Q1&2: Common Foot Disorders & Pedorthics Recommendations Flashcards
Pedorthic Principal Modalities
Therapeutic Footwear and Foot Orthoses
OTS Footwear
most common; wide variety in materials and styles
Custom Footwear
Foot cannot be fit with a premade shoe; unlimited customization based on clinical preference
Shoe design features (heights)
Low-top, High-top, Chucka (supramalleolar)
Shoe design features (openings)
surgical, blucher, balmoral
Shoe Modifications (durometer)
Measure of hardness
Shore A - most soft
Shore D - most rigid
Durometer goal for orthosis material
“An orthosis should be designed similar to the
anatomy of the foot”
Hallux Valgus
Lateral deviation of 1st MTP joint
CC: pain; difficulty fitting into shoes
Causes: footwear choices (W>M); pes planus; metatarsus primus varus
Management of Hallux Valgus
- Full Length FO to control pronation and offload peak pressure
- Toe spacers to improve alignment
- Proper foorwear (increased depth with low heel)
Hallux Rigidus
OA of 1st MTP
CC: Stiffness/Pain and Visual Changes
Causes: Anatomical abnormality (long first MT, forefoot pronation, trauma)
Management of Hallux Rigidus
- Full Length FO (control pronation)
- Carbon Footplate (limit extension of 1st MTP)
- Proper Footwear (stiff sole)
- Shoe mods (steel shank and/or rocker sole)
Sesamoiditis
Irritation of first or second sesamoid bones
CC: Pain at plantar aspect of 1st MTP
Causes: Fx, arthritis, avascular necrosis
Management of Sesamoiditis
- Full Length FO (with dancer pad to offload 1st MP)
- Carbon foot plate (limit motion)
- Proper footwear (stiff sole)
- Shoe mods (rocker sole, steel shank, decrease durometer of material beneath first met)
Turf Toe
Sprain of the first MTP joint; common in athletes
CC: pain in late stance gait
Cause: MTP hyperextension
Management of Turf Toe
- Full length FOs (Morton’s Ext.)
- Stiff Soled shoe
- External Toe cap (protection)
Metatarsalgia
general term for discomfort at MTPs; always check 1st ray mobility
Morton’s Neuroma
Thickening/Inflammation of digital nerve; commonly between 3/4 or 2/3 digits
Management of Metatarsalgia
- Full Length/Sulcus Length FO (w/ met pad)
- Proper footwear
Plantar Fasciitis
Common diagnosis for heel pain
CC: pain at medial calcaneal tuberosity
Cause: repetitive stress on plantar aponeurosis
Management of Plantar Fasciitis
- Therapy (stretching/massaging)
- Activity modifications (switch to biking or swimming)
- NSAIDs
- Heel cups
- FOs
- Temporary heel lift
Tarsal Tunnel Syndrome
compression of the tibial nerve posterior to the med. malleolus
CC: radiating pain or possible parastheia
Causes: trauma, lesion, inflammation, pronation
Management of Tarsal Tunnel Syndrome
- Full Lenth FO (w/ medial post)
Tibialis Posterior Dysfunction
Commonly misdiagnosed; progressive breakdown of the tibialis posterior tendon
PTTD Classification
Stage I - Normal
Stage II - Tendon inflammation and mild weakness
Stage III - Significant dysfunction from partial tear
Stage IV - no function; end stage
Management of PTTD
Articulated/Gauntlet style AFO (stage 2-3); Solid ankle custom AFO (stage 4)
Calcaneus Fx
Jumpers/Lovers; high force magnitude
CC: Pain weight bearing
Management of Calcaneus Fx
walker boot immobilization; goals are to maintain alignment, contain soft tissue and offload painful structures
Follow up care is usually a UCBL or FO
Talipes Equinovarus
A congenital deformity typically idiopathic in nature resulting in a
deformity of the foot/ankle complex
Talipes Equinovarus - “C.A.V.E”
- C: Cavus
- A: Adducted Forefoot
- V: Varus Hindfoot
- E: Equinus
