Student podiatrist needing a little help

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Hi

I am in a bit of a quandary about how to go about treating a 14 year old male with the use of orthotics. The patient has been initially diagnosed with Sever's disease and Osgood Schlatters. In dynamic assessment the foot pronates a little in stance but pronates more when the heel lifts off the ground-which occurs prematurely. He plays a lot of soccer and also presents with tight gastroc, soleus and hamstrings. I'm ok with stretching techniques but am unsure on what is the most important aspect to manage with the orthotics?

Any help would be appreciated.

 

It is hard to say without actually seeing the patient, but I can advise that you might be better off dealing with one set of problems at a time. Prescribe the stretching because that is the more conservative form of treatment and then think of introducing orthotics at a later date. A young male who plays a lot of soccer should not be averse to doing stretching exercise.
Make a treatment plan in which you lay out your goals, discuss it with the patient and see how it goes.