Thursday, September 15, 2005

Heel Lifts and Orthotics: Usage and Indication

Heel Lifts and Orthotics: Usage and Indications

Keith Gurnick, D.P.M.

Adding a HEEL LIFT to the foot orthotic can be a valuable tool in the management and treatment of biomechanical conditions which affect lower extremity and foot function, and the body as a whole. Heel lifts must be carefully prescribed in order to properly treat the patients conditions and to avoid causing other areas of the body to become symptomatic. Heel lifts are useful in all age groups and in all kinds of activities including sports as well as occupational and daily activities.

Here is a list of some of the conditions which might warrant the addition of heel lifts to the orthotic prescription:

1) Structural limb length discrepancy (short leg syndrome)

2) Heel pain (unilateral or bilateral)

3) Ankle equinis (osseous or muscular)

4) Scoliosis

5) Calf or hamstring strain or tear

6) Hip pain

Heel lifts are useful to treat structural limb length conditions to equalize the pelvis and normalize the stance and swing phase of each side in gait. Patients of all age groups can exhibit a structural leg length difference. In adults with hip and back pain it is very common. It is also common to have iatrogenic causes, such as after a hip implant where either excessive bone has been removed or where the implant is so large that the surgical side becomes longer. Generally, a maximum of one-half inch can be added when the patient will be wearing the orthotic in athletic shoes, three-eighths inch maximum in men's lace-ups, and one-quarter inch in men's loafers or women's flats. If additional height is needed, then it is suggested to add to the bottom of the heel or heel and sole of the shoe. Also, remember that many types of foot orthotics can be plantar ground in the heel to create a differential thickness of plastic material for equalizing small differences in limb length (usually four millimeters or less). If you detect a functional limb length discrepancy, then a heel lift might not be required because the orthotic shell and rearfoot post should adequately treat this condition.

Heel pain can be treated with heel-lifted orthotics for the purpose of shifting the weight forward off the heels sooner in gait. These lifts can be of compressible material in order to improve shock absorption and can be removed from the orthotic when the heel pain subsides. Suggested thickness is three to four millimeters.

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Children's Foot Problems

Children's Foot Problems
By Dr. Arnold Ross
For babies and newborns

Often I'm asked, "When is the best time to have my future child's feet checked?"

I answer, "If it is a breach birth, let us check before the child's head comes out!"

Early treatment is essential for most conditions of the feet seen in children and newborns. Their feet are pliable and correctable often with non-surgical techniques. What are some of these conditions?

1. Intoeing...due to many factors
2. Clubfoot
3. Equinas, or toe walking
4. Crooked toes
5. Calcaneal valgus and delayed walking
6. Ingrown toenails
7. Flatfeet
8. Bunions

Pleas feel free to call for a checkup for you and your baby.

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