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Post by TimVS on Jan 17, 2009 11:57:26 GMT
Advice on orthotic fitting for a patient please.
Female, maximally pronated, medially deviated axes. Orthoses to address ff pain. Fairly straightforward. Here's the thing. She is a PA and has to wear slim courts for work. Changing footwear is not an option. Preferred option would be medial heel skive but this probably won't fit in the shoe. Conversely a slimfit device, which would fit, seems pretty pointless as well given the presentation.
Any ideas? What would you do.
Ta
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podmum
Full Member
"There is no dark side of the moon"
Posts: 169
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Post by podmum on Jan 17, 2009 16:06:07 GMT
She is a PA and has to wear slim courts for work. Changing footwear is not an option.Why is changing footwear not an option? How much does she want to be rid of the pain? I would try and compromise with this one and find out how she gets to work and if she is wearing her court shoes for the time she travels. Can she wear different shoes where an orthotic can be used during this time and subsequently when she is not in the office? There is no office job where you cannot change your footwear maybe suggest smart trouser suit where a more accomodating shoe can be worn. I am sure you have tried this route already but just thought I would put my system forward anyway. Podmum
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Post by davidsmith on Jan 17, 2009 20:30:25 GMT
Hi Podmum
But what's your diagnosis? Your description tells us very little. What is the particular tissue that is traumatised and what is the cause of the stress?.
And why do Public Announcers have to wear narrow shoes - does she also wear a tricorn hat and breeches? Oyez Oyez! Introducing for your delight and pleasure - Madame legurts and General foot pain.
Dave
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Post by dtt on Jan 18, 2009 16:33:55 GMT
Hi Dave Oh NO oh No Dont you mean Hi Tim ? ;D ;D Got a point aint he Tim ?? Cheers Buddy D
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Post by blinda on Jan 18, 2009 19:33:45 GMT
Very droll Del Dave, You assume that the court shoe wearer is a Public Announcer. Perhaps she is from the eastern state of America; Pennsylvania, or a member of the interim self-government body for areas under Palestinian control. Have you considered she may indeed be a Pamela Anderson, where centre of mass/gravity would surely be called into question? However, I would assume that we are not talking body piercings hereā¦. Wendy, I think your suggestion of sporting orthoses accommodating footwear whilst in transit to and from her place of work, is an excellent one. A Kasper trouser suit is just as feminine with a chunky, deep toe boxed, stylish brogue type shoe as a dippy court shoe, and far more alluring as she walks with confidence and comfort instead of wincing in pain with every step. I agree the orthaheel slimfit devices will probably accomplish little, but may be better than no insole at all. Personally, I have benefited from the `tadpole` orthoses, only available thorugh Footprints Orthotics, in my summer sillies, but then again I don`t tend to reach end stage, prolonged pronation in gait. Cheers, Bel
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Post by dtt on Jan 18, 2009 22:14:57 GMT
Hi Bel ;D Is that right Tim ?? Yep like to check that one out With modification it may alleviate the symptoms by minimally contolling the rearfoot supporting the MTJ and with an addition of a met dome stabilising the forefoot BUT That is all guesswork Dave had it right ?? AND your fashion statement is somewhat dated IMHO ;D Trainers to work ,sitting down shoes in the desk drawer, trainers home. A DEMAND IN THIS PRACTICE Cheers D
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Post by lawrencebevan on Jan 19, 2009 10:45:17 GMT
"what would you do?"
I would not treat this patient by putting orthotics for this foot-type in a court shoe. The likelyhood of uncomfortable ineffectual orthotics is near guaranteed.
Get her to buy some trainers and put orthotics in those, when she sees the benefits she will make changes to her work shoes.
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Post by TimVS on Jan 19, 2009 12:00:36 GMT
No need for more. it's a question about orthoses and shoe fit, rather than diagnostic help. Thanks anyway.
I think Lawrence, Bel and Podmum have hit the nail. I'm going to go that way in the absence of any other ideas.
Ta for all the replies
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Post by ianl on Jan 19, 2009 17:41:40 GMT
Hi Tim
Is it a court shoe or high heel shoe?
if a court shoe is it shallow or deep enough from an allied dress class 3.
If a high heel then allied do one suitable for that shoe
When I made my own I made the tadpole type out of 3mm polyprop' for some court shoes and high heeled ones. Worked fine, very durable. Don't know if Robert's into using the polyprop stuff for footprints.
Ian
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Post by TimVS on Jan 19, 2009 20:11:07 GMT
Medium courts so a bit of room in the heel. I would usually go for a DC3 but not sure if they can skive that model. Maybe if they filled in the centre of the heel it would be poss? Might phone you actually
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Post by Admin on Jan 19, 2009 20:56:54 GMT
Hi Tim, DC2 are evidently good for heels up to 2" in height. I say evidently because I fitted these to football boots (+ an extrinsic FF post) for a well-known Premier Div Team and they worked really well (Allied advised me they wouldn't work in footy boots!). DC1 work in high heels and don't have a heel-lift problem. They actually do work well . Cheers,
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Post by davidsmith on Jan 20, 2009 10:14:10 GMT
Del
Oh yeah TIM sorry Tim!!
Luv Dave
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Post by davidsmith on Jan 20, 2009 10:21:53 GMT
Tim
I would have thought the type and aetiology of the condition would determine what type of orthosis was needed and whether you could get away with a thin orthosis or take bel and lawrence's advise to leave the court shoes alone and get her into wide shoes.
Dave
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Post by TimVS on Jan 20, 2009 12:08:02 GMT
Really wierd. I keep trying to reply and it's changing my words I'm not swearing, honest. I'll try again later
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podmum
Full Member
"There is no dark side of the moon"
Posts: 169
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Post by podmum on Jan 20, 2009 13:51:59 GMT
Thanks for the reassurance that I didn't read your post incorrectly Although Dave, you did get me thinking about bmx which was a bit scary ;D Podmum
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