Orthotic Devices.pptx

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by Richard Blake21 views·Updated Nov 28, 2022
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Dr Richard Blake introduces the concept of custom versus over the counter orthotic devices in this 10 minute video.

Audio TranscriptAuto-generated

  1. Good afternoon, my name is Dr Rich Blake
  2. and I'm here to discuss
  3. the
  4. controversial at time orthotic devices.
  5. These can be custom off the shelf and there are many modifications that we can
  6. used to
  7. to help.
  8. This is why we're here and why we use
  9. orthotic devices to help all of our injured athletes.
  10. And one of the tricks I use is to try to keep things very simple.
  11. Um and really teach our athletes options when when there are options.
  12. Orthotic devices which can be custom or over the counter are a
  13. vital part of the treatment of biomechanics from the ground up.
  14. They are tools that help us with shoe selection, strengthening, stretching,
  15. braces, gate changes
  16. of bears and Valukas, wedging power lacing, shoe modifications.
  17. There's a lot of different tools that
  18. podiatrists and doctors who treat the feet
  19. will use to help you.
  20. We're all different and it's important to learn both
  21. simple changes and more complex changes when needed.
  22. And as your skill set develops,
  23. um it is still in a situation where you will be good at one thing and you don't,
  24. you want to avoid making everyone a nail when when you're the hammer.
  25. One of the goals that I teach my students at
  26. the Samuel Merritt University California School of podiatric Medicine is that
  27. you should keep learning and I have now been a
  28. podiatrist for 41 years and I continue to learn and learn
  29. and learn some more and basically you'll learn some general rules.
  30. You apply those rules and you'll find out that
  31. they are just general rules and they can become antiquated
  32. custom devices.
  33. They're the common use of a custom orthotic
  34. devices in patients that have severe biomechanics when
  35. you know anything but custom will fall short of
  36. helping the patient during a child's growth spurt.
  37. Um as their feet grow and are and become to our two pro nated,
  38. the orthotic devices are mandatory and helping them
  39. in their foot development, correcting a cemeteries
  40. is a big thing when one ft is much more pro nated or much more super nated
  41. than the than the other.
  42. Um Perfecting biomechanics and chronic conditions can be a reason.
  43. We use custom orthotics.
  44. We know that you know,
  45. a set of biomechanics help somebody with chronic conditions and
  46. you can try to perfect it with your knowledge of
  47. biomechanics and custom orthotic devices.
  48. The lateral column, which is overlooked many times in a super nature,
  49. can be the main reason you'll use custom orthotic devices because there's nothing
  50. in the over the counter world that comes close to helping these patients.
  51. Um
  52. poor experience and inability to adjust Over the counter devices can mandate
  53. that podiatrists use custom devices for everything and use a professional lab.
  54. But these skills and customizing over the counter devices can be learned.
  55. And then specialty orthotic devices like the Hannaford style for
  56. full land shock absorption are only made in a custom,
  57. in the custom world,
  58. you have to remember that pro nated heels are normal in Children
  59. unless they have not outgrown them by the age of eight,
  60. There's a normal straightening of the heel.
  61. And and as the arch develops in a growing child, most times,
  62. the heel of the infant is about 8° averted,
  63. and by the time they're eight years old it gets to be zero.
  64. Um so basically there's about one degree of change per year and this is
  65. easily and accurately measured by apps, like
  66. the one I use is the bubble level Excel app.
  67. Here's just the right foot on a patient with a a ruler used to
  68. signify vertical and where the hell is averted.
  69. And then you put a custom orthotic device.
  70. And and you should see a straightening effect of that heel.
  71. Right now, the sole orthotics are the king of over the counter devices.
  72. I do use pure stride and power step.
  73. Also,
  74. I like any over the counter insert that does not have plastic so that I can adjust that
  75. as much as possible. I can really customize it
  76. to help them maximally.
  77. Here's some common modifications where I'm
  78. improving the arch height and actually putting
  79. various wedges on the bottom to help the chain above the ankle,
  80. all the way up through the knee, hip and low back
  81. here.
  82. I've taken over the counter insert, I've removed all the material under the heel,
  83. added uh a soft material for shock absorption and also added some art support
  84. to be able to transfer the weight into the arch and off the heel,
  85. fur ball of foot pain, dancers padding.
  86. This doesn't adequately show it,
  87. but I've glued both sides and I will apply the pads so it
  88. off waits the big toe joint and tries to attempt to put the weight
  89. Both more into the arch and more lateral on the four ft into the second to 5th.
  90. Metatarsals
  91. do not think that all pain is mechanical, especially when you're treating patients
  92. a lot of times,
  93. pain can be from the nerves coming coming coming from above
  94. the different types of pain that we treat our mechanical pain,
  95. which can be produced by motion or positioning,
  96. or at least affected by changing the motion or position,
  97. inflammatory pain,
  98. which can be alone or secondary to the other two causes of neuropathic pain,
  99. which can be alone or secondary to the other two types.
  100. Two causes.
  101. Remember as you're treating pain to consider all three types and
  102. biomechanics can play a role in all of these injury complexes.
  103. How do we choose between a custom versace and over the counter insert.
  104. Really depends on the individual practitioners skill level,
  105. sometimes depends on what you're trying to achieve.
  106. If you need durability, you think custom, if you need to find craftsmanship,
  107. you need custom.
  108. If you're expecting a situation like clarify china's to be very temporary,
  109. then you can use an over the counter and if
  110. you're experimenting with how much stability the patient needs.
  111. Uh And and there are situations,
  112. especially in knee pain where I'm not sure if I need to very switch their
  113. foot or valve assuage their foot and I'll experiment with over the counter inserts.
  114. Um So this
  115. being able to customize and over the counter insert really helps us uh just decide on
  116. various plans and really get deeper into
  117. plans when the symptoms are recalcitrant.
  118. If we take super nation, which is when our feet roll out.
  119. It's also called under pronation. What are our options?
  120. Um So if someone super Nate's too much, you think symptoms
  121. that are caused by that
  122. like Elliott,
  123. real band
  124. peroneal strain,
  125. some forms of low back pain and hip pain are caused from over super Nation.
  126. There's about 17 different symptoms related over super Nation.
  127. Um uh A more neutral shoe is sometimes needed, vargas wedging on the shoe insert,
  128. or bogus wedging on the over the counter insert.
  129. To help with the super nation taping
  130. parallel strengthening and gait and postural changes.
  131. And
  132. There's also a video I made that showed
  133. the eight common orthotic modifications for super natures.
  134. Um
  135. In the end, we must always observe somebody's motion,
  136. including after anything we put in the shoes,
  137. Are we making them more stable is always the question.
  138. You always want to
  139. go towards more stability and more comfort with the patient
  140. and we'll we'll finish this video just talking about the sort
  141. of the classic tendinitis treatment and that really begins with biomechanics.
  142. So patients come in all the time with achilles, tendinitis, peroneal tendonitis,
  143. ankle, tendinitis, patellar
  144. patellar tendonitis.
  145. And it's important to remember the brisk principle of of tendinitis treatment,
  146. which considers biomechanics rest or activity modification ice
  147. or some form of anti inflammatory stretching and
  148. strengthening as the key components to any tendinitis
  149. treatment uh definitely in the lower extremity.
  150. Thank you so much for being with me in this uh fast.
  151. Um but I hope informative presentation on uh custom orthotics versus
  152. over the counter orthotics and the overall role of biomechanics.