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RICHARD CPED

Posted by JAKE DELHOME on 1/09/04 at 14:36 (141708)

RICHARD,

I HAVE BEEN USING CUSTOM MADE ORTHOTICS WITH A RIGID PLASTIC FOR THE ARCH AREA SUPPORT FOR THE TREATMENT OF POSTERIOR TIBIAL TENDONITIS,ALONG WITH FLEXOR HALLINGUS TENDONITIS/TENOSYNOVITIS. WHILE EXAMING MY ORTHOTIC, I NOTICED THAT THE ARCH MOLDED ORTHOTIC IN MY LEFT FOOT WAS SUBSTASNIALLLY HIGHER THAN MY HEALTHY RIGHT FOOT ORTHOTIC. MY PODIATRIST ADJUSTED MY LEFT BAD FOOT ARCH BY HEATING IT AND ADDING EVEN HIGHER ARCH , BECAUSE I HAD NO RELIEF WITH THE FIRST TIME MOLDING. AS HE ADJUSTED THEM EVEN HIGHER IT MADE THE PAIN MORE EXCRUCIATING AND I HAD TO BE OFF MY FEET COMPLETELEY. DO YOU THINK THE ORTHOTIC ARCH WAS TOO HIGH TO BEGIN WITH AND WAS THE CAUSE OF MY TENDONITIS? WHAT DO YOU THINK I SHOULD DO? YOUR ADVICE WOULD BE APPRECIATED. WHAT ABOUT A LOWER ARCH?

Re: RICHARD CPED

Richard, C.Ped on 1/09/04 at 15:34 (141717)

If the foot was casted correctly in a neutral (or as close to neutral as possible) the arch should be just right. No two feet are alike, so one arch may be higher or lower than the other. I had trouble with my left orthotic while getting used to wearing them.

I don't know why the arch would have been adjusted higher. If casted correctly, you would have perhaps felt instant relief or it may have taken up to two weeks. It is hard to say.

The more I think about it, I also wonder if who ever made the orthosis (a lab perhaps?) did not allow the material to properly heat before adding it to the cast.

Re: RICHARD CPED

JAKE DELHOME on 1/09/04 at 19:29 (141738)

richard

thanks FOR THE RESPONSE. YOU ARE RIGHT IN THE FACT THAT MY PODIATRIST TOOK AN IMPRESSION OF MY FEET WHILE I WAS SITTING WITH MY FEET EXTENDED IN THE AIR, NOT IN A WEIGHTBEARING POSITION. HE THEN SENT THEM OFF TO THE LAB TO BE MADE. DO YOU SUGGEST I GO TO A CPED TO SEE IF I CAN GET A BETTER ORTHOTIC AND DO I NEED A PRESCRPITON TO GO TO A CPED? WHAT ARE YOUR SUGGESTIONS. I THANK YOU

Re: RICHARD CPED

Richard, C.Ped on 1/10/04 at 09:36 (141763)

That method of casting is ok. what you do not want is a total weight bearing impression. I use a semi weight bearing method. If you did go to a C.Ped, they should not do anything without a prescription. I am still wondering if the lab messed up when making your orthotics.

Re: RICHARD CPED

Dr Kiper on 1/10/04 at 10:29 (141776)

I doubt that the higher arch 'caused' your tendonitis. The higher arch position will over correct you and so where you have the problem from an overpronated state you go to an over corrected position. This normally will cause other problems i.e. knees, hip or low back.
The bottom line is that your orthotics do not fit you properly, they do not match the way your muscles walk.

Re: RICHARD CPED

Dr. Zuckerman on 1/10/04 at 13:50 (141784)

I have found that you may need additional treatment such as anti-inflamatory medication, physical Therapy in addition to your orthosis. Sometimes you need a special foot and ankle orthosis instead of just a foot orthosis. This would depend on the outcome of your biomechanical evaluation. You need to control the hindfoot/subtalar joint and ankle joint
You leg length needs to be evaluated also

Re: RICHARD CPED

Andy O on 1/11/04 at 05:03 (141811)

I have found with my own feet that too much support under the arch will put too much tension in the plantar fascia, leading to pain and possible damage at the attachment point.