I have a young female patient who has developed medial arch blisters with wearing her new orthoses. There is no irritation of the plantar fascia. I have only seen it one or two times in 16 years. She has the typical very flat, medially deviated STJ axis. From my view I have just not achieved sufficient control for her foot & she pronates through the device still leading to medial arch irritation (the prescription was for 4 degree inverted pour, minimal arch fill, 4mm medial skive, 16mm heel cup, cushioned covers. I could repress the device with greater control but what other adjustments might be helpful? Adding a PPT type arch cookie would soften the edge but I think I need to increase the control. Are there better ways of doing this? In the past I would add increased medial rearfoot & forefoot posting to shift weight more laterally. Any other suggestions?
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