Orthotic Toolbox - Adjustments for a Tricky Foot

Tony Chiappetta
Tony Chiappetta

Problem

From the looks of the orthotic itself, we're dealing with a very tricky foot here! This visit was just a yearly checkup where we needed to replace some of the additional adjustments... too good to no pass along!

Material

The upper materials are Slow Recovery Poron (SR Poron) which is great for a spongy but relatively firm correction and works for both on top of an insert or on the bottom. The forefoot (FF) adjustment/cutout is a combo of 45 durometer EVA (Microcell Puff - ACOR Orthopaedic, Inc.) and SR Poron for the 1st MPJ to allow for best shock absorption. The ""Arch Bar"" is a 55 durometer 3mm multi-cork.

Solution

This customer has an A1 foot type in combination with a relatively unstable ankle joint. The highly mobile and flexible foot and ankle complex requires a significant amount of correction and over the original course of 3 adjustment periods has led us to this combo. The baseline (molding process) is a subtalar neutral impression. Severe loading of the first MPJ required offloading. Additional midfoot and medial arch correction is accomplished by an upper scaphoid and met pad (not typical). The ""Arch Bar"" is used to load the longitudinal arch in efforts to reduce excessive supination caused by hyper-mobility.

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