Foot Orthotics

Question 1

Reasons for foot orthotics

Answer 1

• Foot Motion Control (Modifying Foot Posture)
• Pressure Relief (Increased Plantar Surface Area)

** foot orthoses should NOT be a stand-alone treatment

Question 2

Position of foot at different phases of gait:

Answer 2

-need 8 degrees of rearfoot motion during the LR of gait

1. initial contact: heel inversion and foot supination

2.midstance: rearfoot eversion and foot pronation

3. swing: back to inversion

Question 3

Contribution of regions of the foot during gait

Answer 3

-rearfoot motion is not a huge contributor to pronation and supination

-midfoot and forefoot motion VERY important–> align the talonavicular and calcaneocuboid joint

Question 4

Motion control from foot orthotics

Answer 4

• Orthotics support the longitudinal and transverse arch of the foot
• Control the magnitude and rate of foot pronation during walking
• it is unclear whether or not controlling motion at the foot helps to reduce symptoms in those with anterior knee pain, post tib tendonitis, or plantar fasciitis –> even though these conditions have shown to benefit from orthotics

Question 5

Orthotics can cause a ___ degree change in rearfoot motion which is a ____ percent decrease in this motion

Answer 5

2 degree

20 percent

Question 5

Plantar contact significance with foot orthoses

Answer 5

Foot orthoses with total plantar contact can decrease strain on the plantar fascia and reduce the collapse of the
medial arch

Question 6

Soft inserts are more restrictive at controlling ________ in comparison to hard inserts

Answer 6

foot mobility

-sensory feedback may be key to controlling foot motion

Question 7

Recommended length of use of a foot orthosis and type recommended

Answer 7

-Foot orthoses can provide short-term (3 months) pain and function improvement

*TYPE OF ORTHOTIC: makes NO difference in degree of pain or function improvement

Question 8

CUSTOM ORTHOSES PROS AND CONS

Answer 8

PROS
* Increased durability (3 to 5 yrs)
* Made from a 3-D mold or image of
patients/clients’ foot
* Can be posted or wedged

CONS
*More expensive
* Requires at least 10 days to 2 weeks for fabrication
* Difficult to modify after initial fitting

Question 9

PRE-FABRICATED ORTHOSES PROS AND CONS

Answer 9

PROS
* Low cost
* Can be fabricated immediately
* Can be posted or wedged
* Can be easily modified after the initial
fitting

CONS
* Decreased durability (8 to 12 months)

Question 10

What is posting/wedging for orthoses?

Answer 10

-Posts are wedges applied to either the rearfoot or forefoot regions of the orthosis–> encourage more inversion or eversion

-medial aspect: control pronation

-lateral aspect: control supination

-** When applying a post in the forefoot, the post should NEVER
extend under the metatarsal heads (can be irritating)