Foot orthotic heel cup height

Members do not see these Ads. Sign Up.

just interested in if there is any liturature about heel cups?

as i know that in general the aim of the deeper heel cup is to offer more control to the patient but what depth of heel cup is clinically considered enough for the average person.

as i have had experiance of making orthotics upto and including 32mm deep heel cups on a device with neautral rearfoot post, is this a practitioner just being over ambitious?

 

Re: heel cups

Whats an average person ?

a heel cup and it´s height should be a variable for each patient, but maybe it´s just me.

 

Re: heel cups

sorry for being vague,

what im interestred in is what are the items that are considered when perscribing a deep heel cup? and what would define the height needed?

as as far as i know as long as the patient doesn't slide out or pronate over the top of the heel cup then it is deep enough, but this is only from limited experience. if this is true is there much clinical evidence that would show for example a 20mm heel cup working better than a 30mm heel cup?

sorry for my limited knowledge

 

High heel cups prevent the heel from sliding off of the device. They also make fitting into the shoe more difficult.

Others have said that high heel cups give better control. I'm not so sure. Imagine a pencil in a cup. The pencil is prevented from falling over because of a force couple from the cup (force at the top of a cup pushing one direction and force at the tip of the pencil at the bottom of a cup pushing the opposite direction.) The farther apart the forces are, the greater the force couple. 30 mm is a deep heel cup, but not very big as a force couple.

Try grabbing a calcaneus and twisting with your fingers and thumb in such a position that there would be 30mm lever arm. It's pretty hard to move.

Also, when the heel cup of the orthotic applies a force couple to the foot, there is an equal and opposite couple from the foot applied to the orthotic. I believe that it is more likely that the foot will cause the orthotic to move than the orthotic preventing the foot from moving.

The above was talking about just the cup. A medial flange that applies a force from medial to lateral at the talar head or navicular probably can have significant effect on the STJ. (That force couple with a lateral to medial force at the lateral side of the heel near the plantar surface.)

So, I doubt that deep heel cups add significantly to supination moment.

Eric

 

A deeper heel cup will make the arch area more rigid, so could give better control that way (so would just making the plastic thicker).

Theoretically a deeper heel cup would be for those with more transverse plane motion or those with a very 'fleshy' heel pad.

 

thanks thats been a big help

 

Also if I remember the average heel cup height in Australian labs is 13 - 18 mm no idea where it came from or why it was chosen to be so.

 

generally we deal with 10 - 20mm but this is from old specs that have been drawn up in the past. was just trying to understand the true benifits of this as one of the benifits of the CAD side is to reduce bulk in areas not offered before, but all this goes a little sideways with the large additions of heel cups and medial flanges

 

Phil

Try prescribing some orthoses to patients!
You will learn more in a shorter period of time.

Phil

 

Meow. Come on Wells give him a break, at least he's trying to learn. Which reminds me, we need to talk over lunch on Saturday... remind me.

 

Phil/Simon

Apologies to you Phil, I was a tiny bit 'catty', but I reckon the best way is to test your company is as a customer. You may not be a clinician but that should not stop you doing a mystery shopper approach and going through the process. You will learn a lot more this way. Try prescribing and fitting you orthoses to family and friends shoes - it will help.

The most important thing to remember is that orthoses are more art than science and consequently experience is the most important factor when running a lab. The variables are endless and cannot be simply categorised.
You will get it wrong but when you do it is not the error that people remember but how you dealt with it!

Preaching over and all the best in your quest!

Cheers

Phil