NMS 3: Orthotics Flashcards
The longitudinal arch is _______ and ____ than the medial arch
Lower and flatter
Transverse arch goes ______ the foot
Across
Plantar vault/dome
The three arches together form a dome shape
Why do we need orthotics?
Maintain foot structure
-for the rest of our body (can lead to degenerative joint disease)
Pronation/Knee injuries
Excessive pronation causes: internal tibial rotaion, patellar tracking problems…
Where do we support the arches of the foot?
Medial longitudinal arch, transverse arch support, lateral longitudinal arch, heel cup option
Rigid orthotics
Build to hold the foot in optimal position
-Only allows movement at the ankle and forefoot
Soft Orthotics
Built to support the foot and prevent the arches from dropping past the normal range
-Allows normal motion of the entire foot while preventing excessive motion
Treatment goals for doctor with orthotics
-Reasonable structural alignment
-Optimal neurological functoin
The Original Spinal Pelvic Stabilizer
-1952 Dr. Monte Greenawalt develops the first SPS
FL helps to:
-Decrease Q-angle
-Help balance the pelvis
-Decrease LBP by 34.5%
Orthotics Goals
-Provide heel strike shock protection
-Enhance sensory-motor reflexes
5 Red Flags of Spinal Stability
- Foot flare during gait
- Excessive shoe wear
- Low medial arches
- Bowed achilles tendon
- Internal knee rotation
Helbing’s Sign
Medial bowing of the achilles tendon with a loss of foot pronation
Too Many Toe Sign
Finding of significant forefoot abduction or pronation, 3 or more toes are visible
Observational changes in the foot (Plantar Fasciitis)
Callus under the 2-4 metatarsal heads
-Abnormal wear of shoe
PSI Card (Navicular Drop Test)
> 5mm difference would indicate a foot issue
Benefits of Scanning
-As accurate as casting
-Faster
-Can be done without ordering
Brannock Device
Ability to size shoe based on measuring persons dimensions.
Plaster cast
Simple copy of the foot without weight
-No transverse arch or correction for problems
Stages of Development in Children
-Birth to 2 years: Bow legs/toeing common
-Age 3-5: Knock knees and toeing out are common
-Age 6-7: Knees and feet should resemble adult positioning
(Medial arch should be observable)
Modifications of Orthotic
-Heel Spurs
-Heel Cups: Keep calcaneus from moving back and fourth
-Heel Lifts: Anatomical Short Leg
-Building Up an Arch
Other Considerations of Orthotics
-Shoe type and quantity
-Measurements
Benefits of Barefoot Running
Natural gait
-Reduct injuries
-More effieicnt
-Improve balance and proprioception
Negatives of Barefoot running
-Slow adaptation phase
-Less protection/insulation than running shod
-Increased risk of plantar faciitis
-More blisters
The size and shape of orthotics is constant between manufacturers?
False
Rigid orthotics are usually made to support the arch in the neutral non weight bearing position?
True
Over pronation of the foot causes all except?
a. Metatarsalgia
b. Morton Neuroma
c. Navicular subluxation
d. Turf Toe
d. Turf Toe
Orthotic companies offer product and modifications to best match the patients feet and condition?
True
The size and shape of shoes is constant between manufacturers?
False
The Navicular drop test measures the distance the navicular moves when?
a. Running
b. Moving from sitting to standing
c. Walking
d. Jumping
b. Moving from sitting to standing
You should make sure you follow the orthotic company instruction on how to collect the information to make the orthotic?
True
Shoe companies design their shoes to fit what they consider the average foot size and shape?
True
One of the advantages of wearing orthotics is that the patients shoes will wear correctly and may last longer.
True
Heel cups are used to keep the calcaneus in the proper position in the shoe?
True
