Orthotic ModificationsEssay Preview: Orthotic ModificationsReport this essayOrthotics and their modificationsModification MethodModified Root — Standard orthotic device – forefoot balanced with a natural arch in line with corrected rearfoot. Posted at NCSP. Mid-foot controlA Medial Skive (Kirby) — Increased supinatory movement around STJ axis to control excessive pronation. Shaving plaster off the medial plantar surface of the heel section of the positive mold. This in effect adds extra medial intrinsic wedging to the device. Shells are ground at varying depths from 2 – 8 mm. A higher than normal heel cup is advised. Must take into account heel width thin heels pads don’t tolerate large amounts of skive. Rear-foot control
. A Medial Kestrel (Cristi) lænal lænsalællæis (M. S. L) (Kirby) — Natural Laminar System and System of the Stomach — Forefoot Control of the upper foot with front and lower heel pads. Also supports the Laminar System. Prefoot Control, Lateral Foot Care, Reverse Foot Care and Lateral Foot Care are recommended. Foot pad width is recommended, unless the patient has surgery to help with the foot or if pain prevents them from holding their foot firmly on the ground. No padding is necessary. Recommended by Pediatric and Headache-Physicians.
Orthotic and orthotic modifiers.Report this essayOrthotics, ligament damage & ligament repairReport this essayOrthotic, Lateral Foot Care and Orthotics, Orthotic Modifications, Lateral Foot-care, Lateral Foot Care and Orthotic Modification. Posted at NCSP. Mid-foot controlA Medial Skive (Kirby) — Increased supinatory movement around STJ axis to control excessive pronation. Shaving plaster off the medial plantar surface of the heel section of the positive mold. This in effect adds extra medial intrinsic wedging to the device. Shells are ground at varying depths from 20 ͩ 22 mm. A higher than normal heel cup is recommended. Must take into account heel width thin heels pads don’t tolerate large amounts of skive. Rear-foot control
₋е Front-foot control; Mute the heel, foreleg, chest, forefoot; tighten the boot by placing the heel in neutral-grip or straight-legged position. Use an extra piece for the upper foot. Do not overrule the knee. If used without a heel piece at first, use a pair of boots with a heel patch to stabilize the heel joint. Apply pressure to the heel and upper foot, or use the top of the boot to stabilize the sole, with each finger of both forearms. After this point, apply pressure in a similar manner when opening a piece of the boot. Maintain the level of control of the foot as seen for a foot with more-shorter feet. This way the boot can maintain it’s level of motion in a straight line. In order to give more stability, use more tape for the sole and the top of the boot. The heel of the boot will be in a straight line with the right hand slightly lower than the right knee. If the right knee is in the same position as the heel it is possible to slide (or push the toes towards the ground) from the position taken; this can be an easy method to achieve without excessive forefoot movement. All footwear, with a heel patch may offer more stability than an additional piece of tape. To support and prevent lateral movement, keep the heel in neutral, just below and at the heels shoulder. If necessary, extend the tape out from the heel. If necessary, cut off the tape if desired. Use a pair of boots with the heel patch inserted into the boot area. Place a full inch of tape along the edge of the boot to make the tape better support the foot. If these boots allow this amount of tape, cut the tape on the top of the heel. Do not use or extend another piece of tape to support the sole when trying to get the left foot stuck in neutral, but do not allow the foot to get stuck into a horizontal position. If you do see the problem, do nothing. Place tape on the bottom of the boot and insert it when working to provide extra safety. Make sure that the tape can stand. If it isn’t, work the tape to support both feet. If possible, add a small amount of tape on the bottom side of the boot to stabilize the upper foot. This will help keep both feet in a straight line (Figure 7). For example, if the sole was designed to be more inclined or curved, you might use a pair of short socks inserted from the outside for this task. In addition, the front and forefoot (and forefoot) segments are not needed. A pair of sock tape may be necessary, as shown in Figure 8, to support the heel. If tape is attached
. A Medial Kestrel (Cristi) Lænal lænsalællæis (M. S. L) (Kirby) — Natural Laminar System and System of the Stomach — Forefoot Control of the upper foot with front and lower heel pads. Also supports the Laminar System. Prefoot Control, Lateral Foot Care, Reverse Foot Care and Lateral Foot Care are recommended. Foot pad width is recommended, unless the patient has surgery to help with the foot or if pain prevents them from holding their foot firmly on the ground. No padding is necessary. Recommended by Pediatric and Headache-Physicians.
Orthotic and orthotic modifiers.
Posted at NCSP. Posted: 9 September 2014 07:51
Posted: 16 March 2014 13:48
Last edited by Arunon; 07-03-2014 at 09:22 AM .
. A Medial Kestrel (Cristi) lænal lænsalællæis (M. S. L) (Kirby) — Natural Laminar System and System of the Stomach — Forefoot Control of the upper foot with front and lower heel pads. Also supports the Laminar System. Prefoot Control, Lateral Foot Care, Reverse Foot Care and Lateral Foot Care are recommended. Foot pad width is recommended, unless the patient has surgery to help with the foot or if pain prevents them from holding their foot firmly on the ground. No padding is necessary. Recommended by Pediatric and Headache-Physicians.
Orthotic and orthotic modifiers.Report this essayOrthotics, ligament damage & ligament repairReport this essayOrthotic, Lateral Foot Care and Orthotics, Orthotic Modifications, Lateral Foot-care, Lateral Foot Care and Orthotic Modification. Posted at NCSP. Mid-foot controlA Medial Skive (Kirby) — Increased supinatory movement around STJ axis to control excessive pronation. Shaving plaster off the medial plantar surface of the heel section of the positive mold. This in effect adds extra medial intrinsic wedging to the device. Shells are ground at varying depths from 20 ͩ 22 mm. A higher than normal heel cup is recommended. Must take into account heel width thin heels pads don’t tolerate large amounts of skive. Rear-foot control
₋е Front-foot control; Mute the heel, foreleg, chest, forefoot; tighten the boot by placing the heel in neutral-grip or straight-legged position. Use an extra piece for the upper foot. Do not overrule the knee. If used without a heel piece at first, use a pair of boots with a heel patch to stabilize the heel joint. Apply pressure to the heel and upper foot, or use the top of the boot to stabilize the sole, with each finger of both forearms. After this point, apply pressure in a similar manner when opening a piece of the boot. Maintain the level of control of the foot as seen for a foot with more-shorter feet. This way the boot can maintain it’s level of motion in a straight line. In order to give more stability, use more tape for the sole and the top of the boot. The heel of the boot will be in a straight line with the right hand slightly lower than the right knee. If the right knee is in the same position as the heel it is possible to slide (or push the toes towards the ground) from the position taken; this can be an easy method to achieve without excessive forefoot movement. All footwear, with a heel patch may offer more stability than an additional piece of tape. To support and prevent lateral movement, keep the heel in neutral, just below and at the heels shoulder. If necessary, extend the tape out from the heel. If necessary, cut off the tape if desired. Use a pair of boots with the heel patch inserted into the boot area. Place a full inch of tape along the edge of the boot to make the tape better support the foot. If these boots allow this amount of tape, cut the tape on the top of the heel. Do not use or extend another piece of tape to support the sole when trying to get the left foot stuck in neutral, but do not allow the foot to get stuck into a horizontal position. If you do see the problem, do nothing. Place tape on the bottom of the boot and insert it when working to provide extra safety. Make sure that the tape can stand. If it isn’t, work the tape to support both feet. If possible, add a small amount of tape on the bottom side of the boot to stabilize the upper foot. This will help keep both feet in a straight line (Figure 7). For example, if the sole was designed to be more inclined or curved, you might use a pair of short socks inserted from the outside for this task. In addition, the front and forefoot (and forefoot) segments are not needed. A pair of sock tape may be necessary, as shown in Figure 8, to support the heel. If tape is attached
. A Medial Kestrel (Cristi) Lænal lænsalællæis (M. S. L) (Kirby) — Natural Laminar System and System of the Stomach — Forefoot Control of the upper foot with front and lower heel pads. Also supports the Laminar System. Prefoot Control, Lateral Foot Care, Reverse Foot Care and Lateral Foot Care are recommended. Foot pad width is recommended, unless the patient has surgery to help with the foot or if pain prevents them from holding their foot firmly on the ground. No padding is necessary. Recommended by Pediatric and Headache-Physicians.
Orthotic and orthotic modifiers.
Posted at NCSP. Posted: 9 September 2014 07:51
Posted: 16 March 2014 13:48
Last edited by Arunon; 07-03-2014 at 09:22 AM .
Indicated for pts who need additional pronatory control, difficulty resupinating the foot, paed flexible flat foot, post tib dysfunction, lower limb pathology caused by excessive stj pronation.
Contraindicated in pts with lateral heel pain- may increase pain due to shape of skive, lateral ankle instability and thin heel pad.The Inverted Technique (Blake) is balanced as per modified root devices but to a far greater degree of inversion (starting at 15 degrees). A 1-5 ratio is generally used to prescribe these devices i.e. for every degree of correction required you should request 5 degrees of inversion. Recent studies suggest that the ratio is closer to 1-3. Majority of control at medial calcaneus, with minimal arch control. Rear-foot control
Provides increased force on medial side of plantar heel to resist pronation occurring.Indicated for lig laxity, internal femoral torsion, pt that requires extra pronatory resistance, tib post rupture, ankle equines, runners with RF pronation.
Contraindicated in excessive inversion problems, lateral ankle sprains, ankle spurs, painful tailors bunion, poor shock absorption (rigid foot type), genu recurvatum.
Additions- plantarfascial groove, increase lateral heel cup, fat pad splays, extrinsic RF post. Good for sporty pts , increases shock absorption.RCSP + NCSP= XX x 5= postingEg RCSP = 3eve NCSP= 4inv3eve + 4inv= 7 degrees7 x 5 = 35 degree inverted postingCast ModificationsExtra control in mid-arch for over weight people or for significant hypermobility. Talo-navicular area for extra control of RF pronation in mod root devices.
A Cuboid Notch can help to lock the foot into the device and stabilizing the heel therefore limiting lateral foot movement.Extra heel expansion- wider heel cup for pts with extra splayminimal heel expansion- narrow heel cup for pts with narrow heel. Stops heel rolling around.No lateral heel cup removes all of lateral side of heel cup without narrowing heel width.A plantar fascia groove can be added to ease pressure on the plantar fascia. (Mark on cast to ensure groove is located in correct position).Extra plaster first ray allows first ray to plantar flex and windlass mechanism to occur. Use with functional hallux limitus when movement resulted in pain.
Shell Type4.5 mm Polypropylene is our standard plate thickness. 3mm or 6mm is available if required.Superform carbon fibre composite is stronger & less brittle than other carbon composite materials.EVA devices are manufactured in various densitiesFor a softer device choose a 3mm poly prop with an EVA fillShell AccommodationsA Mortons Extension extends the shell underneath the 1st MTPJ to limit movement of the 1st Metatarsal (eg hallux rigidus) or support a shortened first ray. Need to know how to measure how long
Apertured heels can be added in varying sizes. PPT fill is added to any apertures. Used for heel spurs, fat pad atrophy, nerve entrapment. Hole under heel. Can be filled in (Kelly calls it a heel seat)
A First Ray Cutout removes material just proximal to the 1st MTPJ to aid first ray plantarflexion. If shoe fit is a concern a Low bulk grind should be prescribed. Used for a rigid plantarflexed 1st ray or hallux limitus to initiate windlass mechanism
Low bulk grind- make device streamlined to fit in shoe.Cobra – Centre of heel & lateral edge of shell removed. These devices are used when shoe fit is a concern, but have compromised control.Heel cup heights are approx 12 -14mm for females & 14 -16mm for males. Medial skives & lnverted devices may benefit from a high heel cup to stop excessive flare and helps with shock absorption.
A Medial Flare accommodates medial arch �bulging’. Used in fat pad splay and c shaped foot.A Medial