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

Improving Pronation Control with Kirby Skives and Medial Column Corrections

When you dispense custom made orthotic devices, you should evaluate the stability they contain separately for the right and left feet. Be somewhat critical of your great prescription writing, and grade yourself on how well you have done. When you are trying to control pronation forces, and the orthotic device dispensed work well on one side vs the other, try to get the function as even as possible. The body loves symmetry. This image shows that the right orthotic device is being marked for 10-15% more pronation correction. The K means adding a Kirby Skive and the MCC means adding a medial column correction. Medial Column Correction stands for more arch support. These are plaster modifications applied before the plastic is heated and pressed.