dr. jack dolbin session 71 orthotic evaluation: dynamic evaluation: internal tibial rotation most...

Dr. Jack Dolbin Session 7Dr. Jack Dolbin Session 7 11

Orthotic evaluation:Orthotic evaluation: Dynamic evaluation: internal tibial rotation Dynamic evaluation: internal tibial rotation

most signifigant.most signifigant. Palpatory exam of foot and ankle: Pain on Palpatory exam of foot and ankle: Pain on

navicular, lateral talus, medial knee jointnavicular, lateral talus, medial knee joint Navicular Drop: Unloaded/loadedNavicular Drop: Unloaded/loaded Angle between anterior tibia-1Angle between anterior tibia-1stst metatarsal metatarsal

Orthotic Prescription Orthotic Prescription

Orthotics and Plantar Orthotics and Plantar FascitisFascitis

The use of foot orthotics in patients with The use of foot orthotics in patients with plantar fascitis appears to be associated plantar fascitis appears to be associated with reduced pain and increased functionwith reduced pain and increased function

Exercise and Sports Injury Laboratory, Exercise and Sports Injury Laboratory, Sport Management program, University Sport Management program, University of Virginia. Epub, 2008 Nov. 20of Virginia. Epub, 2008 Nov. 20


Plantar FascitisPlantar Fascitis

Foot orthotics is the best choice for initial Foot orthotics is the best choice for initial treatment of plantar fascitis.treatment of plantar fascitis.

Dept. of Orthopedics, Lund University, Dept. of Orthopedics, Lund University, Lund, Sweden. Foot Ankle Int. Aug. 27, Lund, Sweden. Foot Ankle Int. Aug. 27, 20062006


Effect of different Effect of different Orthotics as first line Orthotics as first line treatment of PFtreatment of PF

Foam covered rigid orthotics are superior Foam covered rigid orthotics are superior regarding pain reduction and pain free regarding pain reduction and pain free time when compared to thin non time when compared to thin non supporting or soft supportive orthotics.supporting or soft supportive orthotics.

Department of foot and ankle surgery: Department of foot and ankle surgery: Jun: 19, 2013.Jun: 19, 2013.


PatelloFemoral PainPatelloFemoral Pain

Custom made foot othotics were found to Custom made foot othotics were found to be an effective conservative treatment to be an effective conservative treatment to reduce the symptoms of PF pain.reduce the symptoms of PF pain.

Prosthet Ortho Int. 2011, Dec. Epub 2011 Prosthet Ortho Int. 2011, Dec. Epub 2011 Sep 26.Sep 26.


Patellofemoral Pain Patellofemoral Pain SyndromeSyndrome

Foot orthotics provide immediate Foot orthotics provide immediate improvement in functional performance improvement in functional performance associate with pronation.associate with pronation.

Br. Journal of Sports Medicine: 2011 Br. Journal of Sports Medicine: 2011 Mar.Mar.


Orthotics and Low Back Orthotics and Low Back PainPain

Abstract: Hyper pronation plays a Abstract: Hyper pronation plays a fundamental role in the development of fundamental role in the development of low back pain.low back pain.

Foot orthotics improved symptomsFoot orthotics improved symptoms

Prosthe Ortho Inter. 2013 Jan, 17Prosthe Ortho Inter. 2013 Jan, 17


Patient compliancePatient compliance

70% were able to return to previous level 70% were able to return to previous level of activity with the use of foot orthoticsof activity with the use of foot orthotics

94% still wearing Orthotics after a year.94% still wearing Orthotics after a year. 52% : not leave home without them52% : not leave home without them 96% reduced pain96% reduced pain JOSPT 1988; 10 (6)JOSPT 1988; 10 (6)


Dancers with Dancers with hyperyperpronationhyperyperpronation

Dancers in this study demonstrated a Dancers in this study demonstrated a high rate of compliance and experienced high rate of compliance and experienced a significant reduction in pain.a significant reduction in pain.

J Dance Med Sci: 2013; 17J Dance Med Sci: 2013; 17


Posterior Tibial TendonPosterior Tibial Tendon


Flexor Hallucis LongusFlexor Hallucis Longus


Orthotic PrescriptionOrthotic Prescription

InspectionInspection Observation: Static-DynamicObservation: Static-Dynamic Palpation: Navicular, Cuboid, Talus, Palpation: Navicular, Cuboid, Talus,

Calcanius, Cuneiform, Metatarsals, Calcanius, Cuneiform, Metatarsals, Phalanges. Phalanges.

Stability: Navicular DropStability: Navicular Drop


Corrective insertsCorrective inserts


Inserts Cont.Inserts Cont.


Calcaneal Calcaneal Inversion/EversionInversion/Eversion


Effects of Pronation

Pronation, internal tibial Pronation, internal tibial Rotation, Valgus KneeRotation, Valgus Knee


PronationPronation

Medial Tibial stress SyndromeMedial Tibial stress Syndrome Lateral Compartment SyndromeLateral Compartment Syndrome Medial Jt. Line painMedial Jt. Line pain Piriformis syndromePiriformis syndrome Medial Collateral Lig. BursitisMedial Collateral Lig. Bursitis L5-S1 Facet SyndromeL5-S1 Facet Syndrome Atlas side bent to side of pronationAtlas side bent to side of pronation Bone edemaBone edema


Running PronatonRunning Pronaton


Extremity AdjustmentExtremity Adjustment

TalusTalus CuboidCuboid NavicularNavicular Head of FibulaHead of Fibula KneeKnee HipHip SI JointSI Joint


Talo-Navicular AxisTalo-Navicular Axis

Line Up;Line Up;

Talus-Nav.-Ist Cune- !st metatarsalTalus-Nav.-Ist Cune- !st metatarsal


ProcessProcess

AlignAlign

MarkMark

MeasureMeasure

CorrectCorrect


Exercize PrescriptionExercize Prescription

Mobilize: Roll the BallMobilize: Roll the Ball

F-H-L: Great toes flexion: Curl the towelF-H-L: Great toes flexion: Curl the towel

Tibialis Anterior/Posterior Adduction with Tibialis Anterior/Posterior Adduction with dorsal flexion. 45 degree angle.dorsal flexion. 45 degree angle.

Preceeded by MPT and ME.Preceeded by MPT and ME.Dr. Jack Dolbin Session 7Dr. Jack Dolbin Session 7 3939

dr. jack dolbin session 71 orthotic evaluation: dynamic evaluation: internal tibial rotation most...

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