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Hi,

I have come across the Cluffy wedge in the literature over the last few years and I am wondering if anyone has any experience with using this treatment in FnHL, and did they have any success with this?

I am grateful for any feed back.

 

Lots more here:
https://podiatryarena.com/index.php?tags/cluffy-wedge/

 

Thank you Craig

 

I had great success with the Cluffy Wedge for several years. Restoring optimal 1st ray function yielded excellent results for people suffering from pain associated with Morton's neuromas, hammertoes, tailor's bunions, and lateral shin, knee and hip pain.

 

How many mm do you normally suggest?
And do most labs know about the wedge?

 

The Cluffy Wedge comes in 3 sizes (small, medium, large). It's been a long time since I've used these. My store closed in 2012. The Cluffy Wedge has been re-branded as the P4 wedge. I'm sure you can find sizing info if you do a Google search on the P4 Wedge.

As for labs being familiar with the product - I'm sure there are some labs familiar with it. Back in the mid-to-late 2000s there were many who had heard about the product, but not many knew what to do with it. I found it to be especially useful.

 

I have used the Cluffy wedge, and it does work ok, the issue I found most often with it is sufficient room in the shoe for the Hallux. If it is used as part of a foot orthosis I prefer to just grind the shell with a first ray cut out allowing the 1st met. to drop down and the Hallux to ride up over it as intended. Dr. Irwin Abraham got me started with that and at first I was a little skeptical, but it eliminates the space issue and and works just as well. Hope that helps.

 

You are correct. The Cluffy Wedge does not work well with shoes that have a shallow/tight toe box. Otherwise, it works pretty well.

 

I have used Cluffy wedging on many occasiaons over the yeras. However as with all interventions orthotic or otherwise, use it when and if it is appropriate, and use whatever size is appropriate to the individual case in hand, there is no universal orthotic because there is no universal human foot.
If you are intending to relieve functional hallux limitus then make up a tempoaray chairside orthotic and try things out, 1st ray cut out of various sizes, 1st met cut out, kinetic wedging, Cluffy etc or even a combination of all of them. Do not foreget the effect that reafoot posting will have on forefoot function. There is a simple test (Hubschers/Jacks) to check if what you are doing actually does improve 1st ray function. Never forget "Human beings have far more in common with trees (endless variation) than they do with lamp posts". Hope this is helpful.