Orthotics Lab

Calendar November 18, 2010 | Posted by admin

Orthotics Lab

Orthotics Lab

New Help for Heel Pain

Millions of people suffer from heel pain. About one in 4 people will suffer from heel pain at some point in their lives. There are numerous causes for heel pain but the most common is plantar fasciitis.

The plantar fascia is a broad, flat ligament that runs along the bottom of the foot lending the foot support. It is shaped like a trapezoid, being narrower at its attachment to the heel bone then widening as it courses forward toward its insertion at the base of the toes. Patients often present with pain of insidious onset, gradual progression and culminating to a point in which medical attention is sought.

The plantar fascia serves to support the foot so anything that is increasing the demand for support on the foot increases strain of the plantar fascia. Common reasons for increased strain on the plantar fascia include overpronation which is a rolling in of the foot. Overpronation is often confused with a flat foot but the two are very different. The height of the arch has little to do with the mechanical integrity of the foot but it is how the arch functions as we walk (gait) that determines how much strain is placed on the plantar fascia. A foot that rolls inward too much after the foot strikes the ground is a foot that overpronates and is a foot which strains the plantar fascia.

A couch potato probably takes 3000 to 5000 steps per day while an active person may take 10,000 to 30,000 steps per day. Imagine the plantar fascia being over strained or over stretched with each step and that over stretch taking place 30,000 times a day. The cumulative, repetitive stretching of the plantar fascia begins to take its toll and the plantar fascia reacts by thickening and becoming painful. The key to relieving plantar fasciitis in the long term is to stop the repeated over stretching of the fascia in gait. This can be accomplished by a foot specialist making a specialized device called an orthotic that is made from a mold of the foot and functions to hold the foot in a position of minimal stress on the plantar fascia.

There are a number of other treatments like cortisone shots but they are for temporary relief only and can have side effects if used incorrectly. A prescription for physical therapy or massage therapy can also provide temporary relief in a safer fashion. A prescription orthotic is like a prescription eyeglass in that it's efficacy depends on the accuracy of the prescription. Placing one's foot in a foam box to capture its shape only serves to capture the foot in the wrong position. It is up to the foot specialist to position the foot in the corrected position, the position that minimizes strain on the plantar fascia and then capturing that corrected shape with a plaster of Paris mold or with newer technology, a three dimensional optical scanner. The mold or "capture" of the corrected foot shape is then sent to a prescription orthotic laboratory where the orthotic is made. The mold is called a negative cast so the lab has to pour plaster into the negative cast to make a model of the foot. plastic or graphite is then heat molded to the model to make the orthtotic.

How does one know if a lab making a quality product? The labs self-police themselves through an organization called the Professional Foot Orthotic Lab of America (PFOLA). Many patients have the impression that they will recieve the prescription orthotic and that is it. That is actually the start of treatment as the patient becomes accustomed to the beneficial changes in gait and the plantar fasciitis gradually fades into oblivion.

Recalcitrant cases of plantar fasciitis, now termed, plantar fasciosis have cures with two newer treatments: 1) ESWT or extracorporeal shockwave therapy and 2) the Topaz procedure or coblation therapy. ESWT is a non-invasive procedure performed in the office. It involves repetitive controlled shockwaves which induces the body to repair and replace the diseased tissue with new, healthy tissue. The Topaz procedure is a minimally invasive procedure in which the podiatric physician utilizes a radiofrequency wand to remove the diseased tissue.

Orthotics: A Comprehensive Clinical Approach
Orthotics: A Comprehensive Clinical Approach
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Orthotics: A Comprehensive Clinical Approach is an innovative and comprehensive new text that provides essential information about contemporary orthoses to guide the student and clinician in prescribing and utilizing these appliances in neuromuscular, musculoskeletal, and integumentary rehabilitation. Written by recognized authorities in the field, Joan Edelstein, MA, PT, FISPO and Jan Bruckner, PhD, PT, this is a prime resource for practitioners and clinicians. Individual chapters cover orthoses for the foot, ankle, knee, hip, trunk, neck, shoulder, elbow, wrist, and hand. Orthoses for patients with paraplegia, burns, and soft tissue contractures are detailed and illustrated. Prescription guidelines, evaluation techniques, goal setting, and training procedures are presented. Each chapter has interesting "thought" questions and case studies to promote clinical reasoning and problem-solving skills. A unique feature of this text is the inclusion of a point-counterpoint discussion to demonstrate how clinicians can manage the same patient in different ways. This approach inspires broader thinking about clinical management.
Running Anatomy
Running Anatomy
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See what it takes to maximize running strength, speed, and endurance! Running Anatomy will show you how to improve your performance by increasing muscular strength, optimizing the efficiency of your running motion, and minimizing your risk for injury.   Running Anatomy features 50 of the most effective strength exercises for runners, each with clear, step-by-step descriptions and full-color anatomical illustrations highlighting the muscles in action. But you’ll find much more than exercises—you’ll also see their results.   Running Anatomy places you in the action, fundamentally linking each exercise to running performance. You’ll see how to strengthen muscles, reduce injury, and improve gait efficiency for faster times and more fluid runs.   Running Anatomy will prepare you for any challenge that comes your way. You’ll find exercises for varying terrains and speeds, from hill running to off-road running and from sprints to marathons. Plus you’ll learn how to evaluate and rehabilitate the most common injuries that runners face, including lower-back pain, knee aches and strains, and torn muscles and tendons.   Whether you’re a fitness runner looking to conquer hills with more speed or strength or a competitive runner looking for that extra bit of performance and a finishing kick, Running Anatomy will ensure that you’re ready to deliver your personal best.  

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Great Feet for Life: Footcare and Footwear for Healthy Aging
Great Feet for Life: Footcare and Footwear for Healthy Aging
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Healthy feet provide the foundation for healthy aging. This is the first foot care book that is written exclusively for those aged 50 and over. Written by a podiatrist, it describes the changes that occur to our feet as we age and addresses the most common sources of foot pain such as nail conditions, skin conditions, heel spurs, bunions, and swelling. Detailed, illustrated, step-by-step instructions are given for self-care of skin and nails, and a thorough discussion of footwear provides invaluable information on selecting the right shoes to prevent foot pain.

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The Runners' Repair Manual: A Complete Program for Diagnosing and Treating Your Foot, Leg and Back Problems
The Runners' Repair Manual: A Complete Program for Diagnosing and Treating Your Foot, Leg and Back Problems
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This manual has useful tips on the prevention and cure of running injuries.

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Sports and Exercise Injuries: Conventional, Homeopathic and Alternative Treatments
Sports and Exercise Injuries: Conventional, Homeopathic and Alternative Treatments
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Dr. Subotnick has developed an integrative approach to foot health and to sports medicine that is truly a model for the modern physician. The comprehensive nature of the book and the practical information that it provides makes it accessible to all health professionals as well as for the general public.
Rehabilitation Technology
Rehabilitation Technology
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This volume informs physical therapists, occupational therapists, and rehabilitation technologists about the devices that are available today and provides important background information on these devices. Nationally recognized leaders in rehabilitation technology service delivery share their practical expertise. Each chapter provides sources--suggested readings and professional organizations--for further information on each topic. This volume will be useful in the future in giving professionals a method for seeing where new devices fit into the spectrum of assistive technology.

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