Orthotic precription Flashcards
(37 cards)
Goals of orthotic therapy for achilles tendinopathy
-Limit eversion and internal rotation of tibia preventing the twist of achilles tendon
-Reduce load of tendon
-Stabilze midtarsal joint to provide a efficient lever for heel lift
Recommendations for achilles tendinopathy
–medial heel skive, to control heel eversion
-Heel lift 3mm, decreases tensile load of heel lift
Goals of orthotic therapy for limitus and HAV
-Promote first ray plantarflexion
-Reduce compression in the 1st MTPJ
-Improve Hallux range of motion
Recommendations for Hallux limitus or HAV
-Heel cup 14mm
-Minimum cast fill
-Heel skive 2 deg
-inversion 2 deg
-Reverse Morton’s, allows first ray plantarflexion, decreases compression at 1st MPJ, reduces tensile force of plantar fascia
What are some mechanical causes within the foot for FHL
-Rearfoot eversion
-Forefoot valgus
-1st Ray plantarflexion
When would you use a Morton’s extension
-to take pressure away from the 2nd met head
-Limit 1st MTPJ ROM
When would you use a Reverse Morton extension
-Decrease pressure at 1st MPJ
-limit inversion at forefoot
-promote 1st ray function
What is the purpose of rearfoot valgus posting?
-stabilizes inverting rearfoot
-eversion of heel at heel strike
When to use Valgus posting
-Over supination of subtalar joint
What would you prescribe in peroneal tendonitis
-Forefoot valgus extension, to decrease inversion of the foot, reducing tensile load of PL
Goals for orthotics in metatarsalgia
-transfer forces away from the met heads
-provide extra cushioning to forefoot
What are some recommendation for metatarsalgia
-Poron forefoot extension
-metatarsal bar
Goals for Morton neuroma
-reduce intermetatarsal pressure
-separate affected metatarsal heads
Recommendation for neuroma
-forefoot extension with poron
-Neuroma pad
What are some conditions associated with pes cavus foot type
-Metatarsalgia
-Heel pain
-Lateral ankle stability
Goals for pes cavus
-Increase plantar surface contact area, distribute pressure evenly
-resist excessive supination, prevent lateral ankle sprains
-resist both excessive pronation and supination forces, flexible pes cavus foot
Recommendation for pes cavus
-Poly, effectively redistrubte pressure evenly
-deep heel cup, provide more stability to rearfoot
-valgus extension, promote pronatory moment and conteractive excessive supination
-Heel lift, 3mm promote ankle dorsiflexion
Goal for tarsal tunnel syndrome
-decrease tibial nerve traction by control heel eversion by plantarflexing foot and providing medial arch support
Recommendation for Tarsal tunnel syndrome
-Deep cup limit heel eversion
-Medial heel skive, greater force medial to the axis of STJ reducing heel eversion
-heel lift 4mm, encouraged ankle joint plantarflexion
What does the heel post do?
-Provides more stability inside the shoe
-EVA Compression more tolerable and shock absorption
What does a medial heel skive do?
-Increases supinatory moment to reduce excessive pronation
-Shift the force further medial at the heel
-Increases lever arm medial to STJ axis and spinatory torque around the axis
-A deeper heel cup is needed
Goals for plantar fasciitis
-Prevent first ray dorsiflexion
-incorporate valgus correction
-Maintain close contour with arch
-Reduce rearfoot eversion that leads to first ray dorsiflexion
Reccommendations for Plantar fasciitis
-Valgus wedge (forefoot valgus deformity)
-Morton extension (if 1st ray is plantarflexed)
-Minimum arch fill (raise the TNJ to prevent 1st ray dorsifelxion)
-Invert rearfoot
Goals of post tib dysfunction
-Reduce pronation in foot at rearfoot and forefoot
-Shifting the force medial to the subtalar joint axis
