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Hi can anyone give me an idea why the top covers on one of my patients orthotics are wearing out really quickly at the back of the heel.

The orthotics are 3.5 mm polyprop with an eva 3mm top cover from sidas, which she loves but is livid at something wearing after 12 weeks. Her previous PP orthotics were covered in poron and vinyl and she didn't have an issue after 4 years until they went down the chute.

She runs 30km a week, very tight calf musculature, able to single leg squat with a heel raise.

Should I just change top covers to a more shear resistant material?
Remove the top cover?
Add a heel raise?

Would be grateful for any opinion.

thanks

 

Have a look at how it's worn out at the heel. If it looks like slightly torn and frayed on the heel...she's using a shoe horn and that's the culprit! If not and she's wearing it out because of the friction and pressure on the material so use a stronger (firmer density) EVA, say 2 or 3mm thickness, tops. If she needs the cushioning, put either Vinyl (not a fan) or firm, thin EVA on top of 1.5mm or 3.2mm Poron. Just remember, the thicker you make the cover, the tighter the orthoses will be on the foot, depending on how you modified the cast (if at all). MY guess is she's using a shoe horn! There's a heap of materials you can use and a heap of variations within those materials so try and think with "the end in mind" before you put it on.

Neil

 

Most likely friction yes change top covers