Common Adjustment Handbook
Common issues with prescribed orthotics, and solutions to find the right comfort.
- The heel cup may be pinching or digging into the heel- remake the orthotic wider in the Heel Painheel, possibly with a deeper heel.
- Patient may have heel spurs- add a heel spur accommodation.
- Patient may still be experiencing plantar fascial pain where it meets the calcaneus. In this case raise the arch to better support the fascia.
- The pitch of the rearfoot posts may be too high- lower the pitch of the rearfoot post.
- Transition between heel and arch may be too abrupt- lower the transition between arch and heel.
- Arch contour may be too high causing pressure in patients arch- lower the apex of the arch
- Arch contour may be too low allowing patient to pronate onto arch of device- raise the arch.
- Shell length may be too long which lifts MHs up and forces patients arch down onto arch of device. Shorten the distal edge of the shell.
- There may be too much varus posting on the device- lower varus posting in FF and/or RF.
- Pitch of rearfoot post may be too great causing the orthotic to seem too high in the arch. In this case, lower the pitch of the rearfoot post so that the post sits flatter (less of an angle from back to front).
Medial Knee Pain
Usually a patient will experience medial ankle or knee pain when the devices are still allowing them to pronate. To correct this, increase the varus posting in the forefoot and/or rearfoot.
Lateral Knee Pain
Lateral Knee pain can be caused by over correction from the device, to remedy this, decreasing the varus posting to either the rearfoot, forefoot or both
Lateral Arch Pain
Lateral Arch pain can be caused by:
- Lateral Contour to high
- Lateral Skive to aggressive
- Excessive Valgus rearfoot posting
- Excessive Valgus forefoot posting
- Distal edge to long laterally
- Excessive rearfoot varus posting creating to much