Orthotic Toolbox - Adjustments for Rheumatoid Arthritis and Post Tibia Tendon Dysfunction

Tony Chiappetta
Tony Chiappetta


When it comes to Rheumatoid Arthritis (#RA) and Post Tibia Tendon Dysfunction (#PTTD), the body can do some really weird stuff. Today was a quick refresher on the #Orthotic materials but the adjustments here are something to behold!


As complicated as these orthotics are, we're running a ""standard"" 4 layer insert with 35 durometer EVA top cover, 1.5mm Poron cushion, 3mm crepe 75 durometer support layer, and a base 10mm 55 durometer cloud crepe. On top we' re running SR #Poron for the mets, and firm plastazote for the navicular cutout.


When the medial arch breaks down with PTTD and you throw in RA on top of that, the midfoot bones tend to become severely deformed. Here the medial cutout has a firm Plastazote surrounding the #Navicular bone to help offload that friction point. On the left forefoot, we have a 4th MPJ cutout. It's not typical we do a straight cut, but this has significantly reduced heavy callusing that was evident in that area.

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