Orthotic prescription variables for specific pathologies?
Prescribing custom foot orthotics as podiatrists is definitely subjective and we at Alliance orthotics are strong believers that there are no specific pathology “script templates” that can be tailored to pathologies. Yet understanding the patient and their unique biomechanics is paramount to effective orthotic therapy.
We often get calls from prescribers asking “what could I add to the orthotic to help with plantar fasciitis.” While yes, some pathologies such symptomatic hallux rigidus may respond well to variables such as Morton's extensions, a greater understanding of the patient's kinematics is needed to answer this question. Instead, we ask prescribers to think about and address the following questions.
- Is there a specific structure (Muscle, Bone, tendon, ligament, tissue) that is damaged
- Understand the specific force that is contributing to the pathology. Recognise if the force is a shearing force, tensile or compressive force.
- Is there any other biomechanical/alignment factors that may be increasing or contributing the these negative forces
When reflecting on a previously prescribed orthotic again we encourage prescribers to reflect on the following questions:
- Is the orthotic alleviating or redistributing forces away from the pathology
- Are dynamic loading patterns optimised during a gait assessment
- Have symptoms been alleviated
- Has any other structure been overloaded in the process of addressing the previous points A and B