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Children's Flexible flat feet orthotics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by JTValls, Mar 1, 2012.

  1. JTValls

    JTValls Active Member

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    Hello everyone!

    im Podiatry's student in 2 course in spain... Do you recomend any bibliography for flexible flat feet with treatment and best orthotics when you decide to use...

    In what cases do you apply orthosis??? What kind of biomechanic's model u use to make them? is there any actual model to Follow?

  2. Here is an article I wrote about 13 years ago which briefly discusses the biomechanics and treatment of pediatric flatfoot deformity.
  3. JTValls

    JTValls Active Member

    Thx Kirby for your help! I will read the article conscientously
  4. JTValls

    JTValls Active Member

    Hello kirby one question, u told me this article was written 13 years ago, in text u use polipropylene for orthosis... Now... In 2012 Are u continuing with this materials? Or u use any different material? Have you made any change in the orthotics used for flexible flatfoot in children actually?

    i read before, the MLA doesn't rise full structural normality after 10-12years aprox. If you use orthesis... Will it changes the normal devolepement of MLA? what is really the objective of use orthesis in flexible flatfoot if in future can it be normal??

  5. JTValls

    JTValls Active Member

    Thx Simon!

    By the way, I was in 42th Podiatry's Conference of Valencia last October! I liked your Biomechanic's presentation! was fantastic :)
  6. Admin2

    Admin2 Administrator Staff Member

  7. JTValls

    JTValls Active Member

    Thx! all your help is much appreciated
  8. JTValls

    JTValls Active Member

    Hello again!

    What's your opinion about this:

    Is preformed EVA's orthotics efective for increase MLA height? Or need to be more agressive and Stiff material like Polypropylene or Polyester resin?

    more important to treat directly the fallen down MLA only or both: MLA and rearfoot with pronation.... In symptomatic flexible flatfoot?

    Thank you in advance
  9. Daimiros:

    The material used is not the main consideration in the orthosis treatment of children's flatfoot, but rather 1) the shape of the foot orthosis relative to the geometry of the plantar foot and, 2) the ability of the orthosis to resist deformation inside the shoe in response to loads from the foot.

    In children's flat foot, the medial longitudinal arch should be supported firmly and the medial heel needs to be given extra varus support (e.g. medial heel skive modification). In this way, both the medial heel and medial longitudinal arch of the foot will receive increased magnitudes of reaction force from the orthosis which will, in turn, 1) increase the external subtalar joint supination moment and 2) increase the external forefoot plantarflexion moment (i.e. medial arch raising moment).

    It is important to do a proper pre- and post-orthosis dispensing gait evaluation with these orthoses since this is one of the keys to evaluating the effect of the foot orthosis on the biomechanical function foot and lower extremity in children with flatfoot deformity.

    I have attached a chapter I wrote on the subject from 20 years ago that explains these concepts further.:drinks
  10. JTValls

    JTValls Active Member

    Thx Kirby i will take careful notes about that! I think my principal questions are all resolved :bash:, will read all articles if i have new questions... I will continue this post!!

    Thx for your patience, is fantastic to rely with your help!
  11. JTValls

    JTValls Active Member

  12. drsha

    drsha Banned

    Dr Kirby:

    In your article, you state that you have successfully treated the symptoms of the pediatric flexible rearfoot flexible forefoot functional foot type but the scope of your treatment is beyond the article.

    In the thirteen years since, have you ever published on this "scope of treatment"?

    Do you have any proof of how your suggested treatment works?

    Does your treatment of the flexible flatfoot include any improvement in the structural and architectural deformity or only the symptoms? i.e. does it go beyond TS symptomatic relief?

    Do you have any long term followup or case studies of how your treatment worked long term for these children?

    IMHO, this sounds like a personal theory which is unproven and not something that's evidence based and one that could use upgrading and change after thirteen years without one article in a peer reviewed journal.

    To quote your advice to the biomechanical community when dealing with Dr Root's magnificent work as it also refers to yours and mine, "we will need to discard some or even many of your ideas in order to coherently explain the complexities of foot and lower extremity biomechanics and foot orthosis therapy now and in the future. The scientific method demands this from us as researchers and clinicians".

    So as a replacement to your theory I offer:

    Look at this testimonial of foot centering care of a pediatric flat foot that used serial vaulted, aggressive forefoot corrected, deep heel seated orthotics (3 sets now) and an ongoing program of Compensatory Threshold Training of involved muscle engines. Think along the lines of met adductus casting.

    This care has corrected elements of the structural deformity and improved her performance as I promised her mom it would.

    Most importantly, as in this case, functional foot typing diagnoses the pediatric flat foot any time in a patients Wellness Biomechanics Timeline and in most cases, that is before the existence of the symptoms that your paradigm calls for,


    The scope of the actual treatment, at this time due to a lack of foundational knowledge is beyond the scope of The Arena.


    Attached Files:

  13. JTValls

    JTValls Active Member


    is there any possibility to get a copy of this article?

    The triplane wedge. An adjunctive treatment modality in pediatric biomechanics J. Am. Podiatr. Med. Assoc. 1986 76:672-5

    I can't find it! im very interested on it!

    Or is there any reference who explain the triplane-wedge?

    Thx for all

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