Orthotic evaluation: Dynamic evaluation: internal tibial rotation most signifigant. Palpatory exam of foot and ankle: Pain on navicular, lateral talus,

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Presentation transcript:

Orthotic evaluation: Dynamic evaluation: internal tibial rotation most signifigant. Palpatory exam of foot and ankle: Pain on navicular, lateral talus, medial knee joint Navicular Drop: Unloaded/loaded Angle between anterior tibia-1st metatarsal Orthotic Prescription Dr. Jack Dolbin Session 7

Orthotics and Plantar Fascitis The use of foot orthotics in patients with plantar fascitis appears to be associated with reduced pain and increased function Exercise and Sports Injury Laboratory, Sport Management program, University of Virginia. Epub, 2008 Nov. 20 Dr. Jack Dolbin Session 7

Plantar Fascitis Foot orthotics is the best choice for initial treatment of plantar fascitis. Dept. of Orthopedics, Lund University, Lund, Sweden. Foot Ankle Int. Aug. 27, 2006 Dr. Jack Dolbin Session 7

Effect of different Orthotics as first line treatment of PF Foam covered rigid orthotics are superior regarding pain reduction and pain free time when compared to thin non supporting or soft supportive orthotics. Department of foot and ankle surgery: Jun: 19, 2013. Dr. Jack Dolbin Session 7

PatelloFemoral Pain Custom made foot othotics were found to be an effective conservative treatment to reduce the symptoms of PF pain. Prosthet Ortho Int. 2011, Dec. Epub 2011 Sep 26. Dr. Jack Dolbin Session 7

Patellofemoral Pain Syndrome Foot orthotics provide immediate improvement in functional performance associate with pronation. Br. Journal of Sports Medicine: 2011 Mar. Dr. Jack Dolbin Session 7

Orthotics and Low Back Pain Abstract: Hyper pronation plays a fundamental role in the development of low back pain. Foot orthotics improved symptoms Prosthe Ortho Inter. 2013 Jan, 17 Dr. Jack Dolbin Session 7

Patient compliance 70% were able to return to previous level of activity with the use of foot orthotics 94% still wearing Orthotics after a year. 52% : not leave home without them 96% reduced pain JOSPT 1988; 10 (6) Dr. Jack Dolbin Session 7

Dancers with hyperyperpronation Dancers in this study demonstrated a high rate of compliance and experienced a significant reduction in pain. J Dance Med Sci: 2013; 17 Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Posterior Tibial Tendon Dr. Jack Dolbin Session 7

Flexor Hallucis Longus Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Orthotic Prescription Inspection Observation: Static-Dynamic Palpation: Navicular, Cuboid, Talus, Calcanius, Cuneiform, Metatarsals, Phalanges. Stability: Navicular Drop Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Corrective inserts Dr. Jack Dolbin Session 7

Inserts Cont. Dr. Jack Dolbin Session 7

Calcaneal Inversion/Eversion Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Effects of Pronation

Pronation, internal tibial Rotation, Valgus Knee Dr. Jack Dolbin Session 7

Pronation Medial Tibial stress Syndrome Lateral Compartment Syndrome Medial Jt. Line pain Piriformis syndrome Medial Collateral Lig. Bursitis L5-S1 Facet Syndrome Atlas side bent to side of pronation Bone edema Dr. Jack Dolbin Session 7

Running Pronaton Dr. Jack Dolbin Session 7

Extremity Adjustment Talus Cuboid Navicular Head of Fibula Knee Hip SI Joint Dr. Jack Dolbin Session 7

Talo-Navicular Axis Line Up; Talus-Nav.-Ist Cune- !st metatarsal Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Process Align Mark Measure Correct Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Dr. Jack Dolbin Session 7

Exercize Prescription Mobilize: Roll the Ball F-H-L: Great toes flexion: Curl the towel Tibialis Anterior/Posterior Adduction with dorsal flexion. 45 degree angle. Preceeded by MPT and ME. Dr. Jack Dolbin Session 7