speak to resident podiatrists/physical therapists regarding foot orthotics. I am
What I am in the dark about is who qualifies for these orthoses?
I understand the simple rigid vs. flexible deformity, but which diagnoses have you come
across that can benefit from this, apart from PTTD, unless that's the only one?
- Bunions are increased with over pronation
- Hallux Limitus/Rigidus pain is increased with over pronation
- Morton's Neuromas symptoms are worse with pronation
- Arch Strain is worse with over pronation
- Lisfranc's pain is worse with over pronation
- Cuboid pain, and instability, is worse with over pronation
- Anterior Tibial tendinitis, and shin splints, are worse with over pronation
- Plantar Fasciitis is worse with over pronation
- Lateral ankle and subtalar joint (sinus tarsi syndrome) impringement syndromes are worse with over pronation
- Achilles Tendinitis and Hamstring strains are worse with over pronation
- Tibial Stress Syndrome and Fibular Stress Fractures are sometimes related to over pronation
- Iliotibial Band Syndrome is sometimes related to over pronation
- Lateral Knee Compartment pain is sometimes related to over pronation
- Chondromalacia Patellae is sometimes related to over pronation
- Piriformis Syndrome and Ilio psoas strain can be related to over pronation
- Some cases of Low Back Pain are related to overpronation
eversion angles that you find or is it all the 5 to 1 rule?
Dr Blake's comment: If you understand the eversion angles, and your measurement of 0-3 degrees everted is mild pronation in gait, 4-7 degrees everted is moderate pronation in gait, and over 7 degrees severe pronation in gait, we probably measure the same and the 5 to 1 is appropriate. I will try to do a series of videos on it soon explaining the various anti-pronation cast corrections.
|You can see all the cast corrections for the over pronators|
Dr Blake's comment: I am attaching a couple of posts on arch height. The arch height gradually gets bigger with increasing inversions, or adding a medial column correction, but a 15 degree inverted cast probably has the same arch height as a Root Balanced with minimal arch fill. You will see in my cast corrections video over the next couple of weeks how the arch gets higher. I will try to do that video for you first. You hit the nail on the head perfectly by saying that the most important thing is to make sure the maximal arch height is at the medial cuneiform to insure first metatarsal plantar flexion in propulsion.
If there is a clear/ to the point document that I could show them, that would be great. Otherwise, I'll direct
them to your blog. By the way, I am becoming a fan of the technique as I just recently had
a patient with severe PTTD who has not been comfortable in anything (Richie style, Arizona
gauntlets, UCBLs etc.). I made him some orthotics using your technique, along with the
use of work boots to give extra stability, and he loves them! Sorry for so many questions,
but I was so excited from seeing the outcomes in that patient that I want to spread the word
about this in an accurate/appropriate way.
Thank you sir!
Dr Blake's comment: I am just ecstatic it helped. Most of the readers will not know how uncomfortable, or just big, these other devices are. Being able to take a patient that most who put in a AFO, Arizona Gauntlet or UCBL, and make an Inverted Orthotic device work, is a wonderful gift to that patient. The Inverted technique also allows the most normal function of all those techniques, thus the best chance for good strength to be re-established.