Orthotic prescriptions

Question 1

What is a Metatarsal dome?
Clinical uses

Answer 1

Dome placed proximal to the Metatarsal heads and is used to reduce Plantar Pressure in the Forefoot.

Clinical Uses:
* Intermetatarsal Neuroma
* Metatarsalgia
* Plantar Plate Dysfunction
* Fat Pad Atrophy
* Flexible Digital Deformities
* MTPJ Capsulitus (Inflamattion of the MTPJ joint Capsule)
* MTPJ Joint Synovitis (Swelling of the joint linning)

Question 2

What is a Metatrsal Bar?
Clinical Uses

Answer 2

Fan shaped pad placed proximal to the Metatarsal heads 2-4 to reduce pressure at the metatarsal heads:

Clinical Uses:
* MTPJ bursitis
* Plantar plate dysfunction
* Fat pad atrophy
* MTPJ synovitis/capsulitis
* Heavy callus over metatarsals 1-5

Question 3

What is a Heel Raise?
Clinical uses

Answer 3

Extra thickness of material Insert added to the rearfoot of orthoses to reduce Load placed on rearfoot tendons

Clinical uses:
* Achilles tendinopathy
* Patella Tendinopathy
* Osgood-Schlatter’s
* Unilaterally for Limb Length Discrepancy.
* Contracture of Triceps Surae or Hamstrings.
* Rigid Forefoot Equinus
* Haglund’s Deformity

Question 4

What is a Heel Pad?
Clinical uses

Answer 4

Heel pad is a cushion which lines the heel region of the insole and provides pressure relief

Clinical Uses:
* Fat Pad Contusion
* Heel Fat Pad Atrophy
* Calcaneal odema
* Heel Spur
* Plantar Fascviopathy

Question 5

What is Cluffy Wedge?
Clinical Uses

Answer 5

Wedge extending fromt he 1st MTPJ to the proximal and Distal Phalanx.

Its aim is to Pre Dorsiflex the Hallux to engage the Windlass Mechanism earlier.

Clinical Uses:
* Functional Hallux Limitus
* Delayed Windlass Mechanism

Question 6

What is a Cuboid Pad?
Clinical Uses

Answer 6

Pad Placed underneath the Cuboid on the lateral border of the insole.

Facilitate movement of the centre of pressure medially during midstance to make use of Bojsson-Mollor’s high gear propulsion concept.

The Cuboid Pad/notch will provide a pronatory moment at the subtalar and midtarsal joints.

Clinical Uses:
* Cuboid syndrome.
* Support lateral column
* Lateral ankle instability
* Peroneal tendon pathologies (Peroneus Longus/Brevis)

Question 7

What is Rearfoot Medial / Varus Posting?
Clinical Uses

Answer 7

Firm material to the medial rearfoot of the device, intended to increase supinatory orthotic reaction forces under the rearfoot.

Clinical Uses:
* Pes planus/pronated foot type
* Tibialis posterior pathologies
* Sinus Tarsi Syndrome
* Tarsal tunnel syndrome
* Medial tibial stress syndrome
* Plantar fasciopathy
* HAV/Bunions
* Forefoot pathologies