Orthotic query

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Hi all. I am making some orthotics for a family friend. I am relatively new to making custom orthotics as normally use off-the-shelft orthotics. I am just looking for some advice on the following.

The patient in question has left ankle pain which often occurs when they run. They are a keen runner. They also have pes planus and pronate when walking.

I was thinking of putting in a heel lift (unsure of how much), to alleviate the left lateral ankle pain and also putting some medial posting about 5 degrees. Would this be going along the right lines? I am unsure of whether i should look at the arch contour as do not want to over correct them.

I will be using semi rigid polyproplene for the material to make the orthotics to ensure they are quite robust as the patient is a keen runner. If anyone could make any further suggestions I would be most grateful.

Thank you.

 

Hi apod83.

It's difficult to advise without a more specific diagnosis. For instance lateral ankle pain could mean peroneal overuse which may require lateral posting. Or it could mean sinus tarsi compression which may require medial posting.

If you can provide some further information about which specific structures are involved, along with results of any other testing such as lunge tests, supination resistance etc you might get some more helpful replies

Hope this helps
Ian

 

apod83, welcome. I trust that apod83 is not your real name and you may find more responses here if you do provide you real name.

As Ian stated, without a diagnosis it is difficult to advise on orthoses prescription variables, but I would also throw this into the mix- you state that you have been using prefab off-the-shelf insoles with success, why then do you perceive that this particular patient requires a custom foot orthosis?

Which raises perhaps a more interesting question than your initial clinical query for the podiatry arena veterans:

When are custom foot orthoses required and when will off the shelf devices foot the bill?

Peace y'all.