Orthosis Foot.pptx

PT

1. Custom Foot Orthoses Plantar fasciitis Pronation Supination Lower back pain Knee pain Sever’s disease Heel pain Metatarsalgia Hallux rigidus Diabetes Charcot foot Custom Foot Orthoses are beneficial for treatment of many medical conditions and injuries.

2. Anatomy and Biomechanics of the Foot There are 26 bones in the foot that create many joints. There are many muscles, tendons, ligaments and nerves in the foot. The foot can be broken into three parts: Rearfoot/hindfoot Midfoot Forefoot Arches of the foot: Medial longitudinal arch Lateral longitudinal arch Transverse metatarsal arch

3. Goals of Custom Foot Orthosis Treatment Control biomechanical alignment of the foot and ankle in locomotion (pronation, supination) Aid in adaption to surfaces Redistribute pressures on the foot Resist external forces on the foot and ankle Limit excessive movements in the foot and ankle Protect the foot and ankle Provide shock absorption

4. Design of Custom Foot Orthosis Custom foot orthotics are designed to correct the alignment of the foot and ankle. A Certified Orthotist will take a 3-D mould of the feet. This can be performed with the patient in a supine position or in a seated position. The Certified Orthotist will ensure the foot is in a corrected position and the subtalar joint will be in neutral. Certified Orthotists can accomplish corrections to the foot with intrinsic and extrinsic modifications. Intrinsic modifications are changes made to the positive mould of the foot. Extrinsic modifications are accommodative padding added to the custom foot orthotic.

5. Examples of accommodative padding: Metatarsal pad 2-5 bar Metatarsal head cutout Morton’s extension Heel cushion Forefoot extension Scaphoid pad

6. Custom Foot Orthosis Application Custom foot orthotics work best when used within a neutral shoe with an appropriate heel counter. Foot orthotics can be switched between shoes. It is best to remove the insole of the shoe to allow room for the custom foot orthotic.

7. Living with Custom Foot Orthosis (follow up) The correction provided by the custom foot orthotics may take some time to get used to. The foot orthotics should not be painful; however, it is not uncommon to feel some initial discomfort. The break-in period should not last more than two weeks. If you are experiencing pain after two weeks please book a follow up appointment with your Certified Orthotist. It is always recommended to book a follow up appointment with your Certified Orthotist if you experience any changes in condition (pain, growth). The Certified Orthotist can determine what changes need to be made or make recommendations for alternative treatment. Custom foot orthotics can often be modified or refurbished. The Certified Orthotist can reassess determine the course of treatment with you.

8. Heel Cups - Supramalleolar Orthoses (SMO)/UCBL

9. Heel Cups - Supramalleolar Orthoses (SMO)/UCBL Subtalar Instability Flexible Calcaneal (heel) Deformities Neuromuscular Impairment Cerebral Palsy Hypermobility Drop Foot/ Dorsiflexion Weakness Peripheral Neuropathy Multiple Sclerosis Cerebral Vascular Accident (CVA)/Stroke Amyotrophic Lateral Sclerosis (ALS) Diabetes Charcot Marie Tooth Disease (CMT) Guillain Barré Syndrome Tibialis Posterior Dysfunction Osteoarthritis

10. Goals of SMO & UCBL Treatment Provide ankle and foot stability in stance Provide foot clearance in swing phase of gait (walking) Control biomechanical alignment of the foot and ankle in locomotion (pronation, supination) Aid in adaption to surfaces Redistribute pressures on the foot Resist external forces on the foot and ankle Limit excessive movements in the foot and ankle Protect the foot and ankle Provide shock absorption Produce a more energy efficient gait pattern