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orthotics
orthotics
41
Anatomy
Graduate
09/30/2012

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Cards

Term
can a small structural change in orthotics/footwear make a significant clinical difference
Definition
yes
Term
what are hard foot orthotics good for?
Definition
digging in the garden
Term
what to use for quick and dirty temporary inserts
Definition
felt, other materials. Off the shelf inserts such as sof sole, dr. scholl, first step
Term
describe some orthotics that can be made quickly in house
Definition
kramer thermoplastic blanks. Shape to bottom of patient's foot and put in shoe. Hapad wool felt add-ons. Biothotics resin swells in the presence of saline
Term
what type of orthotics does the military use and why?
Definition
hapad: don't need tape/glue
Term
what are scaphoid pads
Definition
pads that go in medial part of shoe. "arch cookies"
Term
what does hapad have to help customize to different feet
Definition
adhesive scaphoid pads and medial posts
Term
what does a metatarsal pad do
Definition
unloads metarsal heads for metatarsalgia
Term
what are sulcus length insoles
Definition
sulcus length ends behind metatarsal heads for tight dress shoes
Term
how do biothotics work?
Definition
add saline, and there is a chamber that swells
Term
what to do for cleats?
Definition
cleats have a low heel counter, so you can't put anyting extra in the shoe that would lift the heel up higher out of the shoe. Instead, grind down cleats.
Term
describe fastech inserts
Definition
they come flat. Has cushy parts for bony prominences. Toe part is floppy, rest is semirigid plastic. Heat it up in a convection oven
Term
how to fit an orthotic
Definition
push down to get a little 3 point bending
Term
what can you do to a fastech orthotic after you've molded it to someone's foot
Definition
put whatever you want to under it. Usually artificial cork
Term
why add cork/stuff to the bottom?
Definition
cork helps supprt the shape that you have. If you don't add cork, the orthotic is only semirigid
Term
what is the recipe for a happy diabetic foot?
Definition
total contact inside the shoe. Make sure there's not excessive motion that brings them over to a specific area of the foot. Stiff, rigid shoe with a little bit of forefoot rocker/convexity.
Term
what is the main concern for a diabetic foot
Definition
pressure ulcers
Term
how to decrease the likelihood of pressure ulcers in diabetic foot
Definition
decrease the force with shock absorbing materials. Increase contact area.
Term
how to increase contact area?
Definition
increase contact area with cushy parts of the foot, like the arch. Find out what's driving abnormal movements such as pronation and fix it
Term
is it better to have a stiff or flexible shoe for a diabetic
Definition
stiff shoe with rocker bottom toe is best. If shoe is flexible, all contact area goes into metatarsal head
Term
what to do if someone has metatarsalgia
Definition
put a metatarsal pad just behind the affected metatarsal head to add cush
Term
how to fix morton's neuroma
Definition
put metatarsal pad between and below the affected metatarsal heads. Send them to get a cortisone injection to reduce immediate inflammation while your orthotics solve the overall problem
Term
what is morton's neuroma
Definition
pain, numbness, tingling at the interdigital nerves
Term
describe the path of the interdigital nerves
Definition
juncture of nerve tissue as it approaches the web space of the webbing of the toes, splits, and goes up the sides of the insides of the toes.
Term
how to test for morton's neuroma
Definition
squeeze metatarsal heads together, dig into the web space between affected diits
Term
what are 2 uses of metatarsal pads
Definition
decrease contact pressures on metatarsal heads, separate adjacent metatarsals to decrease mechanical irritation of a neuroma.
Term
what questions to ask when making/placing a metatarsal pad
Definition
how high should the apex be, where should it go, how large should the circumference be
Term
what is a last
Definition
a wooden form on which a shoe is made
Term
is a curved last better for pronators aor supinators and why?
Definition
better for supinated because a curved last is more flexible. Foot will not provide good shock asorption so you try to get it from the shoe. Also in supination, the forefoot is adducted on the rearfoot
Term
is a straight last better for pronators or supinators and why?
Definition
better for pronators because it pushes against the medial parts of the foot that want to pronate in medially.
Term
what kind of heel coutner shouuld pronators get
Definition
firm, high.
Term
what is a combination last interface
Definition
straight line connecting upper to back, closer to the front
Term
what is a slip lasted interface
Definition
heel counter of shoe connects to rest of inside
Term
where does the beast bend and twist
Definition
at toe break only
Term
what is a dual density midsole
Definition
stiffer midsole material medially to resist eversion of the shoe on the ground
Term
what is external bracing
Definition
bridgework outside the shoe at the medial arch to prevent movement.
Term
define shock absorption
Definition
reducing the forces that come down on the foot
Term
why do stiff shoes not reduce the forces that come down on the foot
Definition
F=m x v/t. if the shoe is stiff, t will be small and increase the force
Term
why not buy shoes years in advacne
Definition
EVA materials deform overtime
Term
what is posterior heel flare
Definition
distance of posterior part of shoe from posterior part of ankle
Term
how does a large posterior heel flare affect the need for dorsiflexion
Definition
the posterior heel flare creates a longer moment arm for plantar flexion, calling for greater concentric/internal control with dorsiflexion
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