Orthotic Reviews and Trouble Shooting Orthoses

Casting is key for fit of the devices.
Testing SR and Jack’s Test on the devices vs off the devices and if these tests improve on the devices.
Retest functional tests with the devices in shoe, e.g. gait, SL squat, calf raise.
Looking for positive, negative (e.g. over-correcting) or no change. Don’t dispense the orthoses if they are not doing what you were aiming them to do.
Should take 5 days to 2 weeks to be comfortable in the orthoses. If still uncomfortable at 2 weeks, something is causing problems.

At the 4 week review, make tweaks and changes if they aren’t able to wear them. But this appointment should be more around touching base on any exercises you’ve given them.

8 week review – re-test full biomechanical examination.

Be clear that it’s not just the orthoses that gets them better, its the strength exercises as well.

Combo devices are harder to adjust. Harder to grind motion in without affecting the balance of the device.

Easier to take control out than add more.

Polypropelene devices, generally the easiest to modify.

If too much medial pressure, then grind the medial corner of heel post.

Educate client that orthoses won’t “fix flat feet”, but will support them and improve function whilst wearing them.