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For those of you who work with runners: Have you had success using UCBL or a modified version for runners with significant overpronation originating in the subtalar joint?

 

No, n=1. Difficult case I'm trying to work with at the moment, she has generalised ligamentous laxity. Pes pancake feet. History of posterior tibialis tendonitis- swollen like a pudding when I first assessed her. Here's the problem: her feet are so flat she gets blisters just from her shoes- saucony hurricane , I make devices, they sort the posterior tib problem but she gets horrible blistering, we remove the orthosis, she gets the posterior tib problem and horrible blistering. I've modified my prescription many times now, and tried a UCBL recently = horrible blisters. We've tried everything I can think of in terms of blister prevention, I've now got her in diabetic gel socks, which help with the blistering, but I still haven't completely cracked the orthotic prescription. One step forward, two steps back. All the fun of the fair.

 

The only real use for UCBL and other flanged type devices is when then majority of the motion is in the transverse plane (ie navicular drift > drop). Why else would you want to put plastic up the sides of the foot for?

 

I often use medial flanges using 6mm PPT or EVA 120, not as an extension of the polypropylene shell. The patient is much more likely to tolerate it.

I do it by adding an arch pad on top of the orthotic which extends 2-3 cms medial from the shell. This extension bends up when in the shoe. The proximal end must be relatively high to exert a force on the medial talonavicular joint.

Rebecca

 

Thank you Rebecca.

 

What stage is the PTTD?Tx is dependent on this, rather than the blistering, as the long term cosequences of uncontrolled hyperpronation/ligamentous laxity far out weigh the benifits of continuing running.Have you tried Richie braces?I have used the Richie brace sucessfully in competative sports people though not runners.
good luck::

 

Simon

I may have non-orthotic solution in a new product we have for eradicating blisters.
Works really well and can be applied by the patient.
I will send you some samples to try out.

Phil

 

I thank you

 

Could you tell us what it is? Is already available?

Regards,

 

Romeu

If you follow this link it should give you the info you need http://www.saltstechstep.co.uk/other-foot-care/hydrocolloid-blister-packs.aspx
The product originated from one of our Ostomy fixing products which we make ourselves. It is a high quality non-sterile Hydrocolloid that has been extensively tested in football and other sports.
At the moment it only comes in one shape but a new product should be out soon that is a 5cm strip on a roll so you can cut it to your own size.

Cheers

Phil