Varus Wedge from Altra: Help for Pronators

In trying to help patients with over pronation, I use various forms of varus (inverted) wedges to help. Some are attached to a custom or OTC orthotic devices, and some to the shoe insert. Here is a product you can buy with a 3 and 1/2 mm varus wedge. Altra sells both in mens and womens sizes. Remember this amount of canting can produce over a 1/4 inch change at the knee, and up to 1/2 inch change at the hip. So, you have to get used to slowly, and blame any new ache or pain on the wedge. If the varus wedge causes you to over supinate (roll to the outside like minor ankle sprains), it could be very dangerous and should be discontinued in that shoe. Some shoes it will work for, others potentially not. The goal is to move you from pronated to less pronated, or even neutral to slightly inverted, without making you laterally unstable with over supination. So, if you have been told you over pronate, and you want to try this wedge, familiarize yourself with what over supination (aka underpronation) is like (I have videos on my blog), and have a friend (you do have friends?) watch your heel from behind to make sure you are not rolling out too far. Good luck.

http://www.altrarunning.com/fitness/en/Altra/womens-gear/womens-stability-wedge

http://bcove.me/7e0eymzu

Wednesday's Article of the Week: The Inverted Orthotic Technique and Changes in Biomechanics

This is the left foot and 55 Degree Inverted Orthotic that allowed a patient to get the heel centered under the leg. The original problem being treated was severe medial knee pain with over pronated feet. The heel is relaxed position was 13 everted or pronated and the 55 degree correction allowed the patient to get close to 2 everted (vertical). 

The article below highlights the Inverted Orthotic Technique. It is a method of designing the functional foot orthotic to help with foot, ankle, leg, and knee biomechanics. The article emphasizes the positive changes to the lower extremity produced by this technique. I designed the technique in 1981, studied it for 2 years before I first made my observations available, then introduced it in 1984. The cartoon on the home page was drawn by the famous cartoonist Dr Robert Hughes who was at my first presentation. The following are injuries that benefit from this technique over standard orthotic devices:

• Bunion Pain
• Hallux Limitus/Rigidus
• Plantar Fasciitis
• Posterior Tibial and Anterior Tibial Tendinitis
• Achilles Tendinitis
• Shin Splints and Medial Tibial Stress Syndrome
• Medial Knee Pain
• Patello-Femoral Pain
• Piriformis Syndrome

There are many orthotic laboratories that make this device including Allied OSI, Root Functional Orthotic Lab, ProLab USA, and Richey and Company.‎

http://www.researchgate.net/publication/8978040_Effect_of_inverted_orthoses_on_lower-extremity_mechanics_in_runners/file/3deec51891a54ae45e.pdf

Monday's Image of the Week: Temporary Kirby Skive for Pronation Control

This photo above is the left foot orthotic device of a patient that pronates excessively. Many times when I am dispensing orthotic devices, I fall short in controlling the excessive pronation enough based on stability required or continued symptoms. I have added in this image a 1/4 inch beveled wedge in the medial heel area of the left foot orthotic device on top of the plastic.I call this a Temporary Kirby Skive. It will give me more correction temporarily to the orthotic device in controlling pronation motion. Eventually I may decide to place that Kirby Skive into the plastic itself. The typical material used for this wedge is Korex, grinding rubber, or EVA. The top cover in the right of the image will be glued back on.

http://www.parisorthotics.com/hcp_lectures/STJA%20Loc%20and%20Rot%20Equil%20Theory_PAC2001.pdf