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Orthotic for just one leg?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kahuna, Apr 21, 2009.

  1. Kahuna

    Kahuna Active Member


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    Hi

    How does the profession currently feel about prescribing just one functional orthotic for a patient? :eek:

    I have a middle aged lady, no significant hx, except a long left leg (by 15mm)....

    In stance, checking NCSP and RCSP, she is ASIS and PSIS level (and notably, most comfortable) with a complete sole lift of 10mm under the right foot. (a heel lift alone doesn't have the same beneficial effect on the pelvis).

    As she doesn't want to have all her shoes built up across the (R) soles, what would be the best orthotic presciption? ..... An orthotic in just the (R) shoe would work well, but she is overpronating bilaterally, so one could rightly argue that a pair of orthoses is indicated....

    However, that would require complete sole thickening on the (R) side, as the usual idea of a heel pad/post on the shorter side is not as globally effective on the lower limbs in this case.

    Thanks
     
  2. Peter

    Peter Well-Known Member

    Hi Kahuna,

    I have no problem using a single orthosis for one foot, provided that the same limb is shorter than the contralateral limb.

    I do wonder though how you have Dx a LLD of 15 mm which is corrected by 10mm of raise?

    Also, what are her symptoms as your rationale for treatment?
     
  3. Kahuna

    Kahuna Active Member

    Thanks for the quick reply Peter !

    The 10mm correction is based on an assessment in stance - it is 10mm that makes her (L) and (R) ASIS level, and, her ASIS to PSIS become level in the sagittal plane.

    (With just a heel raise, there is some effect on the ASIS transverse alignment, but the PSIS is still raised compared to the ASIS).

    My rationale for tx is that she is on referral from her chiropractor, who is treating her for lumbar pain. He has previously tried a 5mm heel lift on the short leg, which hasn't helped her at all.

    Thx again
     
  4. Peter

    Peter Well-Known Member

    In that case then, consider that your pt has a LLD of 10mm. If she has lumbar spinal pain, address the asymmetry 1st not the symmetry. Balance her pelvis with a 10mm raise, and see how she gets on.

    You might just get a 10mm loose tapered 3/4 raise into a hiking shoe/roomy trainer. Start with that 1st, and if she responds well, she might be convinced to have a sole raise to non-accommodative footwear.
     
  5. Kahuna

    Kahuna Active Member

    Great mentorship. Thanks Peter. I'll update this post as the tx progresses with her.
     
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