Post by robertisaacs on Mar 30, 2008 12:39:39 GMT
I've cracked this off from simple insoles made simple because it is really simple insoles made complex!
Derek posted these pictures with the following comment:-
And here are the "techy" ones ;D
Simple they are NOT !! ;D
He's right, they're not.
The design is essentially a hybrid of several principles. Del's problem (foot wise
) is a Sub talar joint essentially locked in neutral, a certain amount of bony ankle equinus, and a complete lack of any kind of function in the transfer of mass from heel to toe (which is very rapid). The digits are fixed in extention and do not contact the ground at all during "toe off". The intrinsic musculature is hypertonic. The Pelvis exhibits a huge degree of sway and the knees tend to hyperextend.
The symptoms are varied. Pain in feet, ankles, knees, hips and lower back.
The insole is very nearly flat in terms of dorsal surface, no frontal plane control to speak of.
The red layer under the heel is poron 94, a very soft compressible vartiety of poron. That is there to decrease planterflexion moments (much like a striker / Sach mod) and to cushion impact throught the hips and knees (do decrease proximal trauma).
The green is poron 4000, a more standard type of poron which is a little harder than poron 94. Its their to decellerate midfoot loading. and assists the poron 94 (which would not be enough on its own.)
The midfoot is made with 2 memory foams which will compress, but only slowly and will not exert much elastic force once compressed.
The black is V9, a high density memory foam (quite hard) shaped as a rocker. This will compress slightly towards late mid stance.
The Blue layer above the black (which looks white in the photo) is diabet. This is a somewhat softer memory foam which will delay forefoot loading more (more rocker effect) but is soft enough to have compressed fully by late midstance.
There is also a shelf under the toes to provide sensory feedback (for balance) and hopefully reduce some of the intrinsic hypertonia, its one of the features of the "neurological" AFO used by orthotists in hypertonic Cerebral palsy.
So the overall aim is to : -
Cushion heel strike
Decrease Planterflexion moments
Delay forefoot load
Create a smoother heel - toe mass transfer
Reactivate some of the extrinsic musculature around the ankles knees and hips.
Be comfy (quite important).
The point of putting all of this up is not to suggest that everyone start using this kind of thing. To be honest unless you are very familier with the different types of material and their properties it would be unwise to try.
The point is that "simple" insoles ain't just arch supports and forefoot cushions. Dels foot was very, very non standard which is why the standard orthotic is not particularly suitable. Its nice to have a modality with the freedom to make exactly what you think the foot needs.
Thanks to del for permission to reproduce his treatment plan here.
Regards
Robert
Derek posted these pictures with the following comment:-
And here are the "techy" ones ;D
Simple they are NOT !! ;D
He's right, they're not.
The design is essentially a hybrid of several principles. Del's problem (foot wise
) is a Sub talar joint essentially locked in neutral, a certain amount of bony ankle equinus, and a complete lack of any kind of function in the transfer of mass from heel to toe (which is very rapid). The digits are fixed in extention and do not contact the ground at all during "toe off". The intrinsic musculature is hypertonic. The Pelvis exhibits a huge degree of sway and the knees tend to hyperextend. The symptoms are varied. Pain in feet, ankles, knees, hips and lower back.
The insole is very nearly flat in terms of dorsal surface, no frontal plane control to speak of.
The red layer under the heel is poron 94, a very soft compressible vartiety of poron. That is there to decrease planterflexion moments (much like a striker / Sach mod) and to cushion impact throught the hips and knees (do decrease proximal trauma).
The green is poron 4000, a more standard type of poron which is a little harder than poron 94. Its their to decellerate midfoot loading. and assists the poron 94 (which would not be enough on its own.)
The midfoot is made with 2 memory foams which will compress, but only slowly and will not exert much elastic force once compressed.
The black is V9, a high density memory foam (quite hard) shaped as a rocker. This will compress slightly towards late mid stance.
The Blue layer above the black (which looks white in the photo) is diabet. This is a somewhat softer memory foam which will delay forefoot loading more (more rocker effect) but is soft enough to have compressed fully by late midstance.
There is also a shelf under the toes to provide sensory feedback (for balance) and hopefully reduce some of the intrinsic hypertonia, its one of the features of the "neurological" AFO used by orthotists in hypertonic Cerebral palsy.
So the overall aim is to : -
Cushion heel strike
Decrease Planterflexion moments
Delay forefoot load
Create a smoother heel - toe mass transfer
Reactivate some of the extrinsic musculature around the ankles knees and hips.
Be comfy (quite important).
The point of putting all of this up is not to suggest that everyone start using this kind of thing. To be honest unless you are very familier with the different types of material and their properties it would be unwise to try.
The point is that "simple" insoles ain't just arch supports and forefoot cushions. Dels foot was very, very non standard which is why the standard orthotic is not particularly suitable. Its nice to have a modality with the freedom to make exactly what you think the foot needs.
Thanks to del for permission to reproduce his treatment plan here.
Regards
Robert
