it is impossible to make a single device that is going to work well in both women’s dress shoes and in an athletic shoe. This current device is simply too narrow and, without a post, too unstable to be used as a running orthosis.

The patient would be better off using this device only in her dress shoes and then using a prefabricated full length posted prefab in her running shoes if she did not wish to get two pair of custom orthotic devices.

It is up to us as the physician to educate patients as to the advantages and disadvantages of different types of orthoses. In our clinic, we let the patients know that we can make an orthosis for dress shoes or for athletic shoes but that the two devices are not interchangeable. Often, they will start with one and later order the other but often they will just simply order both at the same time.

Our client is going to talk to her patient and work out with her and how to proceed. Since this orthosis is working fine in her dress shoes, I would suggest that she continue to wear in those shoes and for now just use the full sized prefabricated orthosis in her running.