Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Lateral foot wedging for medial knee OA

Discussion in 'Biomechanics, Sports and Foot orthoses' started by admin, Aug 13, 2005.

  1. Peter1234

    Peter1234 Active Member

    hi craig,
    do you think that that restriction in stj eversion is due to protective 'locking' of the joint as a result of pain, lld (despite your recent work with lld and pronation patterns), or something else that I cant think of??!! ie. familial disposition, trauma etc.
     
  2. Peter1234

    Peter1234 Active Member

    :good:
    hi Kevin,
    which type of patient is most likely to tolerate the lateral wedges in your experience? The maximally pronated or the non maximally pronated?
    Peter
     
  3. Peter:

    Honestly, since I am titrating the amount of wedge to the patient's tolerance for those wedges, I haven't seen much difference between the foot which has a subtalar joint (STJ) maximally pronated or not maximally pronated in being able to "tolerate" the valgus rearfoot and forefoot wedges I use to treat medial knee osteoarthritis (OA). In other words, since I generally use more valgus wedging in those feet with STJs that are not maximally pronated and will use less valgus wedging in those feet with STJs that are maximally pronated, I am always adjusting the valgus wedging to patient tolerance.

    The goal of orthosis therapy for medial knee OA is to transfer ground reaction force (GRF) laterally on the plantar foot. In the maximally pronated STJ, only a small amount of valgus wedging is required to produce a significant lateral shift in GRF. In the non-maximally pronated STJ, a larger amount of valgus wedging will likely be required to produce a significant lateral shift in GRF on the plantar foot. I believe that individuals with feet that are already maximally pronated at the STJ will require less rearfoot and forefoot valgus wedging to produce the same therapeutic results as treating those individuals with non-maximally pronated STJs with larger valgus wedges with medial knee OA.

    Until researchers start using variable degrees of both rearfoot and forefoot valgus wedging to treat medial knee OA in their research, I don't believe that they will be able to reproduce the very good therapeutic results that myself, and others, have been achieving for the past two decades by using this clinical method of treating medial knee OA.
     
  4. Peter1234

    Peter1234 Active Member

    That makes perfect sense
    Thanks Kevin
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Investigation of the biomechanical effect of variable stiffness shoe on external knee adduction moment in various dynamic exercises
    Jee-Chin Teoh, Jin-Huat Low, Ying Bena Lim, Victor Phyau-Wui Shim, Jaeyoung Park, Seung-Bum Park, Sang Jun Park and Taeyong Lee
    Journal of Foot and Ankle Research 2013, 6:39 doi:
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis
    Olalekan A Uthman, Danielle A van der Windt, Joanne L Jordan, Krysia S Dziedzic, Emma L Healey, George M Peat, Nadine E Foster
    BMJ 2013;347:f5555
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The biomechanical effects of a new design of lateral wedge insole on the knee and ankle during walking.
    Jones RK, Zhang M, Laxton P, Findlow AH, Liu A.
    Hum Mov Sci. 2013 Aug;32(4):596-604.
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Individuals with Medial Knee Osteoarthritis show Neuromuscular Adaptation when Perturbed during Walking in spite of Functional and Structural Impairments.
    Kumar D, Swanik CB, Reisman DS, Rudolph KS.
    J Appl Physiol (1985). 2013 Sep 26.
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Predicting Benefit From Lateral Wedge Orthotics Using Radiographic Parameters In Medial Knee Osteoarthritis
    Goker, Berna MD, Lidtke, Roy H. DPM; Thorp, Laura E. MPT, PhD; Wimmer, Markus A. PhD; Block, Joel A. MD
    American College of Rheumatology Annual Meeting; Oct 26-30, 2013; San Diego
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effects of Lateral Shoe Wedges and Toe-in Foot
    Progression Angles on the Biomechanics of Knee
    Osteoarthritis during Stationary Cycling

    Jacob Kale Gardner
    PhD thesis; University of Tennessee; 2013
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking
    Carsten Møller Mølgaardab & Uwe Kerstingc
    Footwear Science (in press)
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    This clinical trial was just registered:
    Wedged Insoles for Knee Osteoarthritis: the ABCs of OA Randomized Controlled Trial
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The immediate effect of lateral wedge insoles, with and without a subtalar strap, on the lateral trunk lean motion in patients with knee osteoarthritis.
    Esfandiari E, Kamyab M, Yazdi HR, Foroughi N, Sanjari MA.
    Geriatr Orthop Surg Rehabil. 2013 Dec;4(4):
     
  14. JAYNES

    JAYNES Active Member

    Hi
    I have been using lateral wedging for a few years now for medial o.a with great results
    Have always used ppt with lateral wedging on top of orthotic i am interested to know whether any one has used eva density lateral wedging on the bottom of the orthotic with good results?

    Have a very heavy pt with medial o.a concerned ppt will not work for them

    Thanks in advance
    Jaynes
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Real-time knee adduction moment feedback training using an elliptical trainer.
    Kang SH, Lee SJ, Ren Y, Zhang LQ.
    IEEE Trans Neural Syst Rehabil Eng. 2014 Mar;22(2):334-43.
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effects of laterally wedged insoles on static balance in patients with medial compartment knee osteoarthritis
    Fariba Ahmadi, Saeed Forghany, Christopher Nester and Richard Jones
    Journal of Foot and Ankle Research 2014, 7(Suppl 1):A22 doi:10.1186/1757-1146-7-S1-A22
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Foot and ankle biomechanics play a role in biomechanical response to lateral wedge insoles
    Richard K Jones, Graham J Chapman, Matthew J Parkes, Laura Forsythe and David T Felson
    Journal of Foot and Ankle Research 2014, 7(Suppl 1):A39 doi:10.1186/1757-1146-7-S1-A39
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Immediate and medium-term effects of custom-moulded insoles on pain, physical function, physical activity, and balance control in patients with knee osteoarthritis.
    Hsieh RL, Lee WC.
    J Rehabil Med. 2014 Feb;46(2):159-65.
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effect of lateral wedge insoles in patients with medial compartment knee osteoarthritis: balancing biomechanics with pain neuroscience
    Isabel A. C. Baert, Jo Nijs, Mira Meeus, Enrique Lluch, Filip Struyf
    Clinical Rheumatology; May 2014
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Knee adduction moment and medial knee contact force during gait in older people
    Shinya Ogaya, Hisashi Naito, Akira Iwata, Yumi Higuchi, Satoshi Fuchioka, Masao Tanaka
    Gait & Posture; Article in Press
     
  21. spodd

    spodd Member

    Have a perfect candidate at the moment for valgus wedging, has had benefit from temporary wedging but want more support medially and something more permanent so am making orthoses, I understand increasing GRF to the lateral column (RF and FF) is required. lateral heel skive makes perfect sense, however a valgus FF wedge finishing behind the met heads, Im finding harder to visualise. Does the distal end of this wedge just end at this point.. doesn't this 'lip' irritate the patient??
    Is it possible to use a forefoot external wedge that extends the full length of the shoe??
     
  22. The forefoot valgus wedge is a forefoot valgus orthosis extension made generally of korex or EVA from the distal edge of the orthosis plate to the sulcus. The forefoot valgus wedge is just as important as the lateral heel skive in relieving the pain of medial knee osteoarthritis.
     
  23. efuller

    efuller MVP

    I agree with Kevin's points about the extension being important. On the intrinsic or extrinsic forefoot valgus post of an orthotic: I've used this modification quite a bit and have never seen irritation. Usually, the orthotic has a gradual curve away from the foot (over about a 1 cm) and not a sharp drop off. The extension, that goes out under the met heads is quite important, because after heel lift, an orthotic without the extension will no longer have the wedge effect.

    Eric
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Differences in Plantar Loading between Orthosis with and without Lateral Wedge in Healthy Subjects.
    Trieb K, Zachhuber D, Hofstätter S.
    Z Orthop Unfall. 2014 Jun;152(3):247-251.
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Immediate efficacy of laterally-wedged insoles with arch support on walking in persons with bilateral medial knee osteoarthritis.
    Yeh HC, Chen LF, Hsu WC, Lu TW, Hsieh LF, Chen HL.
    Arch Phys Med Rehabil. 2014 Jul 4
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    THE EFFECT OF LATERAL WEDGE INSOLES ON THE ASYMPTOMATIC KNEE OF PATIENTS WITH MEDIAL COMPARTMENT OSTEOARTHRITIS
    J. Sultan, G. Chapman and R. Jones
    Bone Joint J 2014 vol. 96-B no. SUPP 11 180
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    What predicts the first peak of the knee adduction moment?
    Anne Schmitz, Brian Noehren,
    The Knee; Available online 24 July 2014
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Tibiofemoral contact location changes associated with lateral heel wedging - a weight bearing MRI study
    Peter J. Barrance, Venkata Gade, Jerome Allen, Jeffrey L. Cole
    Clinical Biomechanics; Articles in Press
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    This clinical trial was just registered:
    Shoe Orthotics for Improvement of Biomechanics and Symptoms of Knee Osteoarthritis
     
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Valgus Bracing for Knee Osteoarthritis: A Meta-analysis of Randomized Trials.
    Moyer RF, Birmingham TB, Bryant DM, Giffin JR, Marriott KA, Leitch KM
    Arthritis Care Res (Hoboken). 2014 Sep 8
     
  31. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The dose-response relationship between lateral foot wedging and the reduction of knee adduction moment
    Rima A. Tipnis, Philip A. Anloague, Lloyd L. Laubach, Joaquin A. Barrios
    Clinical Biomechanics; Articles in Press
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Superiority of laterally elevated wedged insoles to neutrally wedged insoles in medial knee osteoarthritis symptom relief.
    Hatef MR, Mirfeizi Z, Sahebari M, Jokar MH, Mirheydari M.
    Int J Rheum Dis. 2014 Jan;17(1):84-8.
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?
    Duivenvoorden T, van Raaij TM, Horemans HL, Brouwer RW, Bos PK, Bierma-Zeinstra SM, Verhaar JA, Reijman M.
    Clin Orthop Relat Res. 2014 Sep 30
     
  34. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lateral wedge insole for knee osteoarthritis: randomized clinical trial
    Gustavo Constantino de Campos, Marcia Uchôa Rezende, Thiago Pasqualin, Renato Frucchi , Raul Bolliger Neto
    Sao Paulo Med. J., ahead of print Epub Oct 17, 2014
     
  35. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Pain sensitization and degenerative changes are associated with aberrant plantar loading in patients with painful knee osteoarthritis
    T Røsland, LS Gregersen, TN Eskehave, UG Kersting, and L Arendt-Nielsen
    Scandinavian Journal of Rheumatology
     
  36. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reduced knee joint loading with lateral and medial wedge insoles for management of knee osteoarthritis: a protocol for a randomized controlled trial
    Lewinson RT, Collins KH, Vallerand IA, Wiley JP, Woodhouse LJ, Reimer RA, Worobets JT, Herzog W, Stefanyshyn DJ
    BMC Musculoskeletal Disorders 2014, 15 :405 (3 December 2014)
     
  37. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of an ankle–foot orthosis on knee joint mechanics: A novel conservative treatment for knee osteoarthritis
    Cynthia H Fantini Pagani, Steffen Willwacher, Rita Benker, Gert-Peter Brüggemann
    Prosthet Orthot Int December 2014 vol. 38 no. 6 481-491
     
  38. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Comparison the effect of lateral wedge insole and acupuncture in medial compartment knee osteoarthritis: a randomized controlled trial.
    Ashraf A et al
    Knee. 2014 Mar;21(2):439-44. doi: 10.1016/j.knee.2013.12.002.
     
  39. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Interesting letter to editor on a study posted previously in this thread.
    http://www.clinexprheumatol.org/article.asp?a=7893 (full text)
     
  40. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of unilateral and bilateral use of laterally wedged insoles with arch supports on impact loading in medial knee osteoarthritis
    Amira Abdallah Abd El Megeid Abdallah
    Prosthet Orthot Int February 17, 2015
     
Loading...

Share This Page