Orthotics

Question 1

What is a heel spur accommodation? Where should it be placed? What is it used for?

Answer 1

Cavity in shell material filled with poron and contoured to the shape of the heel. Placed under area of heel spur, typically under the medial calcaneal tubercle. Used for heel spurs or fat pat atrophy

Question 2

What is a horseshoe pad? Where should it be placed? What is it used for?

Answer 2

U-shaped cutout in area of the medial calcaneal tubercle. Used for heel spurs or fat pad atrophy

Question 3

What is a plantar fascia groove? Where should it be placed and what is it used for?

Answer 3

Groove incorporated into shell material in area of medial plantar fascial ligament or flexor hallucis brevis. Used for prominent fascia or flexor tendons

Question 4

What is a navicular sweet spot? Where is it placed and what is it used for?

Answer 4

Cavity in the shell material filled with poron to contour to surrounding shell shape. Used for accessory naviculars, bony exostosis’, or prominent cuneiforms/naviculars

Question 5

What is a 1st ray cut out? Where is it placed and what is it used for?

Answer 5

Corner of shell material under first MTPJ is removed. Used for plantar flexed first ray and functional hallux limitus

Question 6

What is a deep heel cup? Where is it placed and what is it used for?

Answer 6

Heel cup depth greater than standard (14-35 mm). Deepens heel cup for greater support of rearfoot.

Question 7

What is a rigid 1st extension? Where is it placed and what is it used for?

Answer 7

Extensions of shell material under 1st digit to the very end of the digit. Used for conditions like hallux limitus/rigidus, morton’s syndrome, and turf toes

Question 8

What is a sulcus crest? Where is it placed and what is it used for?

Answer 8

Applied in area of sulcus to support central segments of the 2-5 digits. Used when lesions (corns/ulcers) are present on tips of the toes, or when hammered toe deformities begin to stiffen

Question 9

What is a functional hallux limitus/PF first ray accommodation? Where is it placed and what is it used for?

Answer 9

Square cut out under 1st MTPJ, used for functional hallux limitus.

Question 10

What is a morton’s extension?

Answer 10

Extension of shell material under first MTPJ. Used for mild hallux limitus, morton’s toe, or a dorsiflexed first ray

Question 11

What is a metatarsal pad/bar? Where is it placed and what is it used for?

Answer 11

Centered under the 3rd metatarsal, with the peak just proximal to the MT heads. Used for dropped transverse arches, metatarsalgia, dropped metatarsal, forefoot callousing/pressure, or neuromas

Question 12

What is a neuroma pad? Where is it placed and what is it used for?

Answer 12

Pad placed between the 3rd and 4th MT’s, unless neuroma is elsewhere. Used for interdigital neuromas or intermetatarsal bursitis

Question 13

What are the properties of cross linked polyethylene foam (plastazote)?

Answer 13

Easily moldable, cushioning but bottoms out, sheds moisture, closed cell

Question 14

What are the properties of polyurethane foam?

Answer 14

Good shock absorption, long term resilience, absorbs moisture, not heat moldable. Poron, neoprene

Question 15

What are the properties of semi rigid materials?

Answer 15

Provide support, flexible enough to allow motion, won’t bottom out, easily ground. Cork, RCH 500, polypropylene

Question 16

What is the difference between a narrow, standard, and wide fit orthotic shell?

Answer 16

Narrow bisects the 1st and 5th rays, standard fits slightly medial to the bisection of the 1st ray and lateral to the bisection of the 5th ray, and wide fits to the medial and lateral borders of the foot

Question 17

What orthotic features could be used to treat plantar fasciitis?

Answer 17

MLA support, cushioned heel, horseshoe pad for heel, plantar fascia groove

Question 18

What is the difference between a shallow, normal, and deep heel cup?

Answer 18

Shallow will be <=10mm, normal will be about 10-15mm, and deep will be <=20mm